INSURER MANDATES

Insurers will have to pay for longer stays in the hospital for mothers and newborns and for childhood immunizations under separate bills signed by Gov. Mel Carnahan last week.

Both longer stays and immunizations are good ideas that promote health among the very young. But the fact the government must legislate what private insurers will pay is a disturbing trend. It is simply another example of the intrusion of Big Brother into private enterprise. In the end, it isn't the insurance company that pays for government mandates like these. It is the policyholders.

The new extended-stay law requires insurers to pay hospital costs for up to 48 hours after a regular birth and up for 96 hours after a Caesarean delivery. It allows for mothers and babies to leave the hospital early with a physician's permission. And the law requires at least two checkups with a doctor or registered nurse before dismissal.

Backers say that the law was needed because some insurance policies are forcing people to leave hospitals too soon in some cases. But the control really needs to go back to the doctors, not the government. Physicians should decide how long patients should remain hospitalized.

The premise of the immunization legislation sounds good: all children should be immunized. But why must that cost be mandated to insurance companies? Childhood immunizations are already free in Missouri at county health clinics. Perhaps the health clinics aren't as convenient for parents. But the government shouldn't get involved in the business of mandating convenience either.

The new law, which takes effect Aug. 28, requires insurers to cover childhood immunizations with no co-payment or deductible. Carnahan said the cost of basic childhood immunizations can be as much as $550 a child during the early years, which he says keeps many parents from getting their children immunized.

But what about the fact they're already free in each county? Instead of expanding state funding for health department clinics or taking charge to make improvements, the new law simply passes the burden onto private businesses. Pretty slick.

It is true that most parents are at doctors offices more often than county health clinics. But immunizations cannot be given if the child is sick, so it often requires a special trip to a doctor's office just for immunizations.

One change in the law should really help parents. It allows an adult other than a parent or legal guardian to take a child to be immunized. Some parents have a hard time taking off from work to get their child immunized.

Missouri is trying to answer the charge by the Centers for Disease Control and Prevention that ranked Missouri 49th among the states in efforts to immunize children by age 2. The state does require students be immunized before starting kindergarten. It also requires licensed day care centers to keep enrollees current on shots.

But making insurance companies cover the full cost of immunizations won't solve the problem. The state should look at expanded hours and times for health department clinics -- especially at night or weekends when parents don't have to take off work.

Mobile immunization units might also be considered to administer shots at more locations in communities, similar to the campaign to provide polio vaccinations in the 1950s. Missouri should study what other states are doing to step up immunization efforts. Relying on insurance company payments -- which will be passed on to consumers -- just isn't enough.