Like a train pulling out of the station, the nation's healthcare system is leaving behind an increasing number of Americans who can't afford it. That is why - despite more immediate worries over Iraq and the economy - both presidential candidates are talking about fixing health insurance. President Bush wants to lower costs by offering tax incentives for families. John Kerry, his presumed Democratic challenger, would increase health coverage for children and low-income Americans and make available a group health plan similar to the one the president and members of Congress have. But in an election year, neither candidate is talking radical reform or pushing to put the system on a whole new track. So the momentum on reform has switched to the states. Their solutions could prove significant, observers say. They could help swing the national debate by showing what can be done - programmatically and politically.
Already in the works, for instance:
• Maine's new Dirigo Health Plan. The plan groups individuals and employees of small businesses into an affordable health-insurance pool while the state subsidizes the poorest people. It is supposed to start in July, but it's unclear if any private insurers will meet Friday's deadline to bid to run the program.
• California's healthcare mandate for business. Last year, the state passed a law requiring that by 2007 businesses with 50 or more workers provide health benefits to their employees, but a November ballot initiative is seeking to overturn it.
• Massachusetts' universal healthcare proposal. The legislature is taking up a constitutional amendment that would guarantee universal healthcare, though it does not stipulate how it must be achieved. If approved this week, the proposed amendment would face a second vote next year in the legislature and approval by voters in a referendum before it could be enacted.
http://www.csmonitor.com/2004/0610/p11s01-uspo.html