We know the big picture: an embattled President is going for a two-fer, trying to distract a nation from his foreign policy woes while doing a huge favor to an important and loyal piece of his base, the private health insurance industry.  His plan works avoids the big questions of healthcare reform and aims to stall the drive for fundamental reform.

Let's take a look at the details.  

1.    Discouraging Employer Coverage

As noted by McClatchy, the central premise of Bush's speech is to "expand health insurance."  

What does this mean?  Congressman Pete Stark, an advocate for expanding Medicare, notes:

``Under the guise of tax breaks, the president is pursuing a policy designed to destroy the employer-based health care system through which 160 million people receive coverage,'' said Representative Pete Stark, a California Democrat who heads the Ways and Means Health subcommittee.

How does that happen?  Bush's plans to tax health care benefits received by individuals from their employers.  This removes the tax advantages of employer-provided healthcare, which will likely push more people out onto the open market.  

It's one thing to replace employer coverage with a single-payer insurance company, where the whole country is in one big risk pool.  It's another thing to diminish employer coverage while forcing patients to buy insurance as individuals, when it's much easier for insurance companies to rip you off.

2. Starving Public Health to Fund Insurers

Bush's plan is likely to further starve an already-underfunded public health system by taking money away from healthcare facilities and allowing states to use it to subsidize private health insurance.  The LA Times notes:

President Bush's top healthcare official on Monday proposed a strategy for covering the uninsured that would offer incentives to each state to develop its own plan for expanding access, but stopped short of guaranteeing universal protection.

Under the initiative, the federal government could reallocate as much as $40 billion a year that now goes to hospitals and other providers that treat large numbers of uninsured and low-income patients...

This means dollars being used to directly care for people would be fed into the maw of the insurance industry, which wastes at least one-third on administration, bureaucracy, marketing, overhead, profit, and political donations.  Not a solution.

3. The rise of junk insurance

At the same time, the plan would speed the development of junk insurance nationally. Reuters picks up the euphemisms for this:

To get the federal money states would need to make health insurance affordable by such means as "reducing benefit or premium mandates," it said.

Bush also proposes allowing people to buy health insurance offered only in other states.

These are code words from removing any regulations on the kind of insurance sold, and selling "lowest-common-denominator" insurance all over the country.

The problem with junk insurance is it does not really protect patients.  Patients find that their ailments are not covered, that they are subject to high deductibles, and in the event of catastrophe, they quickly run up against their caps.  The result?  More medical bankruptcies.

We'll check in with the answers tomorrow!