Mandates are bad for your health

Among the side benefits of term limits is that the, shall we say, "unfortunate" ideas of otherwise exemplary legislators exit with the lawmakers themselves.

We were reminded of this late in Tuesday's long slog through the presentation of Pasco County's chief concerns for the approaching state legislative session. And though it surely was not Eric Crall's intention to remind us, he did so nonetheless.

Crall, a tidy, well-spoken physician who heads a family practice in Trinity, presented Pasco's legislative delegation with an irresistible proposal: In the interest of expanding the number of Floridians who might take advantage of a test for heart disease that is brief, painless, noninvasive and comparatively inexpensive, Tallahassee should require health insurance companies to cover it.

We are virtually positive Crall's heart is in the right place, and that his interest is in screening Floridians who, despite their inclusion in the low-risk pool, annually comprise two-thirds of the population who suffer a major cardiac event.

If the slow bludgeoning of ObamaCare to (presumed) death has taught us anything, however, it is to be skeptical of lawmakers brandishing health care mandates. Requiring coverage of carotid intima-media thickness screenings falls roughly into the same category of Senate Democrats' radical plan to force legal U.S. residents to buy "approved" health insurance policies. The difference is one of degree only.

Employers aren't interested

Which steers us to a pair of Tampa state legislators - Rep. Ed Homan and Sen. Victor Crist - Republicans who will, for the fourth and final time this spring, sponsor companion bills that would force insurers to cover mental health treatment at the same level as other health services. Current state law mandates minimum requirements; the term-limited Homan and Crist, soon to begin their final Tallahassee adventure, seek to mandate parity.

Crist, whose district includes much of central and east Pasco, has a keen interest in the state's criminal justice system, especially in reducing that portion of Florida's prison population attributable to substance abuse - a key area of mental health treatment.

As a physician, Homan's interest is more organic. But he argues like a lobbyist: Where mental illness is covered, he says, employee productivity increases and absenteeism shrinks, thereby offsetting premium increases for employers. Alas, he says, "We just can't get the insurance companies to listen to that."

Homan's argument is specious. He asks Floridians to believe that insurance companies, alone in the maelstrom of our domestic industries, are immune to the desires of their customers.

If, as Homan says, full-fledged mental health coverage meant a healthier bottom line to employers - America's principal purchasers of medical insurance - a law requiring its inclusion would scarcely be necessary; employers large and tiny would be clamoring for mental health riders.

They are not, prompting mental health lobbyists to sprinkle marketing points around the Legislature aimed at resting the state's boot on the throat of an insurance industry reluctant to act in ways contrary to its clients' interests.

Look out below

Do not misunderstand. This Space is second to none in its respect for the work done by qualified mental health professionals. Employees should be allowed to select levels of mental health coverage above the state minimums during each open enrollment period.

But if we have come to learn anything from the monthslong angst meted out by Congress' attempt to remake America's health care industry, it is that top-down mandates are expensive, coercive and anti-competitive.

The link between a state legislature's subservience to medical service providers and high-priced health insurance policies is well-established. It's also why conservatives include interstate purchase of health insurance - to get around great mountains of onerous mandates (for bone-mass measurements, acupuncture, smoking cessation, contraceptives, infertility services, morbid obesity and so on) - as one of their preferred reforms.

Meanwhile, the Legislature should remain uber-wary of placing additional burdens on Florida's businesses, lest the light at the end of the hiring tunnel turn out to be the proverbial high-speed train.