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Gov Drops Health Plan Bill

By Jason Callicoat
State Capital Bureau

January 20, 1995

JEFFERSON CITY _ Although segments of the medical community say they are willing to continue the governor's fight for health-insurance reform without his help, they add that they will not pursue his proposals to regulate the medical community.

At a news conference after his State of the State Address, Carnahan said he has dropped the health package from his program for the 1995 legislative session.

Another fight in the General Assembly would be futile, he said.

Last year, Carnahan's plan to impose new requirements on the medical profession through "Integrated Service Networks" failed in the legislature after it encountered stiff opposition from segments of the medical community _ particularly doctors.

ISN's would have required physicians to coordinate health services through agreements among different health-care providers. It also would have required community service.

In October, Carnahan's office raised the possibility he would drop all health-industry regulation from his next health-care plan and instead focus on health-insurance regulation.

The House Democratic caucus has endorsed an insurance-regulation plan that would require standard benefit packages and prohibit denying insurance coverage because of pre-existing conditions.

But the governor dropped that both the health-industry and health-insurance regulation ideas from his own 1995 legislative package.

In the meantime, state medical organizations are drafting their own health-insurance legislation which would include many of the same issues as the insurance-regulation provisions the legislature had considered last year.

The Missouri Medical Association, one of the groups drafting insurance-reform legislation, is leaving health-industry reforms off its agenda, for now.

~``ISN's and all that stuff, we fought those last year,'' said C. C. Swarens, executive vice president of the association. ``We feel we ought to do these things incrementally, and insurance reform is the first step,'' Swarens said.

The association took the position last year that Integrated Service Networks limited patients' choices as to who treated them.

The Missouri Hospital Association supported the inclusion of ISN's in Carnahan's plan last year, but is not calling for them in the legislation it is drafting with the Medical Association and the Missouri Association of Osteopathic Physicians and Surgeons.

``We are still in support of developing these networks, but the parties involved (with this legislation) felt it best to focus on health insurance reform,'' said Daniel Landon, director of public policy research for the Hospital Association.

But a lack of legislation calling for ISN's does not mean there is no pressure on the market to develop them, Landon said.

``The formation of these networks is occurring in the marketplace right now without legislation,'' Landon said. ``It's the force of economy that's driving that now, not the force of government.''

Other health-industry requirements considered last session _ such as rural health-care networks _ also are being left out of this legislation, Landon said.