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Rethinking health care

The story on Tuesday's front page was sobering: In less than 10 years, Americans will spend more than $4 trillion on health care — $1 of every $5 spent. Not surprisingly, each of the leading contenders for president has a plan to do something about that. So does Oregon Sen. Ron Wyden, and he wants to be ready to move it through Congress when the new administration takes office next January.

Wyden's plan is ambitious and impressive in its approach, which has some elements in common with plans proposed by Sens. Hillary Clinton and Barack Obama. What's more, Wyden has signed up a dozen co-sponsors: six Republicans and six Democrats.

Where Wyden's plan differs from both Obama's and Clinton's, not to mention John McCain's, is that Wyden would do away with employer-provided health insurance plans. Instead, employers would take the money they now spend on premiums and give it directly to employees as a salary increase. Each employee would use the money to buy a plan from a private insurance company. Insurers would be required to cover every purchaser regardless of pre-existing medical conditions.

Employers who didn't provide health coverage would pay an assessment based on the number of employees and company revenue. It's worth noting here that the National Federation of Independent Business supports the plan.

Eventually, consumers would pay premiums as part of their annual income tax filing. Those below the poverty line would have their premiums paid by the national fund, and those between 100 percent and 400 percent of the poverty line would have their premiums subsidized on a sliding scale.

According to an analysis by The Lewin Group, an independent health-care consulting firm, Wyden's plan would cover more than 99 percent of Americans, and would save $1.48 trillion in health-care spending in the first decade — about 4.5 percent of total health-care spending. Savings would come from lower administrative costs and greater price competition among insurers.

We are impressed with Wyden's approach, although we have some questions about how well parts of it would work in the real world.

Would the 47 million Americans now without health insurance really be prepared to select their own coverage and manage their own health care? Would employees accustomed to having coverage provided for them be ready to take on the task of comparing plans? Would consumers be bombarded with solicitations from insurers anxious for their business, the way auto insurers and mortgage companies now flood our mailboxes?

Those questions and many more will need to be answered in time. But at this point, the details are less important than the intent — to fundamentally change the way our health-care system operates.

The system we have now is clearly broken, with too many Americans uninsured and too many others struggling to keep up with spiraling costs.

Wyden has invested a great deal of time and energy explaining his plan to the public and to his Senate colleagues.

Wisely, he has refrained from endorsing either Clinton or Obama for president — he's a superdelegate — because he wants to be able to work with whoever might become president. He wants to be ready with legislation to implement his plan when the 2009 Congress convenes.

It's a monumental challenge. We're glad he's taken it on.