doc_text: To rein in soaring health care costs, the bill also would establish an independent board appointed by the president to set annual targets for health-care spending, according to congressional aides and others familiar with the plan.
  The panel, called the National Health Care Expenditure Board, would negotiate spending limits with both health-care providers and recipients of doctor, hospital and other health-care services.
  Under the plan, however, compliance with the targets would be voluntary.
  The cost of the plan, which also includes tax breaks for small businesses and self-employed people to buy health insurance, is estimated to be $5 billion the first year and to rise to more than $11 billion in the fifth year, when the plan would be fully implemented, according to a congressional aide familiar with the proposal.
  The Democrats want to make health care a critical issue in next year's presidential campaign.
  The U.S. spent about $660 billion on health care last year, more than 12% of the nation's gross national product and more than double the health expenditures in the early 1980s.
  The spiraling prices forced employers either to cut back on health benefits or to require employees to contribute greater portions of wages to health-insurance premiums.
  At the same time, more than 30 million Americans lack health insurance of any kind.
  And the recession has added to their ranks as hundreds of thousands of laid-off workers have lost their health benefits along with their jobs.
  An administration task force has been studying possible health-care solutions, but has yet to offer a comprehensive proposal.
  Administration officials say they hope to put together a plan to counter the Democrats during the presidential campaign.
  The Senate Democratic bill -- written primarily by Mr. Mitchell as well as Sens. Edward Kennedy (D., Mass.), John Rockefeller (D., W.Va.) and Donald Riegle (D., Mich.) -- is unlikely to be enacted in its current form.
  But it is expected to set the tone for and influence the course of the healthcare reform debate.
  A spate of reform legislation has already been introduced in Congress.
  In addition, Senate Republicans are trying to reach a consensus on their own health-care proposal and the House Democratic leadership is also working on a plan.
  While the Senate Democratic bill is clearly a move to appropriate a powerful issue for their own political gain, congressional aides contend that Mr. Mitchell is committed to health-care reform and that he has tried to put together a workable piece of legislation, making concessions to a number of groups.
  Other details of the Senate Democratic proposal include: --
  Replacing Medicaid, the federal and state health insurance program for the poor, with a joint state and federal program called AmeriCare that would offer a core health package to anyone who doesn't have employer-provided insurance.
  AmeriCare beneficiaries would be charged a premium based on income; people with low incomes wouldn't have to pay for coverage.
  -- Financing AmeriCare with a tax on the payrolls of employers who don't provide health insurance.
  The levy would probably be about 8% of payrolls, according to people familiar with the proposal.
  -- Allowing a two-year grace period before new businesses would have to comply with the so-called pay or play mandate.
  --
  Special allowances for small businesses.
  Companies with less than 25 employees wouldn't have to comply for five years.
  Firms with fewer than 25 employees also would receive tax breaks to help buy employee health coverage.
  Moreover, the bill includes measures to make it easier and cheaper for small businesses to buy health insurance.
  --
  Expanding the federal community health center system to serve rural and inner-city Americans.
  -- Encouraging states to set up consortiums of insurance companies, consumers, physicians and other care providers to negotiate rates to hold down spending to targeted levels.
summary_text: Last year America's health-care costs were approximately 12% of the nation's gross national product.
  Senate Democrats, wanting health-care to be a critical issue in next year's presidential campaign, have introduced a bill to overhaul the health-care system by limiting spending and providing insurance for everyone.
  The bill would require employers to either provide core health benefits for all employees or pay a tax to finance coverage for the un-insured.
  The bill would establish an independent board to set annual targets for health-care spending.
  This Senate bill is unlikely to be enacted in its current form.
  Republicans are trying to reach consensus on their own health-care proposal.