For the Health of Our Nation, Insure All American Children

By Howard Dean

Published May 23, 2003, issue of May 23, 2003.
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In the richest, most advanced country in the world in the 21st century, it’s simply wrong for sick children to go without seeing a doctor because their parents can’t afford it. It’s wrong for a woman to find out she has late-stage breast cancer, because she couldn’t afford a mammogram. It’s wrong for seniors to have to choose between prescriptions they need and putting food on the table. The time has come to make healthcare for all Americans a reality.

It doesn’t have to be this way in America. In Vermont, where I served as governor for the last 11 years, nearly 92% of adults now have coverage. Most importantly, 99% of all Vermont children are eligible for health insurance and 96% have it.

But that’s not it. We coupled our success in insuring kids with a new early childhood initiative that we call “Success by Six.” As a result, nine out of 10 parents with a newborn baby — regardless of income — get a home visit from a community outreach worker who’s there to help them with parenting skills and to put those parents in touch with the services they may need or want. Thanks to Success by Six, we’ve cut our state’s child abuse rate nearly in half, and child sexual abuse of kids under 6 is down by 70%.

If Vermont — a small, rural state that ranks 26th in income in the United States — can achieve this, surely the country that ranks No. 1 in the history of the world can do so as well.

A just-released Congressional Budget Office study shows that nearly 60 million Americans lack health insurance at some point during the year. The number of uninsured is soaring at the rate of nearly 1 million people every year. More than 40% of uninsured adults postponed seeking medical care last year alone. At a time when insurance costs paid by working families are increasing exponentially, and 1,300 babies are born in this country without health insurance every day, there is no excuse for President Bush’s plan to slash funding for Medicaid and the State Children’s Health Insurance Program by $2.5 billion.

For a year now, I have been traveling this country advocating a repeal of Bush’s tax cuts so that we can provide universal healthcare and restore fiscal discipline. Many have questioned the political wisdom of challenging the president on politically popular tax cuts.

I believe, however, that given a choice between having health insurance or keeping all of the Bush’s tax cuts in place, most Americans will choose health insurance. The plan I laid out last week will cost $88.3 billion — less than half of the president’s tax cut — with money left over to pay down the deficits run up by this administration.

My plan consists of four major components.

First, and most important, in order to extend health coverage to every uninsured child and young adult up to age 25, we’ll redefine and expand two essential federal and state programs — Medicaid and the State Children’s Health Insurance Program. Right now, they only offer coverage to children from lower-income families. Under my plan, we cover all kids and young adults up to age 25 — middle income as well as lower income. This aspect of my plan will give 11.5 million more kids and young adults access to the healthcare they need.

Second, we’ll give a leg up to working families struggling to afford health insurance. Adults earning up to 185% of the poverty level — $16,613will be eligible for coverage through the already existing Families and Children Health Insurance Program. By doing this, an additional 11.8 million people will have access to the care they need.

Many working families have incomes that put them beyond the help offered by government programs. But this doesn’t mean they have viable options for healthcare. We’ll establish an affordable health insurance plan people can buy into, providing coverage nearly identical to what members of Congress and federal employees receive.

To cushion the costs, we’ll also offer a significant tax credit to those with high premium costs. By offering this help, another 5.5 million adults will have access to care.

Third, we need to recognize that one key to a healthy America is making healthcare affordable to small businesses.We shouldn’t turn our back on the employer-based system we have now, but neither should we simply throw money at it. We need to modernize the system so employers will have an option beyond passing rising costs on to workers or bailing out of the system entirely. Fortunately, we have a model of efficient, affordable and user-friendly healthcare coverage: the federal employee health system.

With the plan I’ve put forth to the American people, we’ll organize a system nearly identical to the one federal workers and members of Congress enjoy. And we’ll enable all employers with less than 50 workers to join it at rates lower than are currently available to these companies — provided they insure their work force. I’ll also offer employers a deal: The federal government will pick up 70% of COBRA premiums for employees transitioning out of their jobs, but we’ll expect employers to pay the cost of extending coverage for an additional two months. These two months are often the difference between workers finding the health coverage they need, or joining the ranks of the uninsured.

Finally, to ensure that the maximum number of American men, women and children have access to healthcare, we must address corporate responsibility. There are many corporations that could provide healthcare to their employees but choose not to. The final element of this plan is a clear, strong message to corporate America that providing health coverage is fundamental to being a good corporate citizen. I look at business tax deductions as part of a compact between American taxpayers and corporate America. We give businesses certain benefits, and expect them to live up to certain responsibilities.

I believe this plan is sensible and that it can pass Congress — but most importantly, I believe that it is the right thing to do. When my wife, Judith Steinberg, and I graduated from medical school, we took an oath in which we pledged to practice our profession with conscience and dignity and to always make the health of our patients our first consideration. With this plan, and in my campaign for the presidency, I will make the health of all Americans my first priority. Our country has waited too long, and we must do better.






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