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Cardin faces major battle to enact health-care plan

August 10, 2007

When U.S. Sen. Benjamin Cardin, D-Md., visited Hagerstown this week, he backed the idea of a law that would require everyone who could afford it to purchase health insurance.

Those who didn't comply would pay a tax, which would be used to purchase insurance for those who don't do so voluntarily.

If Cardin's plan sounds familiar, it's because it's based on one enacted in Massachusetts in 2006.

In a May 2006 interview in The Herald-Mail, Cardin said, "I think Massachusetts has given us a way out."

Under a new Massachusetts law, by July 1, 2007, every citizen was required to purchase health insurance, just, as The Washington Post noted in April 2006, every driver must have car insurance.

The Massachusetts bill also required insurers to offer lower-cost insurance plans that would be subsidized by the state.

Those without the means to purchase insurance on their own would get a subsidy to do so. But, as The Post reported, the plan is more complicated than a brief description might suggest.

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It's those complications that Cardin and other proponents would have to work through.

One of them is that many states have mandated that health insurance cover certain items.

For example, in 1995, Del. John Donoghue, D-Washington, co-sponsored a bill to set a mandatory 48-hour hospital stay for new mothers following vaginal births.

Other states might have similar requirements written into their laws. Determining what is written into the regulations that govern a nationwide system will require a lot of negotiation.

Another feature of the Massachusetts law is that it set up a new agency to function as a liaison between the government, policyholders and the private insurance companies. We question whether the existing federal agencies could handle that function, unless new staff is hired.

And there is the requirement that private companies pay a fee for each employee for whom they don't provide insurance. That sounds a lot like Maryland's so-called Wal-Mart bill, which was overturned by the courts.

None of this is to say that we oppose health-care system improvements. The existing system subsidizes the care of the indigent by incorporating the cost of their emergency room visits into the hospital rates that everyone pays.

It would be better for all if those folks could have regular physicians, who could deal with ailments before they become chronic conditions that are expensive to treat.

We applaud Sen. Cardin's attempt to deal with an issue that hasn't been seriously debated since Hillary Rodham Clinton pushed for universal health care as first lady in 1993.

We suggest Cardin learn from her mistakes, which included closed sessions that were challenged in a federal court, which ruled that they must be more open to public scrutiny.

When those not invited to a meeting speculate about what is going on inside, they often conclude that their interests are being harmed. Cardin needs to give all the players a seat at the table, because he will need the cooperation of all to make the Massachusetts plan work on a nationwide basis.

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