Ron Wyden came to Medford Wednesday to build support for a bill he's crafted that would provide health care for all Americans and fundamentally restructure many aspects of the health care system.

Ron Wyden came to Medford Wednesday to build support for a bill he's crafted that would provide health care for all Americans and fundamentally restructure many aspects of the health care system.

Oregon's Democratic senator told a crowd of about 100 people at Rogue Valley Medical Center that his Healthy Americans Act, S334, can remake a health-care system that traces its roots to the era of wage and price controls that were in place immediately after World War II.

Wyden said the bill is based on four premises:

We're already spending enough money on health care, but spending it in the wrong places. Health care should focus on disease prevention and wellness instead of sick care. The health-care relationship between workers and employers needs to be modernized. Health-care reform needs to focus on holding down costs and improving quality of care.

Wyden's proposal would require all citizens to obtain health insurance that would provide a basic level of coverage for inpatient and outpatient care and catastrophic emergencies. Individuals and families would have the option to buy more generous benefits than the basic package.

Money that employers currently pay for workers' health insurance would be given to the workers, who in turn would be required to buy health insurance from private companies. He offered a hypothetical example of a worker earning $40,000 from an employer who spends an additional $10,000 to provide health insurance.

"If an employer is paying someone $40,000 in wages and $10,000 in health care benefits, the employer would have to pay the employee the $10,000 in benefits," he explained, joking that the transfer would represent "the biggest wage raise in American history."

Workers would not be taxed on the new income, but they would have to purchase their own insurance. If they found satisfactory coverage for less than the employer's hypothetical $10,000 premium, they could pocket the difference. Insurance companies would not be allowed to reject applicants because of prior conditions.

As the system became established, individuals and families would pay insurance premiums through the federal tax system, as an add-on to their federal tax liability.

Savings that would be gained by creating large new insurance pools would be used to cover part of the cost of insuring those who now lack insurance. Employers who do not currently provide health insurance for their workers would also contribute an "assessment" based on the number of employees and the revenue per worker.

Wyden said the proposal already has won support from the National Federation of Independent Businessmen and labor groups. It's sponsored jointly by six Democratic senators and six Republicans, the first bill in decades with six senators from both parties as sponsors, Wyden said.

Wyden said shifting the cost of insurance to individuals and families instead of government agencies and employers would help hold down costs because people would have a better sense of what's actually being spent on their behalf.

"Most people don't know what's being spent on health care," he said.

Wyden spoke for about 30 minutes and then took questions for more than an hour. When Malcolm Drake of Grants Pass asked him why he did not propose a government-focused single-payer insurance program, Wyden said his personal judgement was that the single-payer concept is "more government than most Americans will accept."

Wyden said he plans to spend most of 2008 building support for the proposal, with the hope that it can win approval in the new Congress that will be seated in 2009.

Reach reporter Bill Kettler at 776-4492 or e-mail bkettler@mailtribune.com