HEALTH-CARE CHANGES CERTAIN, CHAMBER TOLD

Change in America's health-care system is inevitable, said speakers at a joint meeting Tuesday of two Cape Girardeau Chamber of Commerce committees.

The meeting was held between members of the chamber's Health and Human Services Committee and the Small Business Committee.

Speaking were Dian Sprenger, senior vice president of the Missouri Hospitals Association; Kurt May, representative of the Health Insurers Association of America and Health Underwriters; and Tom Schulte, representing U.S. Sens. Christopher Bond and John Danforth of Missouri.

"There are a lot of numbers being tossed around," said Schulte. "Yes, 37 million people are not insured; yes, a great percentage of those uninsured are working; yes, change is needed," he said.

Schulte said Bond and Danforth are planning a regional health-care summit for Southeast Missouri in January to gather information from constituents.

Chamber President John Mehner said: "This is not a Nash Road extension. This is not a riverboat. We are talking about everybody's health -- yours, your kids, your grandkids. If you have hesitated in the past to get involved in legislative matters, take the time now."

Mehner also urged members, before making a decision, to generate a list of "everything the state or federal government has taken control of and done a better job and made more efficient."

Speaking on behalf of the Missouri Hospitals Association, Sprenger said: "We have been advocating health-care reform for almost three years now. Public officials are almost consumed with thinking about health-care issues."

Change is coming.

"A recent study showed that 84 percent of people would like to see the health-care system reformed," Sprenger said. The two top concerns were lowering the cost of health insurance coverage and making sure everyone is covered, she said.

"Concern about health care has become a middle-class issue," she said. "People are uncertain even if they have health insurance today whether they will have it tomorrow."

The Missouri Hospital Association agrees with several points in the Clinton health-care proposal, Sprenger explained.

"Universal access is important for a number of reasons," she said, "The current cost shift has gotten out of control in terms of our ability as providers to pay for services."

She said unreimbursed health care currently costs $1.5 million a day in Missouri. "The result has been to bring up premiums or actual patient bills," she said. "And right now that $1.5 million a day does not hit every provider equally."

The hospital association also favors a benefits package that focuses on preventative health care.

The Clinton package calls for restructuring delivery of care. Today's "fee for service" system provides incentives to do more, Sprenger said. The proposal would provide incentives to look at keeping people healthy.

It also calls for a "proliferation of primary-care professionals but consolidation of more expensive specialities," she said. That means reform in the nation's antitrust laws.

"Providers need to begin to work together, and in the process not be charged with rate setting or market fixing," said Sprenger.

Malpractice reforms are also needed, she said, because of the high costs of diagnostic measures done as precautions.

On the other hand, she said, the hospital association has concerns with some parts of the plan.

"The concerns include the idea of a global budget," said Sprenger. "They are setting into motion a rigid formula with no flexibility, no checks and balances.

"We are concerned that Medicare is looked to as a funding source for the proposed prescription drug and long-term-care added benefits."

She said the association is also concerned about purchasing alliances. "All employers with less than 5,000 employees will be moved into these alliances, which have not yet been tested.'

Local insurance underwriter Kurt May said, "We're going to have change, whether you participate or not."

He asked that as individuals study health-care reform proposals, they keep in mind two issues at work: one deals with access the other deals with finance.

In 1911 national income tax was implemented. In the 1930s government started Social Security. In the 1960s Medicare began. "You know what has happened to each of these programs," May said. "Health care is the issue of the '90s."

He said 84 percent of Americans have health insurance, and health care constitutes 15 percent of the nation's Gross National Product. "Don't throw the baby out with the bathwater," he said.