Health Reform

State lawmakers put finishing touches last week on plans to apply federal health care reforms in Maryland come Jan. 1. But who becomes newly insured — and at what cost —still worries stakeholders as the state speeds toward becoming one of the first to adopt a revamped system. Under legislation passed by the House of Delegates and Senate, more low-income Marylanders would qualify for government-funded health care through Medicaid, and an existing tax on health insurers would sustain a new insurance marketplace once federal support wanes.

WASHINGTON -- Rep. Benjamin L. Cardin, once a youthful star of Maryland politics, is starting to shine at the national level.The same combination of political instincts and policy smarts that won him the post of House speaker during a 20-year career in the General Assembly has made the Baltimore Democrat an influential player in the health care reform debate after seven quiet years on the congressional back benches.As Congress knuckles down to the nitty-gritty work of one of the most ambitious and complex undertaking in decades, Mr. Cardin, 50, is being acknowledged as one of its leading authorities.

Health care insurance reform may be an idea whose time has come, but it is not a new idea. Nor is it an American idea. National health insurance has existed in Europe since the late 1880s, when it was put in place in response to pressure from an activist labor movement. Germany was the first country to have a national health insurance plan, and the other European countries followed.As this country moves forward in the examination of our latest health insurance reform proposal, it is helpful to look at the history of this effort in the United States.

WASHINGTON -- Drawing sharp protests from consumer groups, the chairman of a powerful House committee has offered significant concessions to the health insurance industry in exchange for the industry's agreement to mute its attacks on health reform legislation.The bargain struck by Rep. Dan Rostenkowski, chairman of the House Ways and Means Committee, with the Health Insurance Association of America -- a powerful force in the health care debate -- marks the first erosion of consumer protections included in most of the health bills under consideration.

YOU WILL know when Hillary Clinton's long-awaite health-care reform plan is released by the flood of crocodile tears pouring from every suite in the insurance industry. You will hear a lot of yammering about the importance of preserving as much as possible the trillion-dollar Rube Goldberg machine that is our current health-care system.Don't believe it.Complexity and bureaucracy are essential if those now making a good living from the current system are to continue to do so. The only way to increase access, lower costs and give you peace of mind about your insurance coverage is to make the system simpler.

The governor wasted no time yesterday signing into law Maryland's landmark health care reform bill.The new law, which supporters hope will become a model for the nation, is expected to change the way doctors practice medicine and the way patients pay for it. The General Assembly enacted the measure in the final days of the session that ended Monday night."

WASHINGTON -- In a striking departure from the Democratic Party line, House Majority Leader Richard A. Gephardt raised the prospect yesterday that major health care reform legislation may not be enacted this year.Mr. Gephardt, a Missouri Democrat charged with shepherding a version of President Clinton's health care bill through the House, predicted that his party wouldn't be "penalized" for failing to act so long as the "American people perceive that we tried our dead-level best."The majority leader's comments, made at a breakfast meeting with reporters, were clearly aimed at lowering expectations for approval of a sweeping health care bill at a time when the legislative process has reached a critical phase.

In his press conference last week focusing on health care reform, President Barack Obama stated, "If we do not control these costs, we will not be able to control our deficit." I could not agree with him more. Our economy is buckling under the weight of a health care system that has us spending nearly twice as much per capita than other industrialized countries. Health care already represents 17 percent of our gross domestic product, and that figure is projected to rise to 25 percent by 2025 if action is not taken.

WASHINGTON -- The combination of Republican power politics and attacks by lobbyists appears close to having sapped Congress of the political will to enact health care reform legislation this year.Republican congressional leaders and most GOP members have concluded that they would not be punished by voters for blocking the Clinton effort -- and might even be rewarded for it in the fall elections."The policy is not to try to make this bill better," said Rep. Fred Grandy, an Iowa Republican who is bowing to a request from party leaders to withhold amendments designed to improve a Clinton-like bill being debated in the House Ways and Means Committee.

WASHINGTON -- One of President Clinton's most powerful congressional allies called upon him yesterday to abandon the health care reform effort for the year, saying it is time to give it "a decent burial."The appeal by House Energy and Commerce Committee Chairman John D. Dingell, a Michigan Democrat, which was made in a letter to the president, marked the first time that one of the stalwarts of the campaign has acknowledged publicly what has been obvious for weeks -- that the end is near.Said one dispirited lobbyist: "It's like family members all standing around a terminally ill person.