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Guest Editorial

With health care, there are no game-winning home runs

Over the years, we have searched exhaustively for "the magical solution" to health care, much like Ponce de Leon traipsed through Florida looking for the fountain of youth.

In both cases, the goal has proved elusive.

Today, people everywhere are struggling to find accessible and affordable health care. The problem is that elected officials tend to try to hit game-winning home runs rather than playing "small ball" as Lou Pinella would say. In other words, politicians often devise grand strategies to replace the entire system rather than making incremental improvements.

In 1980s, Gov. Booth Gardner swung for the fences by advancing a "single-payer, government-run" health care system. It was quickly swallowed up in the halls of the State Capitol much as Ponce de Leon found himself mired in the Florida swamps.

Then in 1993, Gov. Mike Lowry pushed lawmakers to pass major health care reforms that were to be the model for the Clinton Administration's national health care system. But those reforms required a federal waiver that Congress refused to grant, and the scheme came unraveled.

Last year, labor unions swung for the fences by proposing "Fair Share" laws in more than 30 states. Organized labor pointed to Wal-Mart and other large non-union employers as the cause for all that is wrong with health care. Only in Maryland did they hit the homer, a victory that was short lived. Recently, the Fourth U.S. Circuit Court of Appeals upheld a lower court's ruling that struck down Maryland's Fair Share law.

Washington's version of "Fair Share" would have required companies with more than 5,000 employees to spend at least 9 percent of their payroll costs on employee health care or pay a fee to the state to make up the difference, but expenditures for fitness and wellness programs didn't count. Speaker Frank Chopp (D-Seattle) put the bill on hold.

This year, our Legislature again will consider a number of health care bills. Some legislators may be tempted to swing for the fences. An example is legislation modeled after Massachusetts' new law that requires everyone to have health insurance. While the goal is laudable, if the delivery system is government, then it isn't. Furthermore, a government mandate telling people what they have to do is hard to enforce. A better way would be to tailor health care plans to people's individual needs and make sure it is affordable.

There is no question that health care is gobbling up larger and larger portions of family, employer and government budgets. However, there are signs that incremental improvements are working.

For example, association health plans authorized by Gov. Lowry and the 1995 Legislature for very small businesses now cover approximately a half-million people in our state. They are affordable and flexible for people, families and employers. So, the Legislature and insurance commissioner ought to build on association plans as a model for what works.

Second, the American Electronics Association (AeA) estimates that by investing $7.7 billion nationwide in electronic medical records, we could reduce prescription errors, enhance efficiency, and improve management of chronic diseases, saving a whopping $81 billion a year.

Third, lawmakers should encourage private sector efforts to eliminate medical errors that not only kill and injure patients but are very costly to correct or to resolve in court.

Finally, lawmakers should look for ways to help people take responsibility for their own health care. According to a recent study by Braden Benefit Strategies, half the health insurance claims filed in this country are for preventable problems caused by lifestyle choices. The top three health risks are obesity, smoking and a sedentary lifestyle.

Lawmakers can't force people to quit smoking, eat healthier foods, or exercise more, but they can support health plans that reward responsible customers with lower premiums.

So, rather than trying to find that one magical solution, our legislators in Olympia need to look for ways to make incremental improvements and build on what's working.

Don C. Brunell is president of the Association of Washington Business.

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