Topeka ? Members of the state’s new Health Policy Authority were at loggerheads Tuesday over principles as basic as all Kansans having access to health care and the role of employer-based health insurance.

“Take out the word ‘insurance,’ it’s a red herring,” said authority member E.J. “Ned” Holland Jr., who’s also vice president of compensation, benefits and labor relations at Embarq, a subsidiary of Sprint Corp.

“We can’t be all things to all people,” said authority member Joe Tilghman, a retired regional administrator at Centers for Medicare and Medicaid Services.

Authority members spent much of the afternoon stating and defending their views on health and health care. They are expected to vote on a set of guiding principles next month.

“I thought the discussion was both robust and welcomed,” said authority executive director Marcia Nielsen.

Lawmakers have given the Health Policy Authority until Jan. 1, 2007, to come up with a plan for putting healthy living on an equal footing with health care.

On July 1, the nine-member authority assumed oversight of most of the state’s Medicaid programs – payments to doctors, hospitals and pharmacies, mostly – and its insurance programs for state employees and uninsured children.

Combined, the three programs cover almost 400,000 Kansans and $2.4 billion in spending.

Much of the sparring, Nielsen said, was tied to confusion over which principles were “big picture” and which would actually be used in setting state policy.

“That was my fault,” Nielsen said. “There’s a difference between the ideal and policy. I should have done more to distinguish the two.”

As proposed, “Principles for Promoting Health in Kansas” included:

¢ Every Kansan should have access to patient-centered health services ensuring the right care at the right time and at the right place.

¢ The health delivery system in Kansas should focus on quality safety and efficiency and be based on best practices and evidence-based medicine.

¢ The financing of health care in Kansas should be equitable, seamless and sustainable for consumers, business and government.

¢ Kansans should pursue a healthy lifestyle with a focus on wellness, physical fitness and nutrition, as well as through the informed use of health services over their life course.

The discussion offered a glimpse of the upcoming debate over how best to craft policy.

Holland, for example, bristled at the notion of using incentives to coax doctors into taking on Medicaid-funded patients. He compared the concept to an airline charging travelers extra for assurances their plane wouldn’t crash.

“It’s wrong to incentivize providers to do the right thing,” he said, adding that too many hospitals and doctors are focused on “building buildings” rather than on patient care.

Authority member Susan Page, chief executive officer at Pratt Regional Medical Center, disagreed.

“There may be a proliferation of building going on in the big cities, but that’s not the case in the rural areas,” she said. “Many (rural hospitals) are not in the black.”

Holland agreed that he may have overstated his position.

Historically, Kansas’s Medicaid rates have been less than a doctor’s or hospital’s costs.

Nielsen is expected to rewrite the proposed principles to address concerns raised by the authority.

“I’d say the August meeting is going to be a big one,” she said.