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Copyright 2000 St. Louis Post-Dispatch, Inc.  
St. Louis Post-Dispatch

August 16, 2000, Wednesday, FIVE STAR LIFT EDITION


LENGTH: 580 words


BYLINE: James Stutz



DURING his recent visit to Columbia, Mo., President Bill Clinton expressed support for the Norwood-Dingell Patient Bill of Rights passed by the U.S. House of Representatives last fall. He compared this legislation to the Missouri Patient Bill of Rights, signed by the governor in 1997, and said the federal legislation should echo the Missouri law.

Now that Congress has recessed with this issue still in question, we have an opportunity to evaluate and challenge this comparison. Though the two legislative proposals differ in several important ways, the key difference is critical -- the Missouri law contains no expansion of employer liability. In contrast, the Norwood-Dingell bill would expose employers of all sizes to new liability in state courts for, in many cases, voluntarily offering health coverage to their workers. This provision creates a huge risk to the continued availability of employer-sponsored health coverage for working Americans.

The St. Louis Area Business Health Coalition was very involved in the debate on the Missouri Patient Bill of Rights. For those who would advocate that Missouri should be a model for the federal law on the issue of expanded employer liability, we agree. This one provision, expanded employer liability, has the potential to change the debate in the federal proposal from one of patient protection to one of a public policy signal on the future of employer-based private health insurance in this country.

In the Norwood-Dingell bill, employers would face a new and apparently unlimited liability exposure as a consequence of sponsoring health plans. Importantly, in the early to mid-1990s, when faced with significant increases in financial liability because of changes in retiree health accounting standards, some employers limited or stopped sponsoring retiree health plans. A similar response to employer-sponsored employee health benefits could occur if new, costly employer legal liability became law.

IN its current form the Norwood-Dingell legislation has the potential to:
* Further inflate health-care costs to consumers and employers.
* Drive even more people to the ranks of the uninsured.

* Encourage employers to drop coverage rather than face this new cloud of unpredictable and expanded employer liability cost.

* Especially discourage small employers who are considering coverage for the first time from taking on new health benefit risks.

So, what can federal legislators and the president learn from our experience in Missouri? The House-passed Norwood-Dingell approach will need major changes as it goes through the full legislative process. We believe the top of that list of changes should be removal of this new employer liability.

To push this federal bill through because of election year politics without making these important changes could undermine the future of our private employer-based health care system and that would be poor public policy. Even the Hippocratic Oath says, "First do no harm." I believe most employees who receive their health benefits through an employer would not favor putting that system's future at further risk as the Norwood-Dingell bill does.

If proponents of the Norwood-Dingell bill, including the president, are serious about looking to the "Show Me State" for an example of how to develop and pass a patient protection act, they should begin by not including this expanded employer liability provision.

LOAD-DATE: August 16, 2000

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