Although not a major talking point in this election, health care may be President Bush's largest and most ambitious campaign during his next term. The price tag on his future health care programs could make the war in Iraq look like a minimal expense.
Many people believe the health care problem is too big to correct or that any action will have to be implemented slowly to ease the pain of a transition. That's true when you have time, but health care does not have that much time.
In another four years, health care will be the most debated item in the presidential debate. The Republicans will be vulnerable with a transition of leadership, and Hillary Rodham Clinton is preparing now for the next campaign, which will begin in three years or sooner.
The Republicans know they could have a distinct advantage if they have a plan underway and not just a promise. If that's the case, something needs to happen next year.
President Bush has the secret ingredient in this complicated problem -- government funding. No matter how you slice it, the government is going to pay more.
With the groundwork already established in his Health Savings Account programs, Bush is promising the following.
* Expanded Health Savings Accounts (HSAs). President Bush will propose a tax credit for low-income families and individuals to purchase health insurance. Families will receive up to $2,000 for their premiums and $1,000 cash to put in their HSAs to help meet the deductible. Individuals will receive up to $700 for their premiums and $300 for their HSAs.
* An above-the-line deduction for health insurance premiums. Individuals who purchase low-premium, high-deductible insurances policies can deduct the premiums.
* An HSA tax credit to help small business employees. Small businesses and their employees who set up an HSA will get a tax rebate for contributions of up to $500 per worker with family coverage and $200 per worker with individual coverage.
Although we have been telling clients that HSA plans are the real solution, the story becomes more believable when the government gives you money only if you have an HSA plan.
* Affordable health care for children. The president will launch a nationwide, billion-dollar Cover the Kids campaign to sign up more children for quality health care coverage. The campaign will combine the resources of the federal government, states and community organizations, including faith-based organizations, with the goal of covering all State Children's Health Insurance Program-eligible children within the next two years.
* A tax deduction for long-term care. This is a new above-the-line tax deduction that individuals could claim for long-term care insurance premiums.
In addition to throwing money in the pot, Bush is proposing the following regulatory changes.
* Allow small businesses to establish Association Health Plans (AHPs). To give small employers and their workers more purchasing power, the president has proposed allowing small businesses to band together and negotiate on behalf of employees and their families.
* Allow shopping for health coverage across state lines. It's easy to use the Internet or toll-free numbers to shop for products. But different rules apply to health insurance. Consumers can only purchase health insurance in the state in which they live. The president proposes giving people the freedom to shop across state lines to find the best rates for their health coverage.
* Promote health information technology (IT). The president has undertaken a new initiative to make electronic health records universally available within the next decade. This will improve health care quality, reduce its cost and improve access to affordable care by applying to health care the same information technology that has transformed so many other industries. Health IT will also help eliminate medical mistakes, leading to increased quality and safety for patients.
With the Republicans in control, they have an opportunity they may not get again. Political scholars and economists have predicted that health care will dominate the next election. One way or another, health care is going to change.
Bruce Bishop (firstname.lastname@example.org) is director of marketing and managing partner of KYBA Benefits. KYBA Benefits provides consulting and administrative services to more than 400 corporate accounts, ranging in size from 20 employees to more than 7,000. Reach Bishop at (770) 425-6700 or (800) 874-2244, ext. 205.