Business bid to cut health-care costs thwarted


ANNAPOLIS -- The business community came to Annapolis this year with high hopes of cutting health-care costs.

But with about a week to go in the 90-day legislative session, most of those hopes appear to be --ed. In fact, some measures headed for passage may add to the average company's health-care bill.

"I don't want to use the word depressed or anything," said Miles Cole, a lobbyist with the Maryland Chamber of Commerce, "but we realize it's an ongoing battle to contain the cost of health care.

"It's not a one-year battle," he said.

To be sure, there have been some victories for those hoping to contain health-care costs, which, according to the federal Health CareFinancing Administration, rose to a record $604 billion nationwide last year.

Businesses and insurers were able to defeat bills that would have created two new mandated benefits, or areas of coverage that insurers must sell to groups and individuals:

* Child wellness services, including regular health screening and immunizations (the bill died because of the potential cost to one large employer, the state of Maryland).

* Coverage for biologically based brain diseases, such as schizophrenia.

Businesses have traditionally opposed mandated benefits because they don't want to pay for them.

Of course, the flip side of defeating a mandated benefit bill is that some people will go without needed health care, according to those who provide and receive the services.

Health-care advocates for women were able to convince lawmakers of the need for a new benefit to cover the cost of mammograms for women ages 35 and over. A committee appointed to study the issue had reported that breast screenings to detect cancer ultimately can be cost-effective.

One other mandated benefit bill passed the Senate but faces an uncertain future in the House. The bill would require insurers to cover the costs of nutritionists and dieticians, if referred by a physician.

"We just feel that in the current situation it just doesn't make sense to bring another set of providers into the health insurance system," Mr. Cole said.

His organization is also disappointed about the failure of two of four health-care initiatives it and the Maryland AFL-CIO had proposed jointly in January.

The bills would have launched major studies of the fees of hospital-based specialists, such as radiologists and anesthesiologists, and non-hospital providers and of the causes of health-care inflation.

The medical community argued that the bills were the first steps in imposing yet another layer of regulation on the industry.

The final question mark for the 1991 session, still very much unresolved, is the fate of the last recommendation of the labor-management group: the creation of a basic health benefits plan that would allow small employers to offer an inexpensive health plan that avoids most of the 32 benefits that are mandated by the state.

The bill passed the House on a unanimous vote, but it faces a tough fight in the Senate. A hearing is scheduled for Tuesday before the Senate Finance Committee, and no one is willing to predict the bill's fate.

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