That’s the modern U.S. health care system, in the view of many.


But reformers in Pennsylvania are working to transform it. Their sweeping universal coverage initiative is called The Pennsylvania Balanced and Comprehensive Health Reform Act. State Sen. Jim Ferlo, D-Pittsburgh, introduced the proposal in the Pennsylvania Senate in February. It has about 15 co-sponsors, all from outside of Lancaster County.


Erie Democrat Linda Bebko-Jones will launch an identical bill in the House Tuesday. A 10 a.m. press conference has been scheduled in the capitol media center.


To Pennsylvanians crushed by health-care expenses, Senate Bill 1085 holds out a potential life buoy.


The $40-to-$45 billion bipartisan package would extend full health, dental and prescription drug coverage to every citizen while eliminating co-payments, caps and deductibles. It would invest in a “culture of wellness,” offer tax rebates to volunteer emergency responders and defuse the medical malpractice crisis with a no-fault program.


At its heart is a single-payer, state insurance plan supported chiefly by a 10 percent levy on employer payrolls and a 3 percent individual wellness tax.


If the radical overhaul ever sees the light of day in Harrisburg, though, it’s bound to spark fierce opposition from the powerful interests it seeks to displace.


“The private insurance companies would be out of business,” acknowledged Steven B. Larchuk, a medical malpractice attorney from Pittsburgh and the chief architect of the concept. “So of course they’re going to fight tooth and nail to save their skins.”


HealthAmerica president and chief executive officer Robert L. Dawson said last week in an e-mailed statement that universal coverage has dim prospects.


The concept “doesn’t address the underlying root causes that are threatening the health-care system today,” he said. “It will simply shift the costs to the government.” Reformers say that’s exactly the point.


Today’s chaotic mishmash of intensely competing private providers, plans, forms and payment schedules breeds massive waste and inequity, said Lancaster software entrepreneur Charlie Crystle, who helped shape the Pennsylvania universal health-care model over the past couple of years.


“None of us knows which of us are going to get cancer. ... None of us knows which one of our kids is going to be autistic.


“We want employees to be anxiety free” and not have to worry about going broke trying to pay medical bills.


Titanic woes


Such predicaments are appallingly common.


According to a 2005 study by Harvard University, more than 45 percent of the personal bankruptcy filers in this country were people who happened to fall ill.


More than three-quarters of those studied were covered by health insurance when they got sick.


An even larger group, one-third of the U.S. population under age 65, is uninsured during some part of the year, according to Larchuk.


At the same time, businesses socked by double-digit increases are cutting benefits to employees and struggling to compete in a global market. General Motors, saddled with $60 billion in health benefit payments, is exporting jobs, according to Dr. Walter Tsou, a leading health expert who helped develop the universal care concept in Pennsylvania.


Nationally, health-care spending now consumes a record 16 percent of the gross domestic product.


But change is in the air.


The Legislature in Massachusetts, one of many states wrangling with health-care reform, this spring adopted an initiative that seeks to insure every resident.


Meanwhile, health insurance providers said they’re improving quality and affordability, while also giving consumers more options and health-care savvy.


“We’re seeing costs moderate right now,” said Leilyn Perri, a spokesman for Highmark Blue Shield in Camp Hill.


Health-care premiums for small and medium-size businesses in central Pennsylvania this year are rising 5 percent, said Perri.


He contends that universal health-care does not address the costs posed by new technology and an aging population. But reformers in Pennsylvania said attempts at market solutions, such as HMOs, have repeatedly failed.


Private insurers, who contain costs by controlling health-care access, are invariably at odds with patients, Crystle said.


Never has so much buck yielded so little bang, added Larchuk, who noted that the United States is the only industrialized country lacking universal care. “Our objective is to have a better system.”


Best ideas


Senate Bill 1085 advocates said they’ve combined the best ideas from many sources to craft a superior plan. Among the advantages they cited:


•An efficient, single-payer program administered by a public Health Care Trust that would save 20 percent of the current cost of care.


•A no-fault component that would eliminate malpractice insurance by self-insuring against most liability claims and save another 10 percent.


•A 50-percent drop in workers’ compensation payouts by companies; the costs would be covered under the public plan.


•A revenue stream from Medicaid, the cigarette tax and other existing sources that would discourage passing health costs to future generations.


Meanwhile, said Crystle, debunking one of the chief myths about universal coverage, doctors would continue to practice privately. Patients would still choose their doctors.


“It’s not socialized medicine. ... This will free up doctors and providers” from strangling paperwork and redundancy.


Weeding out bad doctors is key no matter what the system, he added. “You need peer review.


“I think there is a moral responsibility” to pursue meaningful change, he added.


Yet, legislative action has been lacking.


The United States National Health Insurance Act introduced in 2003 by Rep. John Conyers Jr., D-Mich., has languished in Washington.


In Harrisburg, S.B. 1085 remains in the Public Health & Welfare Committee and has yet to be called for a hearing. Sen. Jake Corman, the committee leader, did not return a call for comment.


State Sen. Noah Wenger has not taken a stance on the bill, according to his Lancaster County district director Mitch Hanna. State Sen. Gibson E. Armstrong’s office could not be reached Friday for comment on the issue.


Rosemary Greco, the director of Gov. Ed Rendell’s Office of Health Care Reform, declined a request for an interview. “If they have a better idea,” Larchuk said, “that would be wonderful. ... It’s up to the states to do something.”




Reach Jon Rutter at jrutter@lnpnews.com

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