On Universal Care
Bill Richardson joined the health care policy fray today with his own plan for universal coverage, taking a veiled shot at his rivals for the Democratic presidential nomination in the process even though the main elements of his plan resemble other proposals that have been presented so far.
At a speech in Iowa, Richardson said he would provide coverage for the 45 million Americans who lack it today through a combination of steps: expanding Medicare eligibility to people as young as 55, letting young people keep their parents coverage up to age 25, expanding coverage for children via Medicaid and the S-CHIP program, and providing a sliding-scale tax credit for people buying their own coverage. All Americans would be required to get health insurance, as is the case with the universal coverage plan being implemented in Massachusetts.
Richardson says he could do all this without tax increases -- the proposal's $110 billion per year cost would be covered by making health care delivery more efficient, allowing Medicare to negotiate for prescription drug costs and requiring businesses which do not provide health insurance to contribute toward helping the uninsured buy coverage.
"We cannot afford a healthcare system that doesn't cover every American," he said. "The cost to our economy and the well-being of our people is just too high."
In an op-ed column in the Quad City Times announcing the plan, Richardson leveled an implicit criticism of health care plans being proposed by his rivals. "As the presidential election approaches, we'll hear plans for creating huge government bureaucracies or forcing a 'one size fits all' approach upon families," he wrote. "Our well-being is too important to leave to massive untested programs. My plan is a common-sense approach that builds upon existing systems, offers well-established coverage programs, and provides Americans with choices of affordable care."
Richardson's reference to "huge bureaucracies" being proposed by others is eye-catching, given that the two other comprehensive health care plans offered by top Democratic candidates so far have featured elements similar to Richardson's plan, and stop short of a broad, single-payer federally-funded system. Both John Edwards and Barack Obama would require employers who don't provide coverage to pay their fair share to cover the uninsured, as does Richardson. And Edwards, like Richardson, would make health insurance mandatory.
Asked about the reference to "huge bureaucracies" in other plans, Richardson spokeswoman Katie Roberts pointed to the "National Health Insurance Exchange" that Obama proposes, which would serve as a watchdog and create rules and standards for both private insurance plans and a new public one that families could buy into. She also pointed to the new public health insurance program that Edwards would create for people who lacked private coverage and didn't qualify for Medicaid. Richardson, by contrast, would let families buy into the existing insurance program used by members of Congress.
The major difference among the plans, though, is that Richardson says he could pay for his through savings and efficiencies, without raising taxes, while both Edwards and Obama say that savings alone won't be enough, and that they'll pay the difference by letting President Bush's tax cuts on the wealthy expire. Many health care experts say that it is all but impossible to provide universal coverage without raising taxes.
Richardson disagrees. "We will not need to raise taxes," he wrote in his op-ed. "By streamlining the system, increasing efficiency, and asking everyone to pay their fair share, we can make accessible, affordable health care a reality for everyone."
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