SEATTLE -- Saying Maryland cannot wait for Congress to devise a national health-care strategy, Gov. William Donald Schaefer is pushing a plan that would require his state's welfare users to undergo mandatory physical checkups before they qualify for health benefits.
Schaefer, who is in this Pacific Northwest port city for the annual meeting of the National Governors' Association, said most long-term illnesses and their financial burdens on taxpayers could be reduced if periodic health examinations were required of welfare recipients.
The governor said he has given Maryland Health Secretary Nelson J. Sabatini the go-ahead to examine the legal implications of requiring the tests.
While acknowledging that the issue of mandatory exams is controversial, Schaefer said he is prepared to withstand criticism.
"If I think that we're right, I couldn't care less about complaints," Schaefer said.
Schaefer unveiled his plan to reporters following an NGA committee hearing on health care that had gotten bogged down in disagreements over minor amendment wordings.
"I was losing patience," the governor later admitted. "I can see we've got to do our own, got to go our own ways."
The NGA committee later adopted a resolution calling on Congress and President Bush to develop a flexible health-care strategy that would offer health benefits to everyone. Although Schaefer's proposals do not address the larger issue of providing health care for all residents, the plan could save enough money to enable the state to restructure its health programs and broaden their impact, according to Paul Schurick, the governor's chief aide.
Under tentative guidelines of the new Schaefer plan, Maryland's 400,000 Medicaid users would be required to undergo annual checkups prior to their standard recertification applications. New applicants would have to show proof that they have visited a doctor, too, before they would be accepted into the state and federal program.
Women would be affected most by the plan, with requirements that they have routine PAP smear exams and mammograms. Pregnant women would have to receive pre-natal care and parents would be required to have their children immunized.
Welfare users with drug and alcohol problems would be required to enter treatment programs -- to be paid for by the state -- before becoming eligible to receive continued Medicaid benefits.
Schurick said the plan would be made flexible enough that no one who needs public assistance would be arbitrarily kept off the Medicaid rolls.
"It will not be a punitive measure," he said.
Schaefer said that once the details of the plan are worked out, the state will seek permission from federal Medicaid officials to implement the program.
The plan, which is based largely on a philosophy of preventive medicine, might cost the state more at first, according to Schaefer, but should save money over the years.
"It you spend a buck now and save 10 later on, it's right," he said.