Once again Maryland Citizens Health Initiative unveiled a major health care proposal. Old wine in new bottles. Maryland business defeated a full-bore attempt in 2000 to impose government-run health care and annual attempts since then to pursue incrementally the same government-run health care objectives.
The issue might sneak by as feel good and harmless if it didn’t involve upward of 20 percent ($30 billion) of Maryland’s economy. Proponents count on it sneaking by anyway.
Recommended Stories
It gets worse. While Maryland citizens are still reeling from last year’s record $1.4 billion state tax increase, they now face enormous unfunded liabilities for the state retiree health insurance programs, approaching $30 billion. Despite these stark impositions, MCHI is proposing a health care initiative with an eventual cost to taxpayers that is unknowable. But, to begin with, it would require yet another tax increase of more than $15 billion over five years. The bulk of these taxes would come from a new 2 percent payroll tax and alcohol and tobacco taxes — notoriously unreliable revenue streams. And those taxes would invite the criminalizing of legal substances through smuggling and divert clientele away from Maryland small businesses to those in nearby states. Taxes are job killers.
Which brings us back to health care. The expansion of existing government health care programs, like Medicaid, is not real health care reform. If the state wants to reform health care, then it should redirect existing government health spending to secure better value and tangible results. Expanding government doesn’t make the system any more efficient or effective. The tough task for lawmakers is to reduce unnecessary mandated benefits and make more affordable coverage available, while redirecting existing funds for low income people to get coverage, particularly the massive amount of funding that subsidizes uncompensated care. The health care sector of Maryland’s economy amounts to $30 billion, and there is ample talent to achieve comprehensive private sector, market-based reform.
There will be plenty of time to discuss the details of the latest MCHI proposal. But we must remember that it is only the latest iteration of a multiyear attempt to expand government control over the financing and delivery of health care. MCHI started with a costly “single payer” initiative to have the Maryland state government control the entire health care system. Then it backed an illegal employer-mandate (the Wal-Mart bill) that was struck down by the federal courts, but not before spawning carbon copies in more than two dozen states. With that one ill-conceived policy, Maryland added greatly to its unenviable reputation of exporting bad ideas to other states.
Maryland needs genuine health reform, especially in its public programs. But it should be reform that transfers more direct control to doctors and patients, individuals and families, and less to Annapolis. It should not be the “reform” of Canada and many other countries that leads inevitably to degraded quality and health care rationing of all sorts.
In particular, it is the $30 billion unfunded health insurance liability — until recently off the books — that must cause Maryland legislators to deliberate as never before regarding the proposed $15 billion expansion of health care. Despite the fact that $.50 of every health care dollar already is controlled by some aspect of government, the United States still has the finest health care in the world because of the private sector. That is why our legislators in the coming 90 day legislative session must seek private health care solutions.
Robert O.C. Worcester, lifelong Marylander, educated at the College of William & Mary and the Johns Hopkins University, has been president of Maryland Business for Responsive Government since its formation in 1983.
