GOV. RENDELL is back on the attack with yet another way to fund fixes in health care, this time shifting money from doctors to provide coverage for the uninsured.
Like all things having to do with health care - a complex, mind-numbing issue - there are multiple parts to the proposal.
And, like all things having to do with health care, it reminds me how criminally inept Congress and the Legislature are in dealing with the problem.
More on that later.
In a nutshell, Rendell now wants the Legislature to grab $400 million (maybe more) in surpluses from a fund created in 2003 to help doctors pay medical malpractice premiums.
That fund exists thanks to a 25-cent-per-pack cigarette tax hike.
It is now a fat fund, Rendell said, because malpractice premiums stopped rising, malpractice lawsuits dropped 38 percent and payout amounts on malpractice claims declined.
"We have stabilized the medical malpractice crisis," the governor said yesterday at a Capitol news conference.
He added that doctors are no longer leaving the state. He said the number is level at around 35,000.
(I expect to get e-mails on this point.)
Rendell would couple this surplus with money from a proposed additional 10-cent-per-pack cigarette tax and a new tax on smokeless tobacco and cigars (he said PA is the only state without such a tax).
That would pay for coverage for 767,000 adults, most of whom are employed and currently uninsured. He put the cost at $1.5 billion.
His hit-the-doctor-fund-plan replaces an earlier plan to hit employers not offering health care with a 3 percent "fair share" payroll tax to fund coverage.
The payroll plan was offered in January and has gone nowhere. Republicans call it unconstitutional and Rendell now calls it "a difficult row to hoe."
Still with me?
I praised Rendell when he offered, on the first day of his second term, that plan and a comprehensive package of 46 other health-care initiatives.
I praised him because so little has been done for so long that anything aimed at making health care better is worthy of attention.
Again, that was last January.
Since then, the Legislature has passed two measures: one allows nurses, nurse practitioners and others to perform more medical services; the other attacks hospital-borne infections (which the administration says killed 2,500 Pennsylvanians last year) with more testing of patients and staff and financial incentives to hospitals.
These could and should bring down some costs.
But so much else could and should be done, starting with covering the uninsured.
Pennsylvania adults (all kids can get coverage under the state's Children's Health Insurance Program) without insurance annually account for 6.5 percent of insurance premiums paid by those with coverage, according to administration figures.
And while Pennsylvania is among the better-insured states (a Washington-based Robert Wood Johnson Foundation program says 43 states have higher percentages of uninsured), there is no rational reason for anyone to be without coverage.
Therefore, efforts at more coverage are immediately imperiled.
What the irrational, convoluted, conniving health-care system does to the middle class is robbery. What it does to the working poor is immoral.
What Congress and the Legislature fail to do makes them complicit in robbery and immorality.
Rendell yesterday was asked about his level of frustration in getting even a modest initiative passed - a statewide smoking ban.
"I have ceased to quantify my frustration level," he said, "because if I did so on a daily basis, that's the only thing I'd do."
Well, my frustration level on this issue remains quantifiably sky-high.
It's a political problem of greed and special interests. And it could be fixed in a heartbeat - if politicians gave up their top-of-the-line, taxpayer-funded health insurance until it is. *
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