Pennsylvania Health Care Reform Faces Resistance
Pennsylvania Gov. Ed Rendell's (D) proposal to reduce health care costs and expand access to coverage "has incited protest from hospitals, doctors, insurers and small businesses," the New York Times reports.
Rendell in January announced his "Prescription for Pennsylvania" proposal, which includes provisions that would:
- Implement a 3% payroll tax on employers that do not offer health coverage to workers, with funds going to cover the uninsured;
- Require hospitals to adopt strict hygiene practices to reduce the hospital infection rate;
- Eliminate reimbursements to hospitals for patient stays that are extended because of medical errors and preventable infections;
- Regulate hospital expenditures for new construction and equipment;
- Provide incentives to health care providers who encourage healthy behaviors and pay closer attention to medications to reduce the hospitalizations for patients with chronic diseases;
- Expand the role of nurses and physician's assistants in treating patients;
- Prohibit health insurers from considering pre-existing medical conditions when setting their premium rates;
- Require that at least 85% of health insurance premiums be spent on health care costs; and
- Prohibit smoking in public places.
Rendell's proposal does not include a health insurance mandate "because he wanted first to drive down the cost of care," the Times reports. Rendell framed his plan as "a form of cost containment" and noted that 6.5% of every health insurance premium in Pennsylvania went toward subsidizing care for the uninsured.
The state Senate is controlled by Republican lawmakers who generally side with hospitals, insurance companies and businesses, which oppose various provisions of Rendell's proposal, according to the Times. Hospitals are lobbying against provisions that would regulate new expenditures and cut off reimbursements for treating patients with preventable complications.
Physicians "do not like" Rendell's proposal to increase the responsibilities of nurses and PAs, and health insurers "are working to defeat" provisions that would regulate premium rates and the percentage of premiums that go toward health care, the Times reports. In addition, small business groups oppose the payroll tax increase.
Rendell in an interview with the Times said, "Everyone's ox gets gored a little bit in this," adding, "If we're ever going to have accessible health insurance for all Americans, we have to begin by containing costs. If costs continue to spiral out of control, there is no way the government can afford to pay for it." Rendell added that 71% of uninsured Pennsylvania residents are employed, so it would be unfair for small businesses not to contribute to providing coverage.
Rendell said he believes his plan has a 50% chance of winning approval. He also said he reluctantly would sign a bill that would expand coverage for the uninsured through a source of funding other than a payroll tax increase. Consideration of the proposal is expected to resume in the fall legislative session (Sack, New York Times, 7/10).