Presidentís health plan isnít ambitious enough
President Bush wants to tinker with a health-care payment system that requires major surgery.
Mr. Bush proposes changing the tax code to discourage people from buying high-priced insurance that might tempt them to seek unnecessary medical care. He would equalize the tax deductions for people who get insurance through their employers and those who buy it individually. And he is encouraging people to set up tax-exempt health savings accounts paired with high-deductible insurance.
These ideas mostly help people who have money. But if you cannot afford health insurance in the first place or donít have a job that provides it, a tax break will not help. If you canít afford to pay the doctor, a high deductible just makes the situation worse.
As a long-term goal, separating health insurance from employment is a grand idea because insurance has become so expensive that it distorts decisions made by employees and employers alike. People stay in jobs they dislike in order to keep their insurance. Employers hesitate to hire because of the cost of benefits.
But right now, employer-based insurance is the only option for most Americans. Still, about 47 million do not have insurance.
We need a simple, universal system that provides affordable care, encourages preventive medicine, prevents financial calamity, and preserves the high quality of care. Achieving these goals will require expertise and resourcefulness. The needs of health-care consumers must receive priority, despite the fact that health-care providers have richer and more powerful lobbies. We must, of course, be fair to providers.
Mr. Bush seems unlikely to take on this challenge in his remaining two years, but many 2008 presidential candidates are making health care an issue. At least two candidates, Mitt Romney and Hillary Clinton, have experience. Massachusetts passed some health-care reforms while Mr. Romney was governor, and Mrs. Clinton tried at the federal level while she was first lady.
ďIf it ainít broke, donít fix itĒ is an excuse politicians often use for avoiding controversial decisions. That excuse sometimes actually fits the facts. Not so with health-care financing. Itís broke and needs fixing.