The most thoughtful health care proposal to emerge this political season comes from Rep. John Baldacci, the Democratic candidate for governor. He has combined the essential principles of a compassionate coverage with an eye on the bottom line to keep the health plan affordable.

The proposal, which he describes as being based on the state’s workers’ compensation insurance model, would establish a nonprofit health insurer in Maine that would create affordable insurance choices. It would be backed with help from federal and current state support and include a health plan that uses the government’s purchasing power to negotiate with the public and private insurers to offer affordable insurance. The result is universal access, which reduces cost shifting, thereby covering everyone and stemming the growth in costs for everyone.

Money is the key issue in the health care debate, and this plan not only provides negotiating power to lower prices, it lowers costs by standardizing and simplifying bills and taking a long-term approach of providing encouragement for good health. As important, it would create a standard benefit package that could allow consumers to shop for and compare coverage much more easily.

Rep. Baldacci’s plan goes beyond insurance, however, addressing workforce shortages, quality of care and accountability and comprehensive coverage – including mental health and dental. How the plan works specifically remains to be seen; but the premise of the idea moves the debate beyond the question of whether the states or the federal government should act first in providing universal access. In a speech last winter, the congressman noted, “… there are those who say a state cannot solve the problem of the uninsured and underinsured, that we must wait for a national plan. I say that the states have led the way in all our major health reforms. Long before Congress took up these issues, the states reformed health insurance laws, the states sponsored children’s health plans, the states led the way on a patient’s bill of rights, and the states addressed the issue of prescription drug prices.”

The cost of care and lack of access are a burden on health, but Maine spends $5 billion a year on health care and has some of the highest insurance premiums around. That makes it also a burden on economic development, as employers know well. The state that lifts this burden most intelligently gains a huge advantage over all others. Rep. Baldacci has presented an excellent beginning to achieving this.