Michael Leavitt

Key elements of the domestic program President Bush unveiled in Tuesday's State of the Union address are aimed at helping cure Americans' discontent with the nation's healthcare system.

But getting the proposals through the Democratically controlled Congress will be a tough sell.

"A rigorous and robust debate is about to ensue on how to accomplish" the goal of providing affordable health insurance for all, says Michael Leavitt, Secretary of Health and Human Services. As part of the selling of the president's healthcare proposals, Mr. Leavitt spoke to a roomful of reporters at a Monitor sponsored lunch Wednesday.

A Gallup Poll conducted January 15-18 found Americans deeply dissatisfied about the US healthcare system. Seven out of 10 of those polled were dissatisfied with the availability of affordable healthcare. Half of those polled were dissatisfied with the quality of medical care. And more than six out of 10 are dissatisfied with the Social Security and Medicare systems.

In his address to the nation Tuesday, President Bush outlined two key health related proposals. First, Mr. Bush proposed a standard tax deduction for health insurance -- $7,500 for individuals and $15,000 for families. The administration argues the plan will make health insurance more affordable and level the playing field for those who buy insurance on their own rather than through their employer.

"For millions of other Americans who have no health insurance at all, this deduction would help put a basic private health insurance plan within their reach," the president said Tuesday evening.

"In my mind, it is simply indefensible for our country to have a tax policy that provides a tax benefit to part of our citizens and simply ignores the rest," Leavitt said. Currently, Americans who get health insurance through their employer pay no tax on the value of the insurance while those who buy insurance on their own get no tax break and pay for insurance with after tax dollars.

The president also rolled out what the administration called an "Affordable Choices Initiative." Under the plan, states that provide poor and hard-to-insure citizens with basic health insurance will get additional federal funding to help cover the cost of the insurance. To come up with funds for this new program, the federal government would give less aid to hospitals that serve large numbers of Medicare and Medicaid patients.

The current approach "is not a very efficient system," Leavitt said. "There is a better way to deal with this. And our desire is to have a discussion in each state on how best to deal with charity care. We need a charity care system. There will likely be people who are uninsured no matter what system...But if you were able to insure half of those people who currently turn up uninsured, they would get better healthcare and there would be no reason for us to be sending the same amount of money to hospitals to care for people who don't have insurance."

Key Democrats show little enthusiasm for the president's proposals, especially the plan to offer a standard deduction for health insurance. House Ways and Means Committee Chairman Charles Rangel (D) of New York told the Associated Press, "This is a dangerous policy that ultimately shifts cost and risk from employers to employees and could result in a higher number of uninsured. " The influential chairman added, "the new Democratic majority in Congress is interested in relieving, not increasing, working families' tax burden."

Secretary Leavitt denied the plan was dead on arrival. "Now it may be the debate will begin to center on different proposals, perhaps it will be an offshoot of this one. But we need to have this debate. This is a problem ripe for solving."

Leavitt also denied that the president ducked on offering solutions to Social Security's and Medicare's long term financial problems. "There is a great deal of conversation going on right now with leaders of the Congress," on those issues, he said. "We are going to see a lot of discussion about both Social Security and Medicare."

While most of the conversation at the lunch centered on healthcare, Leavitt was also asked about the 2008 presidential race. A reporter mentioned a recent poll by the political newsletter Hotline that showed some voters are concerned about former Massachusetts Governor Mitt Romney's Mormon faith. Leavitt, a Mormon who served 11 years as governor of Utah, responded, that Mr. Romney "is going to emerge as a viable, well thought of presidential candidate and I think in time the question of his religion will turn out to be a curiosity for people and not affect his candidacy in a significant way."

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