Observations ATLANTIC CROSSING

Is the president's plan dead even before arrival?

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39112.449282.59 (Published 01 February 2007) Cite this as: BMJ 2007;334:238
  1. Uwe E Reinhardt, James Madison professor of political economy, Princeton University, Princeton, NJ, United States
  1. reinhard{at}princeton.edu

    Bush's proposed health reforms would do little for the millions of low income, uninsured Americans

    In his State of the Union address of 23 January, President Bush unveiled his much heralded health reform initiative to a perplexed nation. As is their wont, the television media swiftly unearthed staunch proponents and staunch opponents of the proposal, and unleashed the extremists upon one another, thus adding to the confusion. It did not help that the president delicately omitted from his speech an important but politically risqué feature of his proposal, most likely to enhance the public marketability of the policy (www.whitehouse.gov/stateoftheunion/2007/index.html).

    The full proposal has three distinct facets.

    Firstly, the president would make health insurance premiums paid by employers on behalf of employees—hitherto not included in the employees' taxable compensation—fully taxable with effect from 1 January 2009. The total loss to the US Treasury from this time hallowed tax preference has been estimated to range currently from $200 to $220bn (£102 to £112bn; €154 …

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