May 7, 2008

The Missouri Health Transformation Act: Everything AND the Kitchen Sink

The Missouri Health Transformation Act of 2008 (SB1283), which would implement several state health care reforms, has passed the Missouri Senate and is now headed toward House approval.

This bill is a perfect example of bureaucracy at its finest. Considering the amount of administrative minutiae in this bill, I’d be surprised if anyone in the Senate other than the bill’s sponsor actually read it.

So what exactly will be “transformed” under the new bill? I’ve spent the better part of the past hour trying to figure that out. Apparently, one “transformation” would be the creation of a new Department of Redundancy Department, which would consist of the existing members of the current state health care agencies. Apparently, this new body is supposed to “coordinate health policy collaboration” across the state by issuing “official state recognition” to employers that promote “healthy workplaces.” The new cabinet also hopes to express its approval of “telehealth” — health advice provided over the phone.

But if that’s not enough, the bill would contain a litany of additional health care “fixes,” such as providing tax credits to private homeowners who modify their homes to be “accessible” (no description of what that means), providing a $400,000 grant to create a “website,” and a $350,000 grant “to be used for the establishment of a study to assess the feasibility of [health] pilot projects in the greater St. Charles area.”

I just don’t understand who this bill is supposed to appeal to. The provisions it would implement are mostly superficial or redundant. The one bright spot is the creation of a state income tax deduction equal to the premium paid by taxpayers for high deductible health care plans purchased through a health savings account. But that benefit seems superfluous when the bill simultaneously expands the Missouri Consolidated Health Care Plan coverage to include benefits such as marriage counseling at the taxpayers’ expense. Considering the degree to which MCHCP is currently underfunded (stay tuned for the future release of our study about Missouri public pensions), this seems like shooting yourself in the foot.

The only thing this bill might “transform” is creating a greater conviction that an expanded role for government management of health care would be a huge mistake.

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