Originally created 02/23/98

Health-care bills separate lawyers, HMOs



ATLANTA -- If it's a new week in the General Assembly, it's time to debate another health-care mandate.

Last week, the House enacted legislation to require that insurers cover testing for osteoporosis, a weakening of the bones that affects about 28 million Americans.

This week, it's screening for chlamydia, a sexually transmitted disease that, authors say, can lead to pelvic inflammation, infertility and problem pregnancies.

These aren't the sexy bills that grab headlines, but they are the type that will continue to keep lawmakers busy over the next few weeks as they grind toward a mid-March completion of the 1998 session.

Hundreds of bills are filed each year dealing with businesses big and small, but few are as closely watched as those involving health care, and managed care in particular.

Bills like those on osteoporosis and chlamydia may seem harmless to the public, but insurers, businesses and medical providers fight over them because of the philosophical, if not pocketbook, implications for health-maintenance organizations and the like.

HMOs and businesses that support them criticize most, if not all, bills that mandate coverage, saying they aren't needed and frequently drive up costs.

Critics in the General Assembly and some anti-HMO doctors say the legislation is necessary because heartless HMOs cut costs by limiting the health care they provide.

"I call them managed-cost companies, not managed-care companies, because they don't care," said Sen. Richard Marable, D-Rome, who runs with the mandate crowd.

Besides chlamydia and osteoporosis, lawmakers have sought to mandate coverage for morbid obesity. As in the case of chlamydia, insurers scoffed at the obesity bill, saying it would never pass. But the chlamydia bill is on the House calendar for a vote today.

Also moving -- possibly this week -- is legislation by Rep. Tom Bordeaux, D-Savannah, that would make HMOs liable when a doctor they contract with is sued for malpractice. HMO officials say lawyers are after the deep pockets of managed-care companies. Mr. Bordeaux is a lawyer, and the bill is in the House Judiciary Committee, which is made up of lawyer-legislators.

In the Senate, legislators may cast the final vote this week on new House districts, a move that could spark another reapportionment lawsuit.

The Senate also is expected to take up legislation by Sen. Don Cheeks, D-Augusta, attacking the cash-advance businesses that are increasingly common in low-income communities. The businesses offer short-term loans against signed personal checks and can collect 15 to 30 percent interest every two weeks.

The House may take up a proposal by Rep. Roy Barnes, D-Mableton, to glue lottery-funded programs like HOPE scholarships and pre-kindergarten classes to the state constitution.

Mr. Barnes' Democratic gubernatorial rival, Secretary of State Lewis Massey, has already passed a proposed amendment in the Senate. However, Mr. Barnes is being supported by House Speaker Tom Murphy, D-Bremen, so Mr. Massey's measure likely faces a grim future.

In the Senate, Mr. Barnes' proposal could get the same treatment from Lt. Gov. Pierre Howard, one of Mr. Massey's mentors and his former boss. On the other hand, Senate Majority Leader Charles Walker, D-Augusta, is backing Mr. Barnes, so he may be able to force it through.

Odds are one of the proposals, or a combination of both, will somehow make it onto the November ballot.