Health care reform prescription

It’s time for health care reform and Maine is ready. Too many people are joining the ranks of the uninsured or underinsured. In fact, an estimated 165,000 Maine people are without health insurance at all, and more than 10,500 policyholders have inadequate insurance with deductibles of $5,000 or more. In this extra cold winter, more people are making tough choices between buying heating fuel or paying for medical care and prescription drugs.

This health care crisis is reflected in our economy. Last year, more than 4,100 bankruptcies were filed in Maine. Research suggests that increasing health care costs, not reckless spending, play a major role in about half of personal bankruptcy filings. Just in the past two months, more than 10,000 Maine workers lost their jobs, most of whom will also lose their health insurance. Unemployment benefits don’t come close to covering basic needs and health care. And small business owners, employing nearly 50 percent of all Maine workers, find it increasingly difficult, if not impossible, to offer meaningful health insurance to employees.

With the state facing a large budget shortfall and the country’s economy in a shaky condition, is it really possible to move ahead and expand health care to more people? Senate Democrats say yes, and we are pleased that Gov. John Baldacci is working hand in hand with us to achieve this goal. The governor is committed to universal health care for Maine people, and we are working closely with him to maintain existing MaineCare health insurance and to move forward on several new initiatives. In fact, the Maine Legislature is considering more than 100 health care-related bills this session, intended to expand access, lower prescription drug costs and improve quality.

Tackling prescription drug costs. Nearly $700 million was spent on prescription drugs by Maine people in 2001. With annual increases in drug sales of 12 percent and average drug prices rising 4 percent a year, it’s obvious that prescription drugs will account for an ever-increasing share of the state’s shrinking budget and consumer checkbooks. With the Healthy Maine Prescriptions Program in limbo before a federal agency, jeopardizing prescriptions for more than 112,000 Mainers, and the Maine Rx program tied up in court, we can’t sit on our hands waiting for Congress and the president to act. Maine legislators are taking the lead in sponsoring several innovative initiatives to reduce costs and provide medications to more people.

Cutting out the middle man. I am sponsoring legislation to protect consumers from unfair prescription drug-pricing schemes. Right now, middle men called Pharmacy Benefit Managers (PBMs) are allowed to cut deals with drug companies which can significantly increase costs to consumers and to businesses paying for health insurance. My bill will require PBMs to follow ethical rules, disclose their activities and pass savings on to consumers. Rep. David Lemoine, D-Old Orchard Beach, is tackling this same problem from a different angle. Senate Democrats support Rep. Lemoine’s bill requiring the state to seek bids from a nonprofit PBM, thus eliminating the profit motive and creating some competition with current PBMs.

Taking advantage of reduced-price medications and eliminating waste. With a $1.2 billion budget deficit, we must employ every strategy we can to reduce costs in our state budget. With this in mind, I’ve introduced legislation to enable the state to tap into federal programs through the rural health clinics and hospitals, a proven strategy to obtain larger discounts. Sen. Michael Brennan, D-Cumberland, is sponsoring legislation to promote use of less expensive generic drugs when medically indicated. Other bills target wasteful advertising and marketing costs. In 2001 the largest drug companies spent twice as much (nearly $45 billion) on marketing and advertising than they did on research and development, so we know there’s room to eliminate waste. Senate Democrats support Rep. Tom Kane’s, D-Saco, legislation to require full disclosure by drug manufacturing companies of this spending. These initiatives, co-sponsored by Sen. Pam Hatch, D-Somerset, Sen. Chris Hall, D-Lincoln, Senate President Beverly Daggett and Sen. Neria Douglass, D-Androscoggin, show real promise in cutting costs sooner rather than later.

Getting health care to workers. Senate Democrats are committed to keeping health insurance costs down for small businesses through the new Small Business Health Insurance Plan. We are also working to help laid-off workers obtain affordable health insurance. Senate President Daggett is sponsoring legislation to provide health insurance to unemployed workers, an approach being piloted right now as Sen. Steve Stanley, D-Penobscot, works with the governor to provide coverage to Great Northern employees. Sen. Douglass is sponsoring legislation to expand health care coverage for Maine’s working disabled.

Protecting consumer choice and affordability. Finally, protecting consumer choice and access continues to be a major concern. I have legislation to require better oversight of private insurance carriers by requiring the state to investigate unfair benefit, rate and marketing practices and also to represent consumers at hearings on rate increases. President Daggett has legislation to prohibit credit scoring in determining eligibility for insurance, a practice that can deny coverage based on unrelated factors. And Sen. Lloyd Lafountain, D-York, has introduced legislation to study the feasibility and effectiveness of providing consumers with better information on health care quality.

We have developed an ambitious agenda and are determined to transform these proposals into policy. With the governor and much of the Legislature committed to universal access for Maine citizens, our goals are within reach. Maine people deserve our help as the gap between health needs and ability to pay grows. Whether it’s a laid-off Mainer with no insurance or an older Mainer who, with access to the right medicine, could still live at home, Maine people from Calais to Kittery are ready for reform. So are we.

Sharon Anglin Treat is Maine’s Senate majority leader.