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With Taylor gone, health plans may suffer

November 13, 2002|By BOB MAGINNIS

Politicians who've been in office for years tend to accumulate enemies, just like a ship that's been in the water for a long time gathers a hull full of barnacles.

That's the image that comes to mind as I consider what may be the end of House Speaker Cas Taylor's political career. No doubt Taylor's support of gay rights and gun-control issues didn't play well in conservative Allegany County, but if voters there had had time to consider his last major initiative, they might have had second thoughts about rejecting him.

In the campaign's final days, Taylor and Maryland Business for Responsible Government announced a new health-care initiative. As proposed, not only would it have increased coverage for those in the lower-income brackets, but would also have forced the so-called "free riders" - well-off people who can afford to buy health insurance, but don't - into the pool.

In Taylor's plan, those free riders who choose not to buy health insurance would lose the personal exemption on their state income tax return.

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How would such a proposal play in wealthy Montgomery County, when most of the benefits would accrue to the poorer counties, like Allegany? Without Taylor in a leadership position, will such a plan even see the light of day?

It's a shame this wasn't presented until Oct. 31, because there's another group - the Maryland Citizen's Health Initiative - that is proposing its own expansion of the health-care system.

In January 2001, a month after it withdrew its plan for single-payer health insurance coverage in Maryland, MCHI's Web site said it had proposed to pay for such a plan by redirecting state money "and new taxes on employer payroll, tobacco products, alcohol products and personal incomes."

This month the group's Web site said it would increase the number of Marylanders covered by supporting a 36-cent-per-pack increase in the cigarette tax, which the group estimates would raise $100 million per year. They would also get the state to do a better job of negotiating with drug makers.

That's a strategy they share with Taylor, who said Oct. 31 that the state gets only a $5 million rebate on $200 million worth of drug purchases. The rebate should be closer to $40 million, he said.

That's $140 million in savings, and just to be as fair as possible, let's accept the figure provided in a study of MCIH proposal by the Lewin Group Inc., which said MCIH's system would save the state $345 million a year.

Now to be even more generous, let's assume that none of the Lewin Group's savings and the $140 million savings from raising cigarette taxes and taking a tougher negotiating stance with drug companies would overlap. That would provide a total of $485 million in savings.

However, the Lewin Group study also said that under the MCIH single-payer plan, health-care expenditures for the present population of the state would increase by $675 million a year. That's $190 million in new funds that would have to come from somewhere.

My reference to the "present population" is also important because if Maryland enacts a health-care plan with benefits significantly better than those available in other states, anybody with a chronic condition would have a strong incentive to move here.

And if part of this proposed plan would be funded with new payroll and income taxes, what would that do to economic development? Nobody is opposed to better health care for those who are in need and who can't afford insurance. It's the unintended consequences that we need to worry about.

All of this never became a campaign issue because the plan was only released Oct. 31 and nobody called to invite me to the Cumberland press conference until that morning. For whatever reasons, Taylor either believed he didn't need the bounce that such a plan might have provided, or he was too busy with other matters, like the problems that shut down Washington County Hospital's trauma center.

Whatever else his critics might say, the health and safety of Washington County residents were protected by his direct intervention at a time when too many local elected officials were taking a wait-and-see approach.

If Taylor does not survive a recount, his replacement as speaker will be Del. Michael Busch, D-Anne Arundel. As a member of the state's shock trauma task force, Busch was involved in talks to settle the crisis, so he at least knows where Western Maryland is.

As for LeRoy Myers Jr., the man who has apparently defeated Taylor, one of his big tasks will be bringing in the high-paying jobs to Allegany County some faulted Taylor for not landing.

There'll be some pressure on Gov. Bob Ehrlich to provide some help to his fellow Republican, but given the mess the state budget is in, "some" may be all that Ehrlich can provide in the near future.

Bob Maginnis is editorial page editor of The Herald-Mail newspapers.

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