MEDICAL PROPOSAL DEBATED; LEGISLATIVE PLAN GETS MIXED REACTION

CAPE GIRARDEAU -- Legislation calling for a state-run health insurance plan received mixed reaction from members of the Southeast Missouri Labor Management Cooperation Committee and others at a public meeting here Thursday night.

About 25 people attended the meeting to hear State Rep. Gail Chatfield, D-St. Louis, discuss his bill. Many of those in attendance also voiced comments about the measure during the two-hour meeting held at Drury Lodge.

All in attendance said they wanted to see health care costs brought under control, but a number of them questioned the wisdom of Chatfield's plan.

Jim Wente, Southeast Missouri Hospital administrator, and Dr. Walter Schroeder of Cape Girardeau criticized the plan.

"It would be my guess that we'll probably socialize medicine," said Wente. But he argued that such a government-run system would put many rural hospitals out of business in favor of larger, regional facilities.

Schroeder said government-run hospitals are not more cost effective because they end up spending all of their budgets so as to assure that they will receive at least the same amount of funding the next year.

Schroeder said the federal government's Medicare and Medicaid programs have not provided sufficient funding to pay 100 percent of health service costs for patients covered by the programs.

"I'm not sure the government has a good track record for doing the things they say they are going to do," he said.

The plan is patterned after the Canadian health system and would provide health insurance coverage for all Missourians. It calls for a tax increase to pay for part of the insurance program.

Chatfield said the legislation would ultimately require voter approval before it could take effect.

Under the plan, new taxes would go into a trust fund to establish disease-prevention programs and pay health care providers for their services. The system would be administered by a state board of directors.

Chatfield said the state-run health insurance plan would be funded with a 7 percent payroll tax on all businesses and a sliding scale surcharge that Missouri residents would pay based on their adjusted gross income.

He estimated the plan would cost about $9 to $10 billion a year.

Critics, including the Missouri Chamber of Commerce, contend that the plan would destroy the current health care delivery system and place the burden of paying for the new government bureaucracy on the shoulders of the business community.

But Chatfield said Thursday night that a 7 percent payroll tax would be a savings for Missouri businesses whose health care expenses, according to a Missouri Chamber of Commerce survey, currently amount to an average of 12 to 15 percent of payroll costs.

Health care costs have escalated to such an extent that by the year 2000, it is estimated that employers will be paying $20,000 per year in health care coverage for every employee, Chatfield said.

"I don't deny that we have the best health care system that money can buy," he maintained.

"I don't care if they make money," Chatfield said of hospitals and doctors. But he added, "I just want them to take care of people, too."

Said Chatfield, "There's 35 million Americans waiting in line that can't get any health care at all."

In Missouri, he said, there are 1 million people who are uninsured or under insured.

He said 25 states, including Missouri, are currently considering creating state health insurance systems. Missouri, he added, is one of two states that have passed such legislation out of committee.

Chatfield's bill was recently approved by a Missouri House committee on a 7 to 5 vote. The bill could come up for floor debate later this session.

"We can fight a war but we cannot take care of people who need health care," Chatfield said.

"Whether we like it or not, national health care is coming," said Chatfield, noting that the number one public concern is the high cost of health care.