Maine doctors talk universal health care Physicians support quasi-public insurer

ROCKPORT – The largest association of Maine doctors moved closer to formally endorsing a form of universal health care at its annual meeting Friday.

Maine Medical Association members who attended a “House of Delegates” meeting discussed the merits of a resolution endorsing the creation of a quasi-public insurer that would be mandated to cover every uninsured person left in the state. MMA officials said the measure was likely to pass muster sometime this weekend.

The measure noted that one in five nonelderly Mainers lack health insurance, one out of 16 Maine children have no health coverage, and less than half of Maine businesses offer health insurance to their employees.

“We’re the pre-eminent medical society in the state and we haven’t come out with a position [on universal health care],” said Dr. Jacob Gerritsen, chairman of MMA’s public health committee. A formal statement should be issued he said.

More than 155 doctors registered for the meeting held at the Samoset Resort in Rockport, and the health insurance coverage resolution was just one of many issues doctors are considering.

The insurance resolution would give MMA executives formal authority in advocating for an expansion of the current patchwork of insurance plans. The issue is expected to be a major topic next Legislative session when a commission studying the feasibility of a single-payer health insurance system is due to report back to lawmakers. A single-payer system would replace the patchwork of government and private plans with a single insurance system to cover everyone.

MMA’s resolution clearly does not advocate a single-payer system.

Instead, it envisions a mandate that would have a “quasi-public” insurer cover all those in Maine who are not covered by other insurances currently. Individuals would pay for the “default coverage” on a sliding scale.

There are few details in the plan and that’s by design, explained Gerritsen as he introduced the topic Friday.

During debate, several doctors spoke of the need to cover individuals who have no minimum level of care available. Dr. Arvind Patel, noted that he sees university students and recent graduates who’ve yet to get a job who are totally without any coverage. He said what the MMA wants is at least a minimum coverage for all.

Dr. Robert Steinhacker, however, said he has reservations about the proposed resolution. He said he doesn’t understand how full participation of everyone in an insurance pool [the default coverage] could save money. He also said that expanding Medicaid and Medicare services in Maine at a time of a state budget shortfall was problematic.

The tone of the resolution also bothered him. “It also sounds like a call to arms,” he complained.

MMA leaders said they anticipated the resolution would likely pass later during the weekend.

MMA took up a variety of other resolutions on Friday that also will be decided later in the annual meeting. One of the more controversial would state MMA’s opposition to hospitals’ denial of credentials to doctors on economic grounds, because the doctors may make referrals to other competing hospitals or take patients there. The proposal states that professional competency and qualifications should determine who get credentials.

MMA developed the proposal after the recent debate generated when Lewiston’s Central Maine Medical Center tried to deny credentials to some physicians who hadn’t sworn off referring cardiac patients to the competing Maine Medical Center in Portland.

During discussion Friday, doctors who spoke were intent on a provision against so called “economic credentialing,” but there were disagreements over the wording of portions of the proposal.

Other resolutions discussed would:

. Advocate for new safety-education programs to stem rising injuries from the misuse of ATVs.

. Develop new guidelines for MMA to develop training for future medical staff leaders of Maine’s hospitals in view of “trends [that] may be compromising the ability of medical staffs to be independent advocates for patients, including the hiring of physicians by hospitals.”

. Establish standard protocols related to access to genetic services for patients.

. Make recommendations on combating the growing problem of childhood obesity.