Voters in the Missouri general election will not be asked to endorse motherhood, the flag or apple pie, but they will face this question:

“Should Missouri law be amended to enable the elderly and Missourians with disabilities to continue living independently in their homes …”

And the question continues, should the state create “the Missouri Quality Homecare Council to ensure the availability of quality home care services under the Medicaid program by recruiting, training, and stabilizing the home care workforce?”

As helpful as all of that sounds, we recommend voters say “no” to Proposition B, known as the Missouri Home Care Initiative. This appears to be a plan that mixes a few good ideas with others that would duplicate existing services and increase health care costs for the state and private providers.

Supporters, including the Service Employees International Union, explain that the proposal would establish a statewide 11-member council to oversee in-home personal services for the elderly and disabled served by Medicaid. The council would recruit workers and run a registry of screened caregivers; create a backup system when workers are unavailable; offer training; and negotiate with workers over wages and benefits, if they choose to form a union.

Many in health care recognize that in-home services are less costly and far preferred to nursing home care. But the head of the Missouri Alliance for Home Care, the state’s largest trade association representing home health groups and private duty companies, is among those who question this ballot initiative.

“It appears the effort is mostly geared toward unionizing this work force,” Mary Schantz said. The Missouri Chamber of Commerce cautioned that the ballot issue “could greatly increase” health care costs.

These interested parties don’t dismiss the need for improved pay and benefits for in-home workers. But both see free-market forces, driven by consumer demand, driving those improvements over time while preserving consumer choice in that matter. That’s the approach we prefer as well.