Modern Physician
Jan. 23, 2003
Breaux unveils universal coverage plan
By Elizabeth Thompson Beckley
Every American citizen would be required to purchase a basic level of health insurance in a new plan for universal coverage unveiled today by Sen. John Breaux (D-La.) at a health policy conference in Washington.
The framework of the Breaux plan would give every American the right and the accountability to purchase health insurance at an affordable group rate through policies such as union, church or employer-based plans or coverage pools created by the states. States would get some federal grants to help in organizing these pooling arrangements and the federal government itself would provide fallback plans.
Additionally, every policy would be required to offer a standard benefits package comparable to the plan offered to Congress and federal employees. The federal government would continue to provide financial help for low-income citizens to offset the burden of cost sharing. A new, refundable tax credit would be available in advance for premium subsidies for the poor.
Penalties would exist for those who do not enroll themselves or their children. Breaux cites the possible loss of the personal child tax exemption as a potential example.
He says because the proposal is coming from a “moderate to conservative” Democrat, more Republicans may be willing to take a look at his plan.
Comment: Everyone agrees that universal coverage must be the goal. But how you get there and what you have after you are there are absolutely crucial. An individual mandate, with all of the administrative waste of our current system of multiple health plans, using tax credits, and penalizing those who cannot afford to participate is an approach that will significantly increase costs and fall far short of universal coverage.
Comprehensive reform should be supported on the basis of sound policy, and not merely because it is a compromise proposal of a “moderate to conservative Democrat.” Compromise, in which flawed policies are adopted because they seem to fall between the extremes supported by the factions, should be rejected, especially when it is possible to agree on sound policies. Instead of negotiating compromise, the factions should be cooperating in achieving desirable goals that all of us support.
The goals in health care reform should include universality, comprehensiveness, assured access, affordability, free choice of providers, efficient administration, and an end to excessive cost escalation. These concepts should not be opposed by moderates merely because of the perception that they originated from the left. Freedom of choice, administrative efficiency, and containing public costs are concepts that are claimed by the political right. So let’s reject the mediocrity that is inevitable with compromise and instead begin cooperating on reform that is in the best interests of all of us.