Editorial: Health Care Unfinished business
Wednesday, Sept. 17

Even though Pennsylvania just implemented its most sweeping public-health measure in years - the workplace smoking ban - this is no time for Harrisburg legislators to sit by while nearly 770,000 people in the state continue to go without health insurance.

State lawmakers just back in session this week need to break their months-long stalemate over expanding health care for the uninsured.

At rallies yesterday in Philadelphia and in Harrisburg, community activists and business leaders alike sought to ratchet up pressure on officials to do the right thing.

The legislative standoff revolves around whether to move aggressively or accept incremental progress. It's a case of House Democrats and Gov. Rendell versus Senate Republicans - whose tax-phobic leaders want a go-slow approach.

But the only new taxes to expand care for the uninsured would be a 10-cent addition to the cigarette tax and a first-time levy on chewing tobacco and cigars. Those fees would also promote healthier lifestyles if the price hike prompted tobacco users to kick the habit.

Rendell and the Democrat-led House have signed on to the best plan to help the uninsured. The House-approved plan would provide access to care for more than 270,000 adults over five years. Combined with regulatory reforms to control insurance costs for the chronically ill, the so-called Access to Basic Care (ABC) plan would be affordable while also progressive.

In the Senate, Majority Leader Dominic F. Pileggi (R., Chester) and his colleagues are pushing proposals that could well enhance the ABC plan, but only if melded with it. On its own, the Republican HealthNET PA strategy doesn't measure up.

The GOP proposal optimistically banks on expanded government health clinics, private doctors donating services, and a likely underfunded high-risk pool to aid those with chronic conditions.

That's clearly a stopgap approach, far short of finding a means to provide the uninsured with access to a family doctor and prescription medicine. Saying this plan would meet the health-care needs of 507,000 uninsured adults is an exercise in wishful thinking.

Marrying the two approaches, though, would make better sense, since the ABC plan still leaves many thousands without health insurance. (The House measure downsized a more ambitious health plan proposed by Rendell early last year.) The Republican plan, crafted in large part by Sen. Ted Erickson (R., Delaware), would help plug the gap.

The cost of inaction is being felt most keenly by those without insurance. These citizens - many of them working poor - suffer needlessly, and risk financial ruin and even premature death due to late diagnoses of disease.

Also feeling the pinch are hospital executives and doctors who rallied in the Capitol yesterday. Their plea for the millions in malpractice insurance subsidies being delayed by the ABC standoff was self-interested, but it's one more reason for Senate leaders to get moving.