STEALTH TAX? CARNAHAN PLAN CALLS FOR $300 MILLION LEVY

Governor Mel Carnahan's health-care reform plan, House Bill 1622, was introduced a couple of weeks ago by Speaker Bob Griffin, D.-Cameron, and 36 co-sponsors. An article in the St. Louis Business Journal is illuminating.

The headling over the store reads: "Insurers: Carnahan plan contains stealth tax/Medical groups would pay $300 million to help fund reform effort.

"Gov. Mel Carnahan's health-care reform proposal requires medical provider groups to pay three percent of their gross receipts to a quasi-governmental agency to help fund the plan.

"Despite the governor's promise that the legislation wouldn't increase taxes, critics of the plan, incluing major insurers, said the 3 percent payments amounts to a tax. The 3 percent levy will raise an estimated $300 million annually.

"'If it waddles like a tax and quacks like a tax, it's a tax,' said Jim Floyd, spokesman for Blue Cross and Blue Shield of Missouri, one of the area's largest insurers.

"But state Health Department consultant Robert Frank, who helped craft the legislation, says the payments are simply a provision within the bill.

"'It wouldn't be a tax,' he said.

"Carnahan's Missouri Health Assurance Plan - labeled MISHAP by one insurer - would drastically alter the health care landscape statewide. The legislation's aim is to provide health coverage for the estimated 600,000 uninsured Missourians.

"'This bill restructures the health care delivery system and sets a road to universal access (to health care) eventually,' Frank said.

"MOHAP, as state officials call the plan, would require all hospitals, insurance companies, doctors and other health-care providers to form large groups known as integrated service networks (ISNs) by 1997.

"...Insurers say Missourians will be paying the bill under the Carnahan plan.

"'People have to understand that the gross receipts tax will increase their premiums by 3 percent,' Floyd said.

Tom Zorumski, executive director of SenCare Sanus Health Plan, said: 'It's a hidden tax that will be paid by the consumer...'

"'...It (HB 1622) would probably be chaos if it passes the way it's written now,' said Dr. Joseph P. Drozda, a cardiologist and President of the Physicians Health Association.

"Physicians, who would have to join ISNs, would refer patients to hospitals within their groups rather than those that offer the best care, Drozda said.

"'You can't just put together networks completely hospital-dominated, because we would have a system that is unbalanced,' he said.

Sanus's Zorunski agreed.

"'It puts a tremendous amount of power back in the hands of the hospitals, which brought us the $200 aspirin,' he said."

To that last remark I would add the caution that, most likely, what Zorumski really meant to say was that HB 1622 would put vast power back in the hands of the very largest hospitals in Missouri. Without exception, the hospital executives with whom I've visited about HB 1622 are opposed to its sweeping reformation of Missouri health care. As am I. At the Southeast Missourian, we'll continue to work to keep you informed about this vital subject.