A modest platform of legislation aimed at curbing the rising costs of health care in Maryland was announced yesterday by the Maryland Chamber of Commerce and the state AFL-CIO, two strange bedfellows created by politics.
The agenda of the group, called the Baltimore Area Labor-Management Committee, includes a proposal to create a minimum-benefits package for employers who can't afford the full array of state-mandated benefits; a bill that would require physicians to disclose their financial interest in facilities to which they refer patients; and a study to decide whether to regulate the fees charged by hospital-based specialists, such as anesthesiologists.
Don S. Hillier, senior vice president for human resources at MNC Financial Inc., pointed out that while hospital costs have been rising at twice the rate of general inflation, non-hospital costs have been increasing at three or four times the inflation rate.
Mr. Hillier, co-chairman of the committee, said that Maryland employers are paying health-care costs of about $2,500 to $4,600 a year per employee. In fact, the Wyatt Co., a national benefits and compensation consulting firm, is expected to release a study tomorrow that says the cost of the average medical plan increased by 21 percent a year from 1987 through 1989, compared with an 8 percent increase in the medical inflation rate, according to Karen Seymour of Wyatt's Washington office.
Blue Cross and Blue Shield of Maryland unveiled last month its version of a minimum-benefits plan, and the Governor's Commission on Health Care Policy and Financing, known as the Feinblatt Commission, has drafted but not approved guidelines for such a policy. Labor groups traditionally have opposed any effort to cut back on the number of benefits employers must offer their workers.
"We're stepping back a little bit from that," said Ernest Crofoot, chairman of the AFL-CIO's health-care committee and a co-chairman of the new group.
"We fought for many of these mandated benefits," Mr. Crofoot said, "but if we can give many of these people [without coverage] some small measure of health insurance, then we want to fight for that."
Blue Cross has estimated that about 570,000 Marylanders lack health insurance. Mr. Crofoot said, however, that his group has not decided whether to endorse Blue Cross' minimum-benefits package.
Janelle Cousino, executive director of Maryland Citizen Action Coalition, a consumer group, said a minimum-benefits package in theory could appeal to some companies that don't offer any insurance to their workers.
But Ms. Cousino said, "I'm afraid what's going to happen is that we're going to have companies on the edge who are [offering the state-mandated benefits] going down a notch" and replacing their plans with the cheaper package.
The committee's other proposals largely target health-care costs generated by physicians and other non-hospital providers. One suggestion would create a commission to study claims data from the non-hospital sector of the health-care industry and provide the information to the public, employers and insurers.
The suggestion to study the fees of hospital-based medical specialists, such as radiologists, pathologists and anesthesiologists, is an attempt to rein in the "completely non-competitive faceless people who have a blank check on what they're going to charge," Mr. Crofoot said.
But Gerard E. Evans, a lobbyist who represents the Medical and Chirurgical Faculty of Maryland, a state physicians organization, said those specialists' "fees are already regulated largely," by Blue Cross, Medicaid and Medicare payment restrictions, and health maintenance organizations. "We're not saying that there's no need for utilization review in some areas and the most aggressive peer review," Mr. Evans added.
The labor-management committee's plan to require disclosure from physicians who own outside medical facilities is a toned-down version of a bill from last year that would have prohibited referrals to such facilities. The bill died in the House Environmental Matters Committee, and Chamber of Commerce President Peter J. Lombardi said the labor-management group decided to bow to political realities and press for the more moderate disclosure bill.
Mr. Evans said his group supported last year a similar disclosure bill but fought against the version that would have prohibited referrals to physician-owned facilities.
The AFL-CIO and the Chamber of Commerce agreed to work together on the legislation because most of the labor strikes in the last five years or so have centered on health-care issues, said Ed Mohler, president of the Maryland AFL-CIO.