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Candidates’ Rx: Carol Moseley Braun

June 9, 2003 at 12:00 AM EST
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MARGARET WARNER: Former Senator Carol Moseley Braun has not offered a proposal to overhaul the existing health care insurance system, as several other Democratic candidates have done. But she told an interviewer last week she expects to produce one this fall. She joins us now from Chicago to talk about this. Carol Moseley Braun, welcome.

CAROL MOSELEY BRAUN: Thank you, delighted to be with you.

MARGARET WARNER: Will your plan focus, as your rivals’ have, on getting coverage to the 41 million-plus Americans who are currently uninsured?

CAROL MOSELEY BRAUN: Well, you know, Margaret, this debate really does touch on a core difference between Republicans and Democrats. Our approach, Democratic approach, is to see to it that there is universal coverage, that everybody has coverage, and that we pay for health care for everybody in a rational way. The plan from the Republicans seems to want to move in the opposite direction, leaving everybody to their own devices to get health care. My proposal…

MARGARET WARNER: How would you…

CAROL MOSELEY BRAUN: I’m sorry.

MARGARET WARNER: I’m sorry, go right ahead. I just wanted to know how you would propose to do it.

CAROL MOSELEY BRAUN: My proposal provides for universal coverage in a way that decouples or takes the payment for health care away from the payroll tax and moves it to a more elastic funding base-that is to say, an income tax base. It a variation on single payer, but that provides for the quality of care that we enjoy in this country to be maintained, and that provides for, if you will, a reenergizing of the relationship between patients and providers.

MARGARET WARNER: Three of your rivals– Gephardt, Kerry, and Dean– have all issued plans or proposals that essentially take the current employer-based system and build on that– augmenting the government programs, for instance, for those who don’t have employers. You would not do that, I gather?

CAROL MOSELEY BRAUN: No.

MARGARET WARNER: Why not?

CAROL MOSELEY BRAUN: I’ve lived with this issue, health care policy reform, since the 1970s, when I defended Jimmy Carter’s attempt to reform health care in litigation as an assistant U.S. Attorney. What I’ve come to conclude over the years in looking at this issue, both at the state legislature and then as a member of the Senate Finance Committee, is that we have tied health care payment to a system that is inadequate, that leaves 41 million Americans with no coverage, young people who are starting out on their own, entrepreneurs. People don’t stay in the same jobs for twenty, thirty years anymore like they did at the time that we initially came up with this system, and the result is, we have a dysfunctional, not very rational way to pay for our health care. Remember, everybody in this country gets health care. It’s just that because of the way we pay for it, many people are left to get it the most expensive way possible and the least rational way possible, and we wind up losing a lot of money because of the transaction costs associated with this dysfunctional system.

We pay more as a percentage of our Gross Domestic Product for health care than any other country. And Americans are no sicker than Japanese or Germans or French or Canadians, for that matter. The difference is that we don’t pay for our health care in a very sensible way. So my view is that we have tinkered with Medicare on the one hand, Medicaid on the other, chips and all the various programs– all of these efforts to try to fix the employment-based system that we have. I think it’s time to just say if we’re going to have universal coverage, then we need to figure out a way to pay for it in a comprehensive way. And to my view, after all these years of looking at it, I’ve come to conclude that a single payer system is the way to go.

MARGARET WARNER: And I assume you mean by that that the government is the single payer. If so, how much would this cost?

CAROL MOSELEY BRAUN: Well, it wouldn’t cost any more than we’re paying now. And let me say also, when you say the government is the payer, right now we have a program called the FEHBP, which is the way federal employees have their health care paid for. And what you have essentially is a low cost of administration, but it essentially pushes out the administration so that private insurers do play a role in administering the program. But there is a single payer. So I think that instead of the notion of “the government is doing,” tends to frighten people and turn them off; I think that we can rationalize the system, provide for a comprehensive way to pay for it, if we decouple from the employment base.

By the way, decoupling from employment will also give a boost to our export sector, to our businesses that compete internationally, because right now they are competing with businesses from countries that pay for health insurance, and so those costs wind up getting passed on, upping the amount that our product has to recoup. And so I think that we can provide a help to workers by essentially taking the regressive payroll tax out of the equation to businesses, by giving them a competitive advantage, and to all of those millions of Americans who have health care uncertainty by providing comprehensive universal coverage in a rationalized single payer system.

MARGARET WARNER: So what kind of taxes would you raise to cover the cost for this, and by how much?

CAROL MOSELEY BRAUN: Well, we’re not talking about raising taxes at all. What we’re talking about is shifting– shifting from the regressive payroll tax…

MARGARET WARNER: Let me interrupt you right there. What do you mean, the payroll tax? Most people think of that as the Medicare payroll tax.

CAROL MOSELEY BRAUN: The Medicare payroll — if we take the whole system and move it over to a progressive tax base, such as the income tax, from the regressive payroll tax, and that is the Medicare part– because you have the Medicare part, and then you also have the amount that employers have to pay, as well as employees pay, for health coverage. So if we take the whole kit and caboodle through and move it to a single payer system, decouple from employment altogether, the cost is… we’re running numbers now. That’s one of the reasons, in addition to the fact that my campaign is all of 94 days old today. We’ve just gotten started. We have not run numbers to put this forward. But we are right now working with people who have worked in this area to see how the numbers roll out, so that we can do dollar for dollar match in terms of how much it will cost.

But I tell you one thing, Margaret; I guarantee you, there is no way that we could devise a system that would cost the 15 percent of our GDP that we’re paying now. There’s no way that we could devise a Rube Goldberg that was more complicated than what we have now. And while the American people don’t have a lot of confidence that politicians are going to be able to fix this health care morass, I am confident that this debate that we’ve engendered and we’ve engaged is going to take us steps closer, and we will be able to clearly see the divide between those who see health care as something that ought to be available to every American, versus those who believe if you can’t afford to take care of your health, well, too bad, I won’t want to know about how I’m paying for it, because after all, they are paying for it.

MARGARET WARNER: Very briefly, can you do anything without raising the deficit further? You were always known as a deficit hawk when you were in the Senate.

CAROL MOSELEY BRAUN: Well, and I still am, and I believe we can. And, again, I don’t have numbers, but I think making certain that we don’t blow up this deficit any more than it’s been blown up already, that we keep faith with spending within our means. But I think it can be done, and I think it will be a cost- saving when it’s done, a variation on single payer that preserves quality of care. That, I think, is what we have to achieve, and I think we can.

MARGARET WARNER: Carol Moseley Braun, thanks for joining us.

CAROL MOSELEY BRAUN: Thank you.