I’ve been a single-payer advocate and fighter for affordable health care for over a decade. When I was in the State Senate in 1992 Rep. Charlene Rydell and I developed a modified single payer plan that would cover all Mainers. The fight for affordable health care was important then as now because health care costs were increasing faster than anyone – families, companies, individuals or governments – could afford. Vermont passed a single-payer plan, but ran into the roadblock of ERISA, the law that governs employee benefits, and became overwhelmed with how difficult it was to proceed without triggering federal laws that took precedence and prevented state action. President Clinton created a plan that ran into opposition from the insurance industry and the Republican majority in Congress.

In the early 90’s Maine spent $3.2 billion on health care. That’s everything: insurance premiums, co-pays, and out-of-pocket that individuals and businesses pay and expenditures by Medicare, Medicaid, and state government. Today we spend $5 billion. It’s almost doubled in 10 years. Maine can’t wait any longer. That’s why Chellie Pingree fought so hard in the Maine Legislature to pass the Maine Rx program that will lower our prescription drug costs.

And that’s why I’m glad that quality affordable health care is a major issue in the gubernatorial race. It’s good that a single-payer system is being proposed. I believe that eventually, a modified single-payer system is where the United States will end up. But it will take years for our elected representatives in Washington to eliminate all the federal roadblocks that prevent us from integrating all the money we spend on separate programs like Medicare and Medicaid into one seamless health care system for everyone. There are reasons for each law and there are powerful constituencies whose concerns must be dealt with. ERISA was passed in 1974 to remedy fraud and mismanagement in private employer pension plans.

So, what to do? Many people believe that a single-payer system is the only way to provide health care that’s affordable to everyone. But it isn’t. There are other ways to expand coverage and control costs. We can do it now. We don’t need permission from the feds. And let’s not kid ourselves; there is no way Maine will get the waivers out of the pro-business Bush administration that a single payer plan needs.

John Baldacci’s health plan is the most exciting piece of health care reform to come along in a long while. It gives us instant relief from sky rocketing prices and puts in place a structure that can be expanded and added to until we cover everyone.

Baldacci’s will use government’s buying power to achieve volume discounts, and create a new, government sponsored non-profit insurance company.

Here’s how it will work: The Maine Plan will be a buyers club for health care services. It will be made up of public sector purchasers at first, but anyone – businesses, individuals or groups – can join. The Maine Health Plan will be able to lower costs to its members by using our buying power and the government’s ability to negotiate with insurers. Any insurance company can put in a bid to cover us and they all will want to because we are such a large part of the market.

Baldacci’s health plan also creates a government sponsored non-profit health insurance company that will offer a low cost, streamlined health insurance product. Here Baldacci is building on the success of another homegrown solution to a problem that has been vexing our state for years – workers comp. This new health insurance company will do for health care what MEMIC (Maine Employers Mutual Insurance Company) did for workers comp – lower overhead and therefore lower costs. Other insurers will have to follow suit if they want to compete.

The $5 billion we are spending on health care is enough to cover everyone in Maine. We just need to spend it more effectively. Our present non-system doesn’t take advantage of efficiencies like bulk purchasing. We are a small state of 1.2 million people. We should join together: businesses, consumers and providers to create a system that works. The Maine Health Plan is a huge step toward universal coverage and controlling costs. And we can do this now. We don’t have to wait for permission from Washington.

There are many ways to achieve universal access, and I think John Baldacci’s approach is the one for Maine today.

Dale McCormick is Maine’s state treasurer.