Health-care panel to study bold reforms

When the state's health-care study group began meeting a few months ago, Gov. Lawton Chiles challenged its members to be bold. Some of them are taking him up on it.

The task force today will consider initiatives that would require all employers to provide basic health insurance for their workers or contribute to a state insurance fund.

In the jargon of health-care reform, the idea is known as "pay-or-play." Many small-business owners who say they can't afford it probably have other names for it.

But a lot of people are looking for bold measures this year to rein in the cost of health care, which has galloped far ahead of inflation. Chiles has put himself amid the forefront of the reformers, calling for the federal government to provide universal access to health care by 1994.

Chiles has yet to commit to a specific solution for Florida, however. He is expected to propose a health-care reform package to the Legislature next month. He also has begun discussions with federal authorities to take over administration of the major federal health-care programs in Florida, including Medicare and Medicaid.

While Chiles' legislative package is being developed, the task force is acting as an incubator for some of the possible reforms.

At least a few members don't particularly like what's being hatched.

"I think there are serious repercussions in pay-or-play for the smaller employer particularly," said Pat Bean, an assistant Hillsborough County administrator who is a member of the work group.

"

"Pay-or-play' as it's variously defined is a problem for employers because they say they can't afford it, and they're right," said Doug Cook, Chiles' budget director. "You have to change the structure so they can."

The draft recommendations are based on members' suggestions but also have been beefed up by the group's chairman, Dr. Leighton Cluff of Gainesville, a friend of Chiles' who has worked with the governor on infant mortality issues.

The proposals also suggest subsidizing insurance premiums for unemployed people through fees on health-care providers. In addition, the proposals call for a Department of Health Care Systems to regulate the health-care industry and establish cost controls.

The work group is scheduled to deliver a set of recommendations to Chiles and the Legislature for the 1992 session, which begins Jan. 14.