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The Associated Press

MADISON, Wis. (AP) - A sweeping universal health care plan that would make Wisconsin's system look more like Canada's than anything in the United States has cleared a major hurdle but its prognosis remains murky.

Business groups and Republicans oppose the $15 billion payroll tax that would fund the plan, and even Democratic Gov. Jim Doyle hasn't said if he favors it.

Despite that, supporters of health care reform say the "Healthy Wisconsin" proposal is what people want and it's only a matter of time before it becomes reality.

"It's pretty far-reaching," said Jennifer Tolbert, policy analyst for the Kaiser Commission on Medicaid and the Uninsured in Washington, D.C. "It sounds more similar to what they have in Canada. … Certainly if this were to pass, it would put Wisconsin in the forefront among the states in taking on health care reform."

If the goal is to have everyone in Wisconsin covered by insurance, the state doesn't have far to go. About 10 percent of its residents are uninsured, and a plan by Doyle to expand the state's health insurance coverage for low-income families and children would drop that to 2 percent.

The Democratic-backed universal health care plan that cleared the Senate this week takes a different approach by mandating insurance coverage for everyone in the state not on Medicare or the state's existing program that Doyle wants to expand. It would start in 2009.

That would shrink the rolls of the uninsured from about 472,000 to 15,000, but would cost about $15 billion a year to be paid through a new payroll tax on employers and employees. Proponents argue there would actually be more than $1 billion a year in savings through lower pharmaceutical and administrative costs, preventive care and discouraging inappropriate emergency room visits.

The new tax would double what the state now collects in income, sales and corporate taxes combined.

"It's clearly a recipe for higher health care costs, higher taxes and fewer Wisconsin jobs," said R.J. Pirlot, director of legislative issues for the state's largest business group Wisconsin Manufacturers and Commerce. "A better approach is consumer-engaged, market-oriented reforms."

While business groups oppose the plan, some individual business owners have said it would be less expensive than the current system. Graphic Packaging, a company with plants in two Wisconsin cities, would save about $4.4 million in health care costs a year for its 800 workers, said its director of human resources Mike Rayome.

Eric Newnham, 39, owner of DeNali's Restaurant in Beloit, can't afford health insurance. He said the plan is morally the right thing to do.

"Every single industrialized nation has had it for a period of time, except for us," he said.

Newnham said under the proposal he could provide insurance for himself and all 10 of his employees for a price less than it would cost just to get private insurance for himself.

A worker earning an average of $42,333 would pay $140 per month for coverage, while his employer would contribute $370. The coverage offered would be equal to that received by lawmakers and the governor.

While most Americans get health insurance through employers, the rising cost of providing coverage has resulted in some employers getting out of the market. Family incomes have also not kept pace with the rising cost of coverage, resulting in state Medicaid and other government programs trying to bridge the gap.

Nationwide, the number of people without insurance is put at about 46 million.

Wisconsin's approach may be the most far-reaching, but it is not alone in tackling it. Massachusetts, Vermont and Maine have enacted universal coverage plans, while California, Illinois and Pennsylvania have put forward detailed proposals.

To become law, the Wisconsin plan must clear the Republican-controlled Assembly where it is almost certain to fail. It could be revived later when a bipartisan committee meets to hammer out a budget compromise that will go to Doyle for his consideration.

Even the staunchest opponents are not counting it out.

"It's very much viable," said Senate Minority Leader Scott Fitzgerald, R-Juneau. "It's still a major piece of public policy that's going to be discussed. … I hope it falls apart as more details emerge."

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