NEW HEALTH CARE PLANS OFFER PROPER APPROACH

The formation of a partnership between area businesses, Blue Cross and Blue Shield of Missouri, and the region's medical community in an effort to hold down rising costs of medical care and insurance is an excellent example of local interests acting on the problem without government direction. We think that is as it should be.

The partnership, involving the Southeast Missouri Business Group on Health, comprises 78 businesses and institutions with almost 10,000 employees. Including their dependents, 30,000 people will be provided health care coverage under the plan when it becomes effective July 1 under a three-year contract with Blue Cross and Blue Shield.

Because 65 percent of medical costs are incurred by only 5 percent of an insured group's membership, the program, through managed health care, will concentrate on those people who are really ill. By focusing on them, the program will eliminate much of the paperwork burden for businesses, health care providers and Blue Cross, thereby offering savings.

Officials at Blue Cross of Missouri said the company receives premiums of more than $800 million a year, and about $100 million goes to administrative costs. Reducing paperwork by 10 percent could save $10 million in health insurance costs, they said. Businesses initially hope to realize a 10 percent savings in their health insurance costs.

Managed health care is just one aspect of the plan. It encompasses the total picture of health care, including the need for tort reform to address the high cost of defensive medicine resulting from lawsuits. One possibility would be establishment of limited liability of doctors who meet guidelines. That too could result in savings to all.

The plan here, and one like it that goes into effect in St. Louis this summer, comes at a time when rising health-care and insurance costs are on everyone's mind. Health care reform is inevitable, but reform should not be imposed by the federal government's meddling in the health care industry, which some politicians in Washington would have it do.

Instead, innovative programs such as the two in Missouri will serve to show that, when left to solve its own problems, businesses, their insured employees, health care providers and the insurance industry can bring about improvements that benefit all involved. We think the programs are the proper approach to the health care dilemma in America. Let's give them time to work.