The Maryland General Assembly has shot down two key bills promoted by a joint labor and business effort to control escalating healthcare costs.
One of the bills would have required a study of medical costs and its companion bill would have directed the state's Health Services Cost Review Commission to study whether hospital-based physicians should be regulated. Both measures were killed this week in committees in the House of Delegates and Senate.
"It appears nothing substantive that affects health care will emerge from this General Assembly," said Ernest B. Crofoot, chairman of the Health Cost Committee of the Maryland State and D.C. AFL-CIO.
The bills were significant because of the increasing importance of health-care costs in labor-management relations. "It's the biggest problem for labor and the biggest problem for management," Crofoot said.
The two measures were a vital part of a group of bills being pushed by the unlikely alliance of the Maryland Chamber of Commerce and the Maryland-D.C. AFL-CIO. Other bills in the package include a measure to allow low-cost, scaled-down medical insurance and a requirement that doctors disclose that they are referring patients to laboratories where they have a financial interest. Both of those bills are progressing through the legislature.
However, the labor and business coalition had sorely wanted the state to study physicians' fees and services as a way of getting to the heart of why health-care costs rise at an annual rate of 20 percent. The Chamber and AFL-CIO tried to do such a study last summer, but found it did not have access to critical information.
"This information is not available," said Crofoot. "It's really a closed club."
While the two bills were backed by two strong interest groups, they were opposed by another powerful lobby -- Maryland doctors.
The Medical & Chirurgical Facility of Maryland, Med-Chi for short, strenuously opposed the bills, saying they were simply pretexts for the regulation of doctors. "The study is a sham," said Gerard E. Evans, a lawyer representing Med-Chi, who points to past efforts by labor and management to regulate physicians.
"They are crying out for regulation of physician fees when fees are already regulated," Evans said, citing guidelines established by Medicare, Medicaid, Blue Cross and Blue Shield and worker's compensation regulations. He said the efforts by the AFL-CIO and the Chamber are part of a larger move toward socialized medicine. "When the rest of the world is rejecting socialism and communism, our own Chamber [of Commerce] is embracing it," Evans said.
But the person representing the Chamber on health-care issues said the business organization does not want regulation of doctors' fees. "I can't conceive of a scenario where we would recommend that physician fees would be regulated," said Don S. Hillier, senior vice president for corporate human resources at MNC Financial Inc.
Even though the bills were defeated, Hillier said, he is confident that the Chamber and AFL-CIO will be able to get the necessary information in other ways. "We have lots of other things we can do and will do," he said. He declined to elaborate on those options, however, saying they have not been adopted by the organizations.