Sen. Breaux Pushes for Individual Insurance Mandate


NEW ORLEANS — The real social crisis facing America right now isn't fixing Social Security but tackling the problem of the uninsured, former Sen. John Breaux said at the annual meeting of the American Academy of Dermatology.

“The crisis that I see in health care in this country is the fact that we have 44 million Americans who have no form of health insurance whatsoever,” he said.

And the crisis is likely to get worse as more and more companies are opting not to provide health insurance to their employees, said Mr. Breaux, a Democrat who represented Louisiana in the U.S. Senate for the past 18 years.

But the problem isn't how much money is being spent on the system, he said; it's the way the system is organized. Currently, most individuals receive their health coverage either through their employer or through Medicare, Medicaid, or the Department of Veterans Affairs.

If they don't fit into one of these eligible groups, or their employer doesn't provide coverage, they are unlikely to be insured.

One way to get away from this traditional system of coverage would be to create a federal mandate that every individual must have health insurance, Mr. Breaux said. Under this type of plan, the government would offer subsidies to low-income individuals to purchase coverage.

The government would also need to create some type of state or multistate purchasing pools and ensure that the system prevents adverse risk selection so that insurance could be purchased at a reasonable price, he said.

Mr. Breaux compared such a plan to the existing requirement in most states that drivers must have a liability insurance policy. “People understand that and they have accepted that,” he said.

Under such a system, if an individual without insurance sought care in an emergency department, he or she would be enrolled in a purchasing pool at that time, he said. Or people might need to show proof of health insurance when they get their driver's license, he said.

Mr. Breaux said that such a plan would help to move away from the current segmented system of health care and the waste, fraud, abuse, and duplication that accompanies each of those separate bureaucracies.

While it's unlikely that such a system would be enacted anytime soon, it's a worthy goal, Mr. Breaux said.

“As we try to get a handle on the costs, we have to move away from the fact that we can just regulate it to death and control costs through regulation,” he said.

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