5 firms vie to study universal health care feasibility

AUGUSTA – Five companies are competing to conduct a feasibility study to determine the economic consequences if Maine created a single-payer universal health care system to cover all of its residents.

The companies have submitted bids for studies ranging in cost from $40,000 to $200,000. How much Maine’s commission studying single-payer options can spend on the work will hinge on the results of a grant request before the Maine Health Access Foundation. The application is expected to be acted upon in the next couple of weeks.

The Health Care System and Health Security Board has members representing the Legislature, employers, hospitals, doctors, nurses, state government and consumer groups. At a meeting Monday, members expressed pleasure over the quality of the submitted bids.

“It’s very rewarding that we’re able to get five proposals to take on this, frankly, first-in-the-nation work,” said Sen. John Martin, D-Eagle Lake, co-chairman of the board.

Created by the Legislature last year, the 19-member group is charged with developing “recommendations to provide health care coverage to all citizens of this state through a plan or plans that emphasize 24-hour coverage, quality, cost containment, choice of provider and access to comprehensive, preventative and long-term care.”

Given just $10,600 by the Legislature, the board has since received more than $34,000 in donations, including nearly $30,000 from the Maine State Nurses Association and its affiliates from other states.

The board was created in a compromise over a deadlock on single-payer legislation between the House and Senate in 2001.

The House had voted for a single-payer health plan sponsored by Rep. Paul Volenik, D-Brooklin. The Senate, however, in a close vote, turned back the proposal, which carried a $3.4 billion annual fiscal note.

Gov. Angus King suggested that supporting the bill would be like “jumping off the cliff without any idea what is at the bottom.” He supported the study.

That the bill even made it to the floor was an accomplishment. Volenik’s previous attempts didn’t make it out of committee. The success was hailed as a shift in thinking about the need to address the growing problems in health care.

With businesses being socked with double-digit health insurance premium increases year after year, single-payer, which means universal coverage provided largely by tax money, is being seriously scrutinized by many who once opposed the concept. The single-payer initiative, along with the state’s trail-blazing Maine Rx Program aimed at lower prescription drug prices, is being watched closely elsewhere in the country.

At the polls last year, Portland residents voted 52 percent to 48 percent to support the notion of a single-payer health plan. The measure won despite a $380,000 opposition campaign funded by Anthem Blue Cross and Blue Shield.

Opponents argue that putting the government in charge of health care insurance would raise taxes and reduce choice. They say that a Canadian-style system, for instance, could cause waiting lists for medical procedures and reduce access to some prescription drugs. Some argue that the single-payer idea could only be carried out properly by the federal government.

Proponents say a single-payer plan would eliminate duplicative administrative expenses and the profits that go to companies such as Anthem. The savings could be used to give the more than 160,000 Mainers who don’t have any insurance access to health care.

Volenik, who is the commission’s co-chairman, said federal, state and local taxes already cover about 55 percent of health expenditures in Maine. The other 45 percent is paid through insurance premiums and out-of-pocket payments.

Bidders on the study contract are: Solutions for Progress Inc., Philadelphia; Center for Health Affairs, Project Hope, Bethesda, Md.; Mathematica Policy Research Inc., Washington, D.C.; The Lewin Group Inc., Falls Church, Va.; and LECG LLC, Evanston, Ill.

The companies propose to use census data and information from Maine sources to measure the effect a single-payer system would have on the economy.

On Monday, board members decided they would individually review the proposals without comparing notes before the next meeting in July. At that time, the board will likely have a decision on its $200,000 grant request from the Maine Health Access Foundation, an organization created out of $82 million from the sale of nonprofit Maine Blue Cross Blue Shield to Anthem Insurance Cos. of Indiana.

“If we get the full $200,000, we’ll have some excellent choices here,” Volenik said.