Critics see Bush's plan as no health benefit

President Bush at a roundtable discussion on cancer prevention at the National Institutes of Health in Bethesda, Md. on Jan. 17, 2007.

KAI RYSSDAL: President Bush pretty much stuck to the script last night. About half the speech on Iraq. About half on domestic issues.

We're in for new energy policies and some changes to most tax bills, thanks to the president's health care proposals.

Helen Palmer's at the Marketplace Health Desk up at WGBH in Boston. Hi Helen.

HELEN PALMER: Hi there Kai.

RYSSDAL: Helen, as you've been talking to people today trying to figure out the reaction to the president's speech last night, what are you hearing?

PALMER: Well, there's a pretty negative reaction, I have to say, from activists for patients and for low-income people. They're saying that this whole idea of giving a tax deduction won't really benefit people who don't pay much in taxes. Plus, there's this whole argument that there won't really be enough cash for people to be able to buy insurance on their own, or they might find themselves buying a very cheap, bare-bones policy that doesn't cover useful things like preventive care.

RYSSDAL: The plan, of course, is meant to protect the uninsured and low-income workers in this country. And when you think about people who traditionally advocate for their rights, you think about organized labor and unions. What do they have to say about the president's plan?

PALMER: Well, they're really pretty unhappy as well. Because you see, suddenly what you don't see at the moment, the amount of cash that your employer pays to insure you, is going to be visible to the worker. And they fear that the employer might suddenly say "Well, if he's getting his insurance through me, or if he's getting it in the private market, it's still the same amount of money. I'll leave him out on his own to do it."

RYSSDAL: Helen, as you know and as you've reported more than once on the program, the states have been taking the lead in health care lately. Massachusetts, of course, one of them. Did I hear it right last night that the president is, in essence, jumping on the states' bandwagon and offering some federal grants to sort of prod them along?

PALMER: Yes. The whole idea is that there will be these affordable grants for states. And this sounds like a great idea, particularly as some of them are intended to be targeted at people with high health costs to help them buy insurance. I mean, part of this . . . part of what underlies this is the whole idea that health will become a thing that belongs to the individual. And that the individual is responsible for, rather than the employer. And that's actually a very important thing. But the problem with this whole idea of grants to states is, where will the money come from?

RYSSDAL: Well, let's answer that question. Where do you think it might come from?

PALMER: Well, it's not certain, but one potential pot of money that has been identified already are these special grants, they're called

"dish grants," that go to hospitals and the like that treat disproportionate numbers of the uninsured. They actually get some extra cash from the federal grant, and there's $30 billion in this altogether. And there's a suggestion that some of this will actually go to help the states.

Now, it sounds like a great idea, and of course in some ways it is. But the hospitals think this is truly terrible. They're saying, you know, well there has to be a safety net, and we're it. And if you take money away from us, the many, many uninsured who still won't get coverage will just fall through all the cracks.

RYSSDAL: You know Helen, it's not like Congress and the president haven't been down this road before. If you think back to '93 in the Clinton White House, almost . . . what, I guess 15 years ago now. They tried health care reform, it didn't work. Is this just the latest in a long list of plans and ambitious agendas that might go to Congress to die?

PALMER: Yes, but basically we have an unsupportable health care system in this country. There just isn't the money for most people to actually be able to pay for decent health care. And until we can actually get some handle on health costs . . . yeah, it's headed to Congress to die.

RYSSDAL: More to come, I'm sure, from Helen Palmer up at the health desk of WGBH in Boston. Thank you, Helen.

PALMER: Thanks Kai.

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