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Bradley Outlines Healthcare Initiative
Views Projected Surplus as Foundation for Universal Coverage
"It is not right that kings and dictators come to this country to get the best medical
care in the world, while Americans two blocks away may not be able to afford any medical care at all," said former Senator Bill Bradley in a keynote address to those attending a healthcare conference at
Manhattanville College on December 7th. The conference, sponsored jointly by the Institute for SocioEconomic Studies and Manhattanville, focused on the shortcomings of the current healthcare system and
possible avenues for reform. 
Bradley, a former three-term Democratic Senator from New
Jersey, described healthcare as intrinsic to life, stressing the vital role that he feels government must play in ensuring that access to quality care is available to all who need it. Despite
great prosperity in recent years, 11 million American children continue to go without medical care, either because their parents can’t afford it or because confusing Medicaid eligibility
requirements discourage many from enrolling in the program. All together, said Bradley, "the forty-four million Americans without health insurance equal more than the total number of
people living in Minnesota, Iowa, Missouri, Arkansas, Louisiana, Oklahoma, Nebraska, Kansas, South Dakota, North Dakota, Montana, and Colorado combined."
According to Senator Bradley, projected federal surpluses could make it easier to
address healthcare reforms in coming years, but even so, resources will need to be utilized in increasingly creative ways. In particular, he stressed the growing importance of
the Internet and how it could prove instrumental to streamlining the current system. He cited such reform as crucial, pointing out that "of the more than $1 trillion spent on
healthcare in 1998, $250 billion was related to the delivery of unnecessary care, redundant tasks, and excessive administrative costs."
While Bradley repeatedly underscored the need for reforms to address the problems of
America’s uninsured population, he also stressed the need to make medical insurance portable, so that even Americans receiving healthcare benefits as a result of employment
would not be trapped in discouraging jobs or risk losing their coverage if their life circumstances changed. Despite articulating a very definite role for government in terms
of financial support for such reforms, Bradley cautioned against the move to have healthcare completely regulated by the state. "Americans want a viable and manageable
healthcare system, not one that is hobbled by a massive government bureaucracy," he cautioned. "They want a system that cares about quality and respects their wish to have
a real choice of doctors, treatment options, and affordable insurance plans in which to enroll their families."
Institute for SocioEconomic Studies Announces Research Findings On Alternative
to Managed Care
Insurance against major health costs could be provided to most Americans simply by
redirecting current publicly-financed health care expenditures, according to Thomas Jackson and Jim Bryan, who outlined a new alternative to managed care based on
research conducted at the Institute for SocioEconomic Studies.
 Using data from the Department of Health and Human Services, Institute researchers have been examining the socioeconomic characteristics of uninsured Americans, the
incidence of “catastrophic” medical expenses, and national healthcare spending patterns. The Institute’s research is part of an effort to identify alternatives to the failures of managed care.
Under a plan advanced by the Institute, Americans under age 65 would purchase insurance limiting their responsibility
for healthcare expenses to a percentage of annual household income. Several model plans have been identified, with deductibles and coinsurance typically amounting to no more than 10% of income combined.
Like conventional health insurance, this plan protects against the risk of financial
devastation from serious illness or injury. Unlike typical policies today, however, it minimizes interference by third parties in the doctor-patient relationship. By returning to
patients the responsibility to pay for routine health services, the Institute’s plan would expand freedom of choice, improve the quality of medical care, restore clinical autonomy
to doctors, and increase patient satisfaction.
Such insurance for catastrophic expenses would cost less than the “first dollar” coverage
common under many managed care plans today. While purchasing this coverage would be the responsibility of individuals, assistance would be available to those with lower incomes.
According to Institute researchers, both the uninsured and those experiencing catastrophic expenses are concentrated
in families earning under $40,000. Refundable tax credits could cover the full cost of insurance for families with incomes below $20,000, and part of the cost for those with
incomes between $20,000 and $40,000, for $85 - $89 billion annually. This is slightly less than the $90 billion currently spent on publicly-financed healthcare for this population.
Additional assistance could come from limiting the tax exemption for employer-provided health benefits, which costs Federal and State governments $125 billion each year.
The Institute believes that given an affordable alternative, few people would maintain
insurance for routine services, especially since this results in the loss of patient choice and reduce clinical discretion for physicians.
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