ANNAPOLIS -- Amid all the pre-session hoopla over health care reform, there was a telling comment from Gov. William Donald Schaefer. At the start of the two-day health care summit in January, he told participants: "Don't try to solve the whole world. If you can bring just one or two things out of here . . . we can accomplish a miracle."
This week, the House Economic Matters committee will take a look at the three major plans that some believe would "solve the whole world" of health care problems in Maryland, in Mr. Schaefer's words.
But there's little hope among legislators and lobbyists that anything will come of them. The three plans are broadly known as "employer play-or-pay," where employers either provide insurance or pay into a fund to insure workers, "consumer tax credit," a variation on President Bush's proposal, and "single-payer," which is inspired by Canada's national health plan.
Last year, when Economic Matters Chairman Casper R. Taylor Jr., D-Allegany, sponsored a bill to give small employers a break from some of the many mandated health benefits, he spent the entire session in negotiations with lobbyists over details of the bill. It ultimately passed.
Now, with more than a third of the session over, there's been little or no comparable activity over the sweeping health plans, a clear sign to some that this isn't the year for fundamental change. Without extreme pressure from everyone who pays for health care, the insurance, health and business groups that stand to lose under the various reform scenarios will never let the General Assembly abandon the current system.
Instead, there are smaller bills aimed at individual tangles in the overall health care knot. Some would add mandated benefits that proponents believe would save employers money in the long run, such as child wellness services; one would penalize doctors and other health care workers who bill for services they don't provide; and one would prohibit a doctor from sending patients to a facility in which the doctor has a financial interest. The state physicians' society supports the bill -- a 180 degree turn from two years ago when it almost single-handedly defeated that bill.
Last week, Economic Matters heard testimony on a measure called "small group market reform." The bill, advocated by the governor's commission on health care financing, would limit the wide disparities in price among health plans for small companies, and prevent insurers from increasing annual premiums beyond a prescribed percentage. As a result, some companies would see lower prices, and some would have to pay more.
Most of the health, insurance and business groups in Annapolis have signed onto this plan as an incremental advance. But some consumer groups, businesses and insurers argued at the hearing last week that small group market reform actually would result in more uninsured people.
No one believes this approach is the answer to Maryland's health care problems. But given the level of interest in it, and the lack of enthusiasm for the sweeping changes, the consensus is that small group market reform is destined to be one of the small steps whose passage Governor Schaefer, at least, believes would represent a miracle.
The House Judiciary Committee last week considered a bill to allow for the formation of "limited liability companies." The LLC is a new breed of business entity that provides the tax benefits of partnerships and the protection against individual liability that corporations afford.
The Senate Judicial Proceedings Committee will hear the Senate version of the bill tomorrow.
Supporters believe it could help small, high-tech start ups attract capital because it lacks many of the rules on ownership and classes of stock that restricts the use of S-corporations, which also combine tax benefits and liability protection.