President Bush on Wednesday promoted his plan that would expand health care coverage to millions of people by shifting decisions - and responsibility - to individuals.
Bush's proposal is one of the few major initiatives from his scaled-back State of the Union address last month. It assumes market forces and tax law changes will expand affordable choices.
"The best decisions are made by providers and patients, not by governments or insurance companies," Bush said at the Chattanooga Convention Center.
"If you want a health care system that really works, you want the decision-maker to be the individual, in consultation with somebody who knows what they're talking about - somebody trained to help that person make the proper decision," Bush said. "That'd be your doctor."
Under Bush's proposal, the law for the first time would treat health insurance costs as taxable income, meaning workers' taxable wages would rise.
In turn, Bush wants a standard tax deduction for people who buy health insurance - $15,000 for family coverage, $7,500 for individual coverage. The tax bill would go down for people who pick policies below the size of the new deduction.
Democratic leaders say the plan does little to help the poorest of the uninsured and undercuts a system built on employer-provided coverage.
"While the president's focus on health care is important, his proposals will only worsen the crisis by undermining the quality coverage that millions of working families now rely on," said Sen. Edward Kennedy, D-Mass. He is chairman of the Senate committee that oversees health matters.
White House officials see health care as one of a few areas in which they might advance their agenda with Democrats who now control Congress. The effort got a boost last week when a bipartisan group of 10 senators told Bush they want to work with him to expand health coverage.
Consumer awareness cited
Bush received a hearty ovation as he described his plan in Chattanooga. He shared a stage with people who hold full-time jobs but cannot afford to insure their families.
For Danny Jennings, a father of two who manages a nursery, the plan would save about $4,500 a year on his tax bill, Bush said.
"There's more money in his pocket as a result of the standard tax deduction, and there's more peace of mind knowing that his kids - and he and his wife - are covered," Bush said.
The president said people will start paying attention to how much health procedures really cost, and that is bound to help. He compared it to knowing how much a car costs.
Then he realized he does not know that.
"I used to," said a laughing Bush, who travels by limousine. "I will soon."
Earlier, Bush toured the nonprofit Erlanger Hospital, which is allied with the University of Tennessee's College of Medicine. Erlanger serves patients from 50 counties in a 150-mile radius.
Dr. Donald Chamberlain explained to Bush how he used a robot-assisted device to minimize blood loss during a recent cancer surgery. As Bush watched a video of the invasive procedure, the doctor asked him: "Blood OK? You OK with blood?"
"Heck yeah, I'm OK with blood," Bush said, with an eye on the cameras on him. "How about you, doc?"
The White House characterizes its approach as one of basic fairness: Everyone would get the same tax deduction whether he is covered through a job or on his own.
Bush also wants to redirect federal dollars that hospitals and other institutions get to help cover costs for caring for the uninsured. With this money, states would set up programs to assist people in getting health coverage and help people with high-cost health conditions.
On the way out of town, Bush popped into Porker's Bar-B-Que restaurant, posed for photos, shook hands and sat down for a lunch of ribs.