Gridlock again

December 29, 2004

WELL, NOW WE know what happens if you call a special session of the General Assembly without an agreement over the particulars: You get chaos.

Three plans to address Maryland's skyrocketing medical malpractice insurance rates floated around Annapolis at various times yesterday -- the governor's, the Senate president's and the House speaker's. How do they differ? We couldn't have put it better than the physicians' lobbyist who called the governor's plan medium on tort reform but underfunded, the Senate's as light on tort reform but well-financed, and the House plan as good on both fronts.

House Speaker Michael E. Busch offered the best hope for real reform that is also fiscally responsible. Senate President Thomas V. Mike Miller's proposal was far less impressive; there was comparatively little in it to ensure that malpractice insurance costs won't continue to escalate.

But what's important is that both bills would remove the HMO premium tax exemption. As a result, HMO premiums would be taxed at a rate of 2 percent, putting HMOs on a level playing field with other health insurers. (And putting Maryland in line with a majority of states that tax health maintenance organizations in a similar manner.)

More than $48 million in annual tax revenue would immediately lower malpractice rates and pay for an increased Medicaid reimbursement to high-risk specialists like obstetricians and emergency room doctors.

Unfortunately, Gov. Robert L. Ehrlich Jr. is calling the HMO tax a deal-breaker. He has promised to veto any malpractice reform plan that includes a repeal of that long-standing exemption afforded HMOs. How would the governor pay for his bill? He'd cut the budget elsewhere. And what exactly would he cut? He's not saying but the biggest potential target, ironically, is health care for the needy.

That would make Mr. Ehrlich the anti-Robin Hood, taking from the poor to give to the rich. That should be a deal-breaker.

If this sounds like the hopeless grinding of political gears, you've got the picture about right. Even if Mr. Miller and Mr. Busch find enough common ground to approve significant reforms, the legislation is certain to contain the HMO tax and the governor will likely veto it.

Doctors are hoping the General Assembly will ultimately override that veto, but while the House might, the Senate probably wouldn't. Mr. Miller is too likely to be content with the status quo.

Mr. Ehrlich knows this and that makes his veto threat all the more troubling. The governor, it seems, would rather score political points than heal the state's malpractice ills. Experts have a diagnosis for Mr. Ehrlich's condition. It's called hubris, an excess of pride and a disrespect for the interests of others. Until that malady is cured, Maryland's malpractice problems probably won't be.

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