Appearances do matter, but Gov. Jeb Bush's staff seems to have been blind to them when it scheduled the time and place for the first public meeting of his task force on affordable health insurance. It was inserted into the program of an industry-oriented insurance symposium being held at the Biltmore in Coral Gables, one of Florida's most opulent hotels, for which a $200 admission fee was being charged. Private citizens who weren't insurance executives could get the fee waived, but nobody connected with the symposium, which was sponsored by the Office of Insurance Regulation, went out of the way to tell them and they had to pursue the fine print to figure it out.
For incongruity, it recalled the swank Capitol Hill luncheon - "steak and jail," as her critics quickly called it - that Paula Hawkins, Bob Graham's predecessor in the U.S. Senate, put on to announce her proposal for cracking down on welfare cheats. But on that occasion, at least, members of the general public were not invited.
The insensitivity this time was, if anything, more significant. Concern is spreading in Tallahassee that what the governor's task force and that of House Speaker Johnnie Byrd have in mind is to make health insurance more affordable to employers by making it less valuable to their workers. There's talk again of "flexible benefits," with massive exclusions and minimal coverage, that would create the illusion of insurance without providing any real substance. If that's the game, the Biltmore was as appropriate a venue as any.
The real solution to the high cost of health insurance, and to the scandalous fact that some 2.8-million Floridians haven't any, is to see to it that everybody is enrolled, including those who think they are too healthy to need it. This doesn't necessarily mean government-run single-payer systems like Canada's. "Play or pay," in which employers have the choice of sponsoring their own plans or paying taxes into a public plan, is a viable option.
Such sensible alternatives are of course as distasteful to the political management at Tallahassee as to the health insurance industry, which makes a large part of its profits not from delivering care but from denying it. The climate will change for the better only when Florida's doctors and hospitals begin to see that they have as much to lose from shrinking coverage as their patients do.
