Universal access

Leave it to a mom who had a sick kid to come up with a serious health care plan for Maine. Pat LaMarche, the Green candidate for governor, has offered the sort of proposal Maine should have adopted years ago, before its thousands of citizens lost their insurance and costs for everyone else went up.

Actually, Ms. LaMarche wasn’t the first to draft a universal-access plan that would get people in to see doctors before their illnesses became crises and that would allow doctors to spend more time with patients and less with paperwork. Other nations — one just across the border — properly have seen health care as a right of citizenship for decades and, more recently, the Maine Health Care Reform Commission concluded in 1995 that, “Not only is access to health care essential to the quality of life for Maine citizens, it is only with universal coverage will we be able to understand and address cost-containment and quality assurance.”

Ms. LaMarche’s son John, now a healthy 11-year-old, suffered from a congenital precursor to malignant melanoma. She supported universal access before her son’s illness — through the strength of a politically active mother and a father who was chief of medicine at Eastern Maine Medical Center — but her fight with an insurance company must have removed any doubt about her commitment. The company decided that the surgery that would use pieces of the boy’s legs to reconstruct his back after surgery was merely cosmetic and initially refused to cover the cost of the operation. After a lot of fighting, the company came up with 80 percent, and Ms. LaMarche and her former husband spent years paying off the rest to a very patient surgeon.

If anything, the rise of health maintenance organizations has made insurance battles like this one more difficult for consumers in the intervening years. Health care in the extreme in Maine and across the nation is a contest between the sick and needy vs. accountants armed with lawyers. Guess who wins?

The sad part is that one of the biggest losers is business, or at least businesses that already provide part or all of employees’ health insurance. They pay too much for unnecessary health-related paperwork, too much to dispute workers’ comp cases, too much for the inevitable cost-shifting used to cover the uninsured.

Health care should not be a burden of business any more than public education is, but Ms. LaMarche has chosen a payroll deduction tax as a way to finance part of her plan. Businesses already paying for health care probably would save under it; those that do not pay — often large service-oriented corporations — would have to pay. The plan also depends on Medicaid and Medicare funding and federal and state dollars currently being used for health care.

The specific sources of funding, while important, should be subject to debate. What should not be is the ability of all Maine residents to receive high quality medical care. Pat LaMarche’s plan makes an excellent start with that idea at the forefront.