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Health Care at Any Cost?

Due to inaccurate information supplied by the Department o Personnel, the Oct. 21 editorial on state health insurance contained an erroneous figure. State workers in the preferred provider plan must pay $15 per visit, not $10 as stated. Also, any visits to doctors outside the plan cost preferred provider members $20.

The Sun regrets the errors.

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Some 58,000 current and retired state workers are furious at the Schaefer administration. Their gold-plated health insurance

program is in jeopardy because of its excessive costs. The governor's advisers are anxious to find a way to get more state workers to choose a less expensive option.

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What's happening in Annapolis to state government workers is no different than the situation at thousands of companies -- the skyrocketing cost of medical care is threatening to bankrupt businesses. The result: companies (and governments) are using economic pressures to prod workers into managed-care alternatives.

In the case of Bell Atlantic Corp. (parent company of C&P; Telephone), for instance, switching to a managed-care health plan saved the company $125 million in 1992, but not without a strike by workers over the health-care change.

In the case of Maryland state government, persuading workers to shift from a popular top-of-the-line Blue Cross plan to a less costly plan (either one with deductibles or one of six different managed-care plans) would save $40 million this year. Unless the preferred provider plan is reined-in, finding money for employee raises in 1994 (there hasn't been one in four years) could prove impossible.

Nearly two-thirds of eligible state workers are in the Blue Cross/Blue Shield preferred provider plan. And no wonder: It is a Cadillac in the health insurance field. If you stay within the network of physicians offered by the plan, your only out-of-pocket expense is $10 per medical visit. The state picks up the entire medical bill. There is no incentive for the individual to think twice before visiting an emergency room for a sore throat, for instance. And yet the premium for this benefit is astonishingly low: $11 every two weeks for an individual and $26 every two weeks for a family of three.

Over the past few years, the state's health-care costs -- paid by taxpayers -- have soared. Since 1989, payments for state employee medical expenses have increased $163 million, or 118 percent. No wonder the Schaefer administration wants to discourage workers from signing up for the preferred provider option. It is unfortunate that hypocrites on a Senate committee, who take pride in being budget watchdogs, suddenly turned into big-spenders this week by demanding that state workers retain their expensive benefits. Re-election concerns triumphed over fiscal responsibility.

Whether we like it or not, managed care options, such as health-maintenance organizations and large medical group combines, are the wave of the future. They are the backbone of the Clinton health-care reform package soon to be unveiled in Washington. As much as Maryland state workers may wish to keep their Cadillac coverage, it just isn't financially feasible for taxpayers.



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