WITH THE boldest, most comprehensive proposal of his incumbency, Gov. Ed is looking to change the face of health care in Pennsylvania.
And he's back on the bus, in campaign mode, to sell a plan statewide, starting with a stop in Philly today at the Penn School of Nursing.
It's a plan that could potentially touch every citizen.
It would provide health insurance for all; ban smoking in all restaurants, bars and workplaces; raise taxes on cigarettes; put new taxes on smokeless tobacco and cigars; and heavily regulate hospitals and other health-care providers to cut costs by more than $7 billion.
Much of it requires legislative approval.
Announced in the Capitol yesterday, the first day after his second inauguration, it's clearly the centerpiece of his second term, his potential legacy and a national attention-getter.
It was two years in the making and (because it steps on the toes of powerful health-care and tobacco interests) was offered only after he became a lame duck.
But it's offered with what appears to be personal commitment.
"Don't any skeptics out there tell me we can't drive down the cost of health care," he says.
He adds that as part of his health push, he'll lose 25 pounds.
(Current self-estimates - in my view, optimistic - put him at 238.)
His proposals unquestionably are good ideas for the health of the state and the head of the state.
The likelihood they all happen seems painfully slim.
They require 47 pieces of legislation and a significant number of regulatory changes. Even if both legislative chambers fully embrace them - which, face it, is as probable as a plague of locusts - and do nothing else this year (no budget, no reforms, no transportation fixes), they present a formidable challenge.
But I'm all for it.
The fact that so little has been done for so long in the state and nation to address the problems and costs of health care borders on criminality.
By elevating the debate, Rendell at least is doing something and, almost assuredly, will get parts of his plan into law.
And it has good parts.
Dubbed "Prescription for Pennsylvania," it provides basic health coverage for the uninsured, paid for with assessments on businesses, federal grants and sin taxes.
Currently, 767,000 adults have no coverage. And although all kids are about to be covered by the state's Children's Health Insurance Program, medical care for the uninsured annually costs taxpayers a total of $1.4 billion.
The plan seeks to cut emergency-room costs (by 40 percent) by lifting restrictions on nurse practitioners so they can provide lower-cost care.
It attacks what Rendell calls "unnecessary and avoidable" costs such as hospital-acquired infections (which he says cost $3.5 billion and 2,500 deaths per year), hospital re-admissions caused by medical error and hospitalizations that better care could prevent. He puts combined "avoidable" costs at $6.2 billion.
And it seeks total loan forgiveness for med-school grads agreeing to practice in under-served areas.
The Guv notes a 75.6 percent increase in health-insurance premiums since 2000 as opposed to a 17 percent increase in overall inflation and a 13.3 percent increase in average wages.
"Employers and individuals," he says, "have virtually no chance to keep up."
It's a strong argument for action long overdue.
I'd like to see some of that action more directly attack administrative costs, marketing and profits in the health-care system.
But then I'd like to see the Legislature, Congress and all elected officials ban political contributions from health-care providers and insurers and work on fixing the system instead of profiting from it.
But, listen, this Rendell effort is a good thing. I hope it does more than make a lot of lobbyists richer. *
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