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Despite Push, U.S. Health Care Lags
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Despite Push, U.S. Health Care Lags

Despite Push, U.S. Health Care Lags

Despite Push, U.S. Health Care Lags
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President Bush's complex health insurance plan will likely be rejected by Congress, leaving the United States as the only major industrialized country without government-subsidized health insurance.

MELISSA BLOCK, host:

In his interview with NPR's Juan Williams today, President Bush said the budget he sends to Congress will include the healthcare plan he proposed in his State of the Union Address last week.

(Soundbite of archived speech)

President GEORGE W. BUSH: I'm asking the Congress to reform the tax code, to treat everybody fairly. And in my judgment, such a plan will encourage and enable more individuals to be able to buy a health insurance, which will help us deal with the uninsured.

BLOCK: NPR's senior news analyst Daniel Schorr has quite a history covering healthcare, and he has these thoughts on the current proposal.

DANIEL SCHORR: Forty-seven million Americans without health insurance, dependent on the emergency room or getting no care at all. And here we go again with a complicated plan going nowhere. I say again because in 1970, I wrote a book on the financing of health care and predicted that because of rising costs, that would be the year for national health insurance, the next big step after Medicare and Medicaid.

It didn't happen then and not much has happened legislatively since. In 1988, Congress passed a bill providing Medicare coverage in cases of catastrophic illness. Because it required senior citizens to pay sizeable premiums, the reaction was so stormy that Congress repealed the bill. Another big push came in the first year of the Clinton administration, when a taskforce headed by Mrs. Clinton produced a complex bill that was shot down by the insurance industry using clever TV commercials.

What changed in the interim is that it's not just the uninsured who are hurting. Major American companies say they can't compete internationally because of the high health insurance cost they are stuck with, while governments underwrite the bill in virtually all major industrialized countries. So now another president, another plan. President Bush, beleaguered over Iraq, has produced a health care proposal for Congress to chew on.

The complicated plan would operate through the income tax code. Briefly, people who buy their own health insurance would get tax breaks equal to the deductions enjoyed by those who get health benefits from their employers. How many of the 47 million will be taken of their roles of the uninsured? The White House says three to five million. But health policy experts say that even that incremental improvement has a potential to destabilize coverage for the 147 million who are covered right now.

A second part of the president's proposal would offer states flexibility in using federal funds to expand health insurance coverage, as Massachusetts is doing and California is considering. However, the funds that would be used for this purpose are the Medicare and Medicaid funds now supporting hospital care for the uninsured. As of now, Democratic leaders indicate the president's bill will be dead on arrival.

And so health insurance remains a subject for speeches by Senator Kennedy, Senator Clinton, even by President Bush. And America remains where it was in 1970, the only big industrialized country without universal health insurance.

This is Daniel Schorr.

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