Wednesday, April 27, 2005

"Co-pays" hide the true cost of government

Omnibus bills are difficult for the average citizen to follow. An omnibus bill is a large collection of related bills that are considered and voted upon as one bill. Even after they have passed, to figure out which part of the omnibus bill your legislator favored, and which ones he or she opposed, you pretty much have to get them on the phone and ask. Unfortunately, not enough people bother to do this.

The Senate education finance omnibus bill currently percolating at the Legislature, for example, contains a few provisions that you should know about. DFL Senators have removed local school districts' excess levy authority from the bill. So even lacking "adequate" funding from the state (if "adequate" can even be defined), local school districts would be powerless to go to their own voters for more money.

Second, in spite of a larger increase to K-12 education than in Governor Tim Pawlenty's budget, the Senate bill still does not say how it would pay for such largesse. Back in February, Sen. Steve Kelley (DFL-Hopkins) told the Star Tribune, "I know how we're going to fund this is critically important. I think tax increases need to be in the mix."

The DFL likes to finance K-12 education, and everything else, by raising taxes -- someone else's taxes. Republicans, at least the fiscal conservatives, don't like to raise anyone's taxes, but if more money is truly needed for good reasons, they prefer to have those who would benefit be responsible for the cost. It's much easier for you to schedule an appointment with your city council member or school board member down the street than it is for you to lobby the entire Legislature in Saint Paul, most of whom don't need your vote (believe me, I've done both). It's called "local control."

My company offers a health savings account (HSA) with a high-deductible health plan. I fund my HSA with pre-tax or tax-deductible dollars. I pay for my medical expenses out of this fund at full fare, up to a deductible amount. Then the insurance pays 80% and I pay 20%. I own the money in the HSA forever, even if I were to leave the company. Local control!

The first few times I had to shell out the full costs (instead of a $10 or $15 co-payment) for a lab, office visit, or prescription medicine, I was in sticker shock. But it forced me to question whether each charge was necessary, or whether there was a more cost-effective alternative. For instance, now I take over-the-counter loratadine instead of a prescription hay fever medicine. I have more incentive to stay healthy, and the health care community and drug companies will have an added incentive to keep their costs in check.

As a state, we would all benefit by getting rid of most "co-pays" and being forced to deal with the real costs of government services.

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