HOUSE BILL 1622 IS A RADICAL APPROACH TO HEALTH CARE

Last week, a bill was introduced in the Missouri legislature that, if enacted, would radically change the practice of medicine, as well as health care delivery for every Missourian. Breathtaking in scope, brazen in design, a virtual state version of the Clinton health care plan, House Bill 1622 would effect a gigantic increase in the power and size of state government. Precisely what it would accomplish toward its stated goal -- improving health care for all Missourians -- is unclear.

Ordinarily, such a radical proposal would be going nowhere. Because HB 1622 was introduced by House Speaker Bob Griffin and is Gov. Mel Carnahan's health care reform package, there is reason to believe that it might actually become law. This will not happen if enough Missourians study its sweeping provisions and reflect on their implications.

Some will accuse us of overstatement in calling HB 1622 "radical." Judge for yourself. Proponents cite us to no other state that has tried such a farreaching reformation of its health care delivery system. Among its 130-plus pages, HB 1622 contains the following provisions:

-- By January 1, 1997, all health care providers must belong to what the bill calls an "Integrated Service Network" (ISN). ISNs are wholly new bureaucratic creatures that would be created by the bill to divide up the state into various territories. ISNs must provide comprehensive services, including preventive care, wellness education, primary, acute, and tertiary care, mental health services and any other public health services as deemed appropriate by the Department of Health.

-- Speaking of the Department of Health (DoH), HB 1622 will confer on it unprecedented powers, remaking it into the all-powerful bureaucratic "czar" of Missouri health care. For instance, anywhere that an ISN has not been created, the DoH has unlimited power to create one. All ISNs will be regulated by the DoH, which gets sweeping new powers to rule over health care. Moreover, any person not covered by an ISN or other plan by 1997 will be assigned to an ISN by the DoH.

-- Tired of bureaucratic alphabet soup? Sorry, there's more. A lot more. HB 1622 creates nine -- count 'em, nine -- new boards, task forces and commissions, all but two of them within the DoH. Apparently, the most powerful will be the new "Missouri Health Care Assurance Board", a 16-member board appointed by the Governor. As the bill is written, DoH and the new board will go about their business with precious little oversight from the people's elected representatives in the General Assembly. But then, if you accept the bill's premise, who needs elected representatives? HB 1622 should contain a preamble that states its guiding premise: "Bureaucrats Know Best."

-- This new board will establish a centralized purchasing pool through which pharmacies will buy drugs. The board would assist DoH in developing a "plan of allocation" which would govern the use of any "new technology," which would include any machine or genetic or medical treatment that costs more than DoH bureaucrats think it should cost.

-- The bill contains what one observer calls "18 tortuous pages of bewildering language governing the keeping and disclosing of medical records."

-- In what is probably the most alarming aspect of the entire scheme, if by 1997 the federal government does not have in place a plan to guarantee universal coverage, the DoH will have power to develop its own universal coverage plan and implement it by rule and regulation.

In the chillingly Orwellian manner of Big Governments everywhere, HB 1622's proponents have given it a soothing name: the "Missouri Health Assurance Plan." This is misleading rubbish. At a time when freedom and markets are sweeping the world, some of our leading Jefferson City politicians propose a vast expansion of government that will drive the best and most highly trained doctors out of Misssouri and subject every Missourian to the tender mercies of the health care bureaucrats.

To them we say, "No thanks."