In his interview with Gail Wilensky, a former Medicare chief and the John M. Olin senior fellow with Project HOPE in Bethesda, Maryland, Breaux outlined his recent proposal to extend coverage to all Americans -- including the 41 million uninsured people -- as well as his plans for Medicare and Medicaid reform that he hopes the Senate will debate this session.
Breaux's proposal to cover the uninsured includes offering a basic health insurance plan for all Americans, with full premium subsidies for families with incomes below 150 percent of the federal poverty level through a refundable, advanceable tax credit, and partial subsidies to families with incomes up to 250 percent of poverty.
"Look at the problem we have right now in this country with employer-sponsored health insurance. Health benefits are among the fastest-growing costs employers face now, and some can't afford to pay for health care anymore-many, particularly small businesses, are dropping it entirely," Breaux says. "Of course, a lot of people like their employer plan and would want to stay in it. We want to make sure that we don't discourage those who are providing coverage from continuing to do so, if it works for them.
"Right now, we accept employer-sponsored insurance because we're used to it. But it's a relic from the post-World War II era, when we had price controls on wages, and people offered insurance as a way to attract employees," he continues. "That's not a justification for it now, but the reality is that 163 million people in this country currently have it."
Breaux also says he believes the elevation of Sen. Bill Frist (R-Tenn.) to Senate majority leader increases the chances of passage of competitive Medicare modernization he and Frist have sponsored. "A funny thing happened on the way to the elections," Breaux says. "The elections came and went, and my colleague (Frist) is now the majority leader. ...That's definitely good news for proponents of Medicare modernization and prescription drugs."
But he calls on President Bush to take an active role in ensuring that the Medicare reform proposal passes. "It won't be just Frist and me and the Senate," Breaux says. "President Bush is a major player in this, and I think that he could really help generate additional support, help educate the public, from the bully pulpit that he has. He could help to assure seniors that they're getting something that's better than what they have now."
Health Affairs also is publishing Breaux's proposal for covering the uninsured, first presented January 23 at the National Health Policy Conference sponsored by Health Affairs and AcademyHealth.
The interview can be viewed at http://www.healthaffairs.org/WebExclusives/Wilensky_Web_Excl_030503.htm.>.
Breaux's white paper can be viewed at http://www.healthaffairs.org/WebExclusives/Breaux_Web_Excl_030503.htm.".
Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research.
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Health Affairs