Pennsylvania Health-Care Reform

Uninsured need more than a sedative

Monday, June 25, 2008
Philadelphia Inquirer
Editorial

Republican leaders in the Pennsylvania Senate - fully insured for their medical needs - can breathe a sigh of relief. Their eleventh-hour patchwork of health-care proposals has had the desired effect: It's a sedative, not a cure.

As a result, Gov. Rendell is no longer talking about stronger medicine. For the senators, the immediate political risk has passed for now.

That means Senate Majority Leader Dominic F. Pileggi (R., Chester) and his colleagues won't have to take any courageous steps any time soon to come to the aid of the state's nearly 800,000 adults without health insurance.

While Rendell hoped to use the state budget talks to nail down the Senate's agreement on a House-approved plan that truly would expand access to health care, the governor conceded last week that key elements of his reform might have to wait.

As Rendell knows well, there's only one reason time is running out for health care during this budget season: GOP leaders engineered it that way.

Credit Republican leaders with making progress on health care by finally breaking the deadlock on a smoke-free law. But they ignored the uninsured for months, and then cobbled together a strategy that, for most uninsured patients, would substitute an occasional doctor's visit for health-insurance coverage.

The GOP plan would expand government health clinics, promote voluntary care by private doctors, and set up a high-risk fund for people denied insurance due to existing health problems.

Nothing wrong with those building blocks. Who's opposed to expanding access to health clinics?

But the grand boast that 507,000 uninsured adults would have their health care needs fully met by this strategy is just that, a boast.

It's also a safe bet that not a single legislator would want to be told to head over to a health clinic for his regular check-ups. Why should the uninsured, most of whom are working, be told that the solution for them is to take a ticket?

A chief virtue of the GOP plan, say sponsors including Sen. Ted Erickson (R., Delaware), is that it doesn't raise taxes. It taps existing funds, while also providing tax credits for business. Great. But Rendell only proposes boosting tobacco taxes in addition to tapping existing funds - hardly a general tax, and it's one that gives smokers more reason to quit.

As modified by the House, Rendell's more expensive but still affordable plan would provide real coverage for hundreds of thousands of uninsured. Senate leaders have not offered a better alternative, so there's no reason to delay action.