JEFFERSON CITY _ One of the prime architects and lobbyists for the governor's health care plan of last year conceded it might have been a "good thing" the plan was rejected by state lawmakers.
"I haven't said this publicly, but it's really a good thing the (health care) legislation didn't pass last year so we were able to continue this discussion," said Coleen Kivlahan, Director of Missouri's Health Department.
Kivlahan made her comments at the opening session of the Missouri Health Systems Partnership appointed by the governor to generate ideas on expanding health care access.
The panel includes representatives from government and the private sector, and also will study the issues of cost and quality of health care.
A substantial dialogue between the public and private sectors was missing from last year's debate, Kivlahan said.
"Last year it was government, it was our proposal," she said.
By including physicians, insurers, managed care representatives and small and big business representatives, panel members expressed hope they will come up with more universally acceptable ideas for health-care regulation.
"We'd like to see the very best for Missourians in the area of health care, and we will work for that type of policy if you will help us to know what it is," Gov. Mel Carnahan pledged to the panel.
"I'm impatient," Carnahan said. "I want the panel to move forward in the next 18 months, and I want to see the result."
Moving forward with actual legislation might prove more difficult than generating the ideas for it, especially after the death of the governor's comprehensive health-care regulation package during the 1994 legislative session.
Panel members made references throughout the meeting to the decreased interest in health care during this session.
"In the summer of 1993, there was significant state discussion about health-care reform, and that discussion resulted in legislation that was eventually not successful," Kivlahan said. This year, "the level of discussion and debate does not match what occurred last year."
The panel will begin its work by trying to set up a method to identify the uninsured in Missouri and a method to more accurately rate the quality of health care for consumers. The panel also will study the impact of managed care on the economies of communities where it is prevalent.
Kivlahan said she hoped the panel's discussion would result in legislation that addresses access to, and the cost of and quality of health care, but said that legislation probably would not come about before next year's session.