Sen. Biden Proposes Changing the Health Paradigm


WASHINGTON — Sen. Joseph R. Biden Jr. (D-Del.) will tell you right up front that health care would not be his top priority if he were elected president.

“Ending the war in Iraq will be my single highest priority, and preventing war in Iran will be one of my highest priorities as well,” the senator, a candidate for the Democratic presidential nomination, said at a forum on health care policy sponsored by Families USA and the Federation of American Hospitals.

That said, Sen. Biden, now in his sixth term, added that there is no reason he couldn't put several elements of his health care plan into motion in the first 6 months of his presidency.

Unlike Sen. Hillary Rodham Clinton (D-N.Y.) and former Sen. John Edwards (D-N.C.), Sen. Biden said he would not mandate that every citizen obtain health insurance. Instead, he would encourage employers to continue offering coverage by guaranteeing that the federal government would pay 75% of all costs for catastrophic health care that exceed $50,000 for an individual employee.

“The carrot is that [employers] get reinsurance, but the stick is they have to insure everybody,” he said at the forum, one in a series with presidential candidates underwritten by the California Endowment and the Ewing Marion Kauffman Foundation.

One reason politicians have backed away in recent years from proposing catastrophic health care coverage is that they remember what happened 20 years ago with the Medicare Catastrophic Coverage Act, the senator noted.

That law, signed by President Reagan in 1988, gave Medicare beneficiaries full coverage for hospital stays of any length after a $560 deductible for hospital costs and a $1,370 deductible for doctor bills. It was repealed in 1989 due to Medicare beneficiaries' concern over the additional premiums they would have to pay. But “that was a different world, and a lot has changed,” Sen. Biden said.

Another part of Sen. Biden's plan for the first 6 months of his administration would be getting all children covered. He would start by expanding the State Children's Health Insurance Program (SCHIP) to include children in families making up to $60,000 per year. “Anyone who thinks a couple who makes $60,000 a year and has four kids … is fat and happy and willing to spend $1,400 per month for health insurance, they ought to get out more,” the senator said.

Sen. Biden also proposes allowing the public to buy into the Federal Employees Health Benefits Program, even though he admits it may not be the best health insurance program available.

“My wife is a teacher, and when I was hospitalized, we used her insurance because it was better” than the federal employee health plan, he said. “Why not go out and pick a more perfect plan? The reason is, it's there, everybody understands it, and there's a sense of confidence about it—'If my senator has this, it must be good enough for me.'”

Using the federal employees' plan instead of another plan is an example of the kind of consensus-building that Sen. Biden said he hopes to do as president. “This is about whether or not you're going to be able to, as president, generate a national consensus, because if you're a Democrat, you're going to have to get 15%–20% of Republicans to vote for it; you can't do it with just Democrats. And you're going to have to be able to convince the American people that this is understandable.”

Another part of Sen. Biden's health care proposal includes letting anyone 55 years and older buy into Medicare. The government would provide subsidies for low-income citizens who couldn't afford to pay the Medicare premium.

He estimates the cost of all these proposals at $90-$110 billion annually, which he said can be partly achieved by rolling back tax breaks for the richest 1% of Americans, tax breaks “that they didn't ask for and don't need.” He would also eliminate tax breaks on capital gains and dividends, and end tax loopholes for hedge fund managers and private equity partners.

In addition to his health insurance proposal, Sen. Biden said he would like to see the federal government put more emphasis on prevention, although he admitted such an investment might not pay off for a while. “That's one reason I want to insure children at the front end,” he said. “You have children who don't have health insurance, and parents not being able to take them to a regular physician … they build up problems, so they end up being less healthy by [the] time they're 21 years old.”


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