BUSINESS HEALTH-CARE EXPERT SAYS CHANGES NEEDED TO CONTROL COSTS

Changes are needed in health care to hold down costs and make health care more accessible to all Missourians, the head of the St. Louis Area Business Health Coalition said Monday.

Jim Stutz, the group's executive director, spoke to about 120 doctors, medical officials and business leaders at a meeting at the Holiday Inn in Cape Girardeau. The meeting was sponsored by the Cape Girardeau County Area Medical Society and the Southeast Missouri Business Group on Health.

Dwight Fine, a lobbyist for the Missouri Hospital Association, also addressed the issue of health care reform.

Fine said the two underlying principles driving health-care reform are that costs are out of control and that some 37 million Americans have no health insurance.

"Change is not easy, folks, but it's coming," said Stutz. He urged the Cape Girardeau medical and business communities to work together to develop a system that will work best for the area.

"It's better to be part of the process and to try to shape it than to be outside and constantly throwing darts at this thing," he advised.

Both Stutz and Fine are members of a statewide group of citizens, health professionals and government officials who have developed proposals for health-care reform in Missouri.

Plans call for: reform of health insurance, controlling the costs of Medicaid by promoting managed care, strengthening the public-health infrastructure, developing an effective primary-care system and creating a health-care information system.

State Sen. Peter Kinder said that at this point the whole issue of health-care reform in Missouri has been driven mostly by the state's executive branch and not by the state legislature.

"I think we are very near the beginning of the process and we've got a long way to go," said Kinder.

Stutz said Gov. Mel Carnahan hasn't made any commitments so far regarding any health-care proposals.

But Stutz said there's no doubt some type of reform is coming. He said there's "an increasing acceptance of the idea that health care is something we've got to manage."

Statewide, there are about 600,000 Missourians who do not have medical coverage, he noted.

He said the statewide task force concluded that there's a need for standardized insurance plans that spread the risk among all segments of the population, and a need for development of a managed-care system for the Medicaid program in Missouri.

A managed-care system for the Medicaid program is already in place in the Kansas City area (Jackson County).

Under the health insurance reform proposal, no one would lose coverage because of a change in jobs or an illness.

The ShowMe health reforms, as they are called, envision strengthening the public health system in the state to serve as the "whistle blower" regarding health care in Missouri, Stutz said.

The task force says incentives need to be put in place to increase the number of primary-care providers graduating from Missouri medical and nursing schools.

Statewide, there needs to an electronic claims system to help reduce paperwork, the ShowMe group says.

Fine said there are 1,200 insurers doing business in the state.

Both Stutz and Fine said the future of health care may involve development of health-care groups, which purchase medical coverage for member businesses and their employees.

Stutz maintained that public employee groups should be the "first guinea pig" in any health insurance purchasing pool. He said he can envision setting up a purchasing group that would involve both public and private employees in Missouri.

Many Americans, he said, don't realize the cost of the medical benefits they receive through their employers.

Fine said he believes the nation will implement some type of managed competition. But if that doesn't work over the next decade, he said, the government will end up setting rates.

Fine said he believes Missouri, being a conservative state, will move in stages toward universal health coverage, with reforms phased in over three to five years.