He's looking to make something of a political deal. Republicans would get Bush's standard deduction and a private insurance market in which consumers would have incentives to hold down costs. In return, Democrats would get universal coverage, with subsidies for low earners to pay for coverage. As John Goodman of the free market National Center for Policy Analysis points out, additional revenues from those with policies worth more than $15,000 could be used to subsidize low-earners.
Wyden has been talking with Republican senators, especially fellow members of the Finance Committee, and says he has been getting positive reactions. As for Democrats, those who seek more government provision of healthcare will probably be uninterested. But some may be affected by the apparent success of the Medicare Part D prescription drug benefit. Many Democrats believed that seniors would have a hard time choosing policies from an array of choices and that they would end up being gouged by private insurers. But polls indicate that the vast majority of seniors are pleased with the results, and the cost of premiums -- and costs to the government -- have come in lower than experts predicted.
One of the prime lessons of the last third of the 20th century has been proved once again: Markets work -- and more quickly than government mandates. It took 38 years to get a prescription drug benefit in Medicare. In contrast, in the parts of the healthcare sector where market forces are free to work, technology improvements can result in lower costs, as with Lasik eye surgery or cosmetic surgery. Bush's proposal, or Wyden's version, would give markets more room.
This kind of major reform is a long-shot in this Congress. But it does show a way forward.