To boldly go

As a primer for some of the problems with the delivery of health care in Maine, the draft report from the governor’s Blue Ribbon Commission on Health Care does an adequate job of describing what experts have been talking about for the better part of a decade. As a way to help Maine out of its current health care morass, it will have to become a lot more specific to take the state much of anywhere.

“Be bold,” urged Gov. King at a commission workshop this week. “Be the kid who said the emperor has no clothes.” The draft is anything but bold. It relies on well-established ideas for saving money, particularly through administrative efficiencies, involving patients in their own health care both through co-pays and by encouraging healthier lifestyle choices. And it reaffirms such ideas as subsidizing insurance for children and for the very poor and creating purchasing pools. Not a bad idea in the bunch, but nothing new either.

For bold, the governor would have to go back to 1995 and a previous group, the Maine Health Care Reform Commission. That panel, which was instructed specifically to develop various coverage models, was bold enough to say that every Mainer ought to have health care coverage and it offered ways of providing it. Unfortunately, while it presented several alternatives, it priced only one, a standard package that was too expensive for the state. Parts of the ’95 group’s ideas have been adopted by the state – expanding Medicaid, using money from the tobacco industry to fund programs for children, incorporating preventive care, education and wellness – and many others are mentioned in the current commission’s draft.

But if this latest group breaks little ground, at least it tells the state that five fairly well-informed non-health care experts could look at the difficult problem of access vs. rising costs and land in the same areas of reform as others before them. Unfortunately, that also means that they will run into many of the same obstacles that previous groups have encountered and may conclude, finally, that the problem rests largely with the federal government.

The blue ribbon commission has until November to grow bold. It has time to make strong proposals that could become legislation early next year and be more fully debated by lawmakers. Given that health care coverage rises out of reach for more Maine residents each year, reform is no place for the timid.