State Senate's Sad State of Health

March 16, 1995

The Senate Finance Committee holds a hearing in Annapolis today on one of the most contentious health care bills before the General Assembly. Yet the treatment of this bill will provide a glaring example of the problems created by the Senate's lackadaisical approach to conflicts of interests. It will showcase the folly of giving a legislator power over bills that could affect his own interests.

The legislator in question is Baltimore Sen. Larry Young, who chairs the panel's health-care subcommittee. Last year, Mr. Young received thousands of dollars in campaign contributions from health care companies. He is employed by one of those contributors, an ambulance company, as an executive assistant for marketing, public relations and community relations. Not bad work for a senator in charge of health-care bills, if you don't mind mixing the public's business with your own.

The dilemma for the Senate -- and for every Marylander -- is whether the complex issues raised by this legislation will get the objective consideration they deserve, or whether pressures arising from Senator Young's own interests will unduly shape the committee's deliberations.

The issue at stake is a hot topic -- finding a balance between patient choice and cost controls in health care delivery. The Patient Access Act would require Maryland's HMOs to let their subscribers visit a health care provider outside the network, if the patient is willing to shoulder all fees above 80 percent of the cost the HMO would pay for the service in-house. HMOs, which contributed to Senator Young last year, vehemently oppose the bill. Groups supporting it include the Medical and Chirurgical Faculty of Maryland (the professional society of physicians), which gave nothing to Mr. Young last year.

HMOs claim the bill would undo their control over health care costs and effectively eliminate from the market a product that offers comprehensive health care for the lowest cost. Supporters of the bill question the HMOs' insistence that offering patients even a limited choice would destroy their ability to control costs.

The question facing legislators is this: Will this compromise -- giving HMO patients a limited ability to select care outside the network -- really eviscerate HMOs' healthy profits? Answers never come easy when so much is at stake -- not just millions of dollars in health care costs and profits, but also the well-being of thousands of Marylanders and the level of training and research available for the physicians who serve them.

What is abundantly clear, however, is that Marylanders deserve to know that legislators will address tough questions in the best interests of the public. Sadly enough, when the Senate Finance Committee takes up this and other health-care issues, citizens have good reason to wonder whose interests will prevail.

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