A task force appointed by the City-County Board of Health gave the board a stack of new ideas Tuesday for bringing universal health care to the county, although some of the ideas in the report — like a hospital tax district — were not agreed upon by all the task force members and go well beyond the power of the Board of Health alone.

One 12-page version of the second phase of the task force’s report, “Local Access to Universal Health Care in Lewis and Clark County,” first presented to the board in April, included a handful of action items for the board to consider, including improving community oversight of St. Peter’s Hospital; seeking additional funding for the county’s Cooperative Health Center; taking steps to improve health care access and affordability; and investigating other publicly funded health care programs created by counties across the country. […]

[T]he board received an expanded version of the task force’s work Tuesday — some 189 pages, including appendices and supporting materials — with several additional ideas that were not consensus items.

“There were a handful of us that wanted to make sure that we fleshed out to the board all of the things that we considered that had been given some level of agreement by some group of task force members,” said Alan Peura, a member of the task force and former member of the Board of Health and of the Helena City Commission.

Among those ideas that some of the task force supported: a “carrot and stick” approach to St. Peter’s Hospital. The hospital has certain legal obligations to the community related to its tax-exempt status, and the report urges the board to consider working toward a public hospital taxing district to expand services at the hospital and at the Community Health Center.

Such tax districts are permitted under Montana law, Peura noted. They’ve been established in Montana communities including Lincoln, which built its clinic (part of the county Cooperative Health Center) with the funds. Or, said Peura, the county could start looking at funding health care through a local income tax.

The expanded task force report also recommended creation of a new community-based health plan in the county. Dr. Robert W. Putsch III, a member of the task force, noted such plans with success in places like San Francisco and Denver, with co-ops providing primary care coverage for the otherwise uninsured. Starting in 2013, such plans can apply for $6 billion in federal funding under the Patient Protection and Affordable Care Act signed by President Obama last year, Peura said.

Another of the action items in the expanded report: Initiate a statewide referendum to recognize the human right to health care across Montana.

“What stating health care as a human right does, is it essentially challenges the current economic model of delivering health care in this country and in this community,” Peura said. “And that frankly is what is broken. It’s the business model of delivering health care as another market commodity, not as a public good and service, as a human right.”

The first phase of the task force’s report, released in October, noted a widespread community concern about access to care, especially primary care […].

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