Disagreement over Market- or Government-Based Approaches Will Stall Efforts To Cover Uninsured, CongressDaily/AM’s Rovner Says

The uninsured are "back on the political radar screen," but broad reform is unlikely, CongressDaily/AM's Julie Rovner writes in her "Health Matters" column. Rovner notes that President Bush's health care speech earlier this week in Wisconsin outlined his plan for the uninsured, and a broad 12-member coalition on Feb. 13 launched a $10 million campaign to help reduce the number of Americans without coverage. But she writes that two "fundamental" differences could impede any congressional action: liberals' and conservatives' "inability ... to agree on whether any solution to the problem should be more market-based or government-driven" and disagreement over whether the problem should be tackled with an "incrementalist" approach or sweeping overhaul. Rovner writes that former Social Security Commissioner and "Medicare pioneer" Robert Ball is in the broad reform group and favors a dismantling of the employer-based system. He said to reporters last week, "Putting health insurance costs on employers on a voluntary basis makes it impossible to maintain a good system." Ball said that he agreed with the broad reform approach of House Ways and Means Chair Bill Thomas (R-Calif.), but he doesn't "necessarily embrace" Thomas' approach of providing credits to help individuals buy insurance on their own. However, Rovner writes that even Thomas has "hedge[d] his bets," as the short-term tax credit proposal he helped insert into the last version of the House-passed economic stimulus bill -- which would have covered 60% of private health insurance costs for the unemployed -- was "carefully crafted not to undermine the existing employer-system." Similarly, in his Feb. 11 speech, Bush outlined an incrementalist approach, calling for tax credits and expansion of the nation's safety nets. As for the new "Covering the Uninsured" campaign, "building on the current employer-based system is the only thing on which the 12 organizations" agree, Rovner writes. Chip Kahn of the Federation of American Hospitals, a member of the coalition, said, "The only day we'll see real progress is if both sides of the ideological spectrum are accommodated. That may mean progress is modest, but modest progress is better than no progress at all" (Rovner, CongressDaily, 2/14).