Gov. Baldacci’s health plan – time to step up

Some day soon a guy with scant hair but more testosterone than God gave stallions is going to stand up in the leaking ship of Maine’s health care system and lay claim to the title of captain. He is then going to suggest to the crew that they set sail with him on the course he has plotted to the land of universal health insurance coverage. Then he is going to ask who is with him.

The guy is Maine Gov. John Baldacci, and within days he will announce his plan to ensure that every Maine resident has health insurance of some kind. The crew – Maine’s hospitals, health insurance companies, physicians, nurses, legislators, etc. – should salute the new captain and say “Aye, aye, sir!” Then the big boys and girls of Maine’s health care politics – that crew – should agree to adapt, adopt, and implement Baldacci’s plan.

Why? Because if Baldacci’s effort fails, you can stick a fork in us, we are cooked and sunk. There will be no one else for years to come with the will and the clout to develop a successful alternative. He is the only guy standing up, his is the only plan, and they have to start somewhere on a job that Maine’s health care leaders have thus far failed to do themselves.

Almost a third of all Mainers under the age of 65 (and therefore not covered by Medicare) are without health insurance at some point in any given year, and 80 percent of those without health insurance have a job or are actively seeking one. That lack of insurance often means lack of adequate health care, unnecessary costs from untreated illness, and huge costs shifted to those with insurance. It means the people hauling lobsters or cutting wood for a living, who work long hours at dangerous jobs, cannot get adequate health care for themselves or their families. That is not “the way life should be,” and in the richest country on earth is a fact that stinks like bad bilge water.

More alarming, the cost of health insurance for Maine employers is rising so fast that in a few years most employers here will have to choose between providing health insurance for employers and remaining in business in Maine. The ship is taking on water fast and is not long for the surface.

The Baldacci plan will probably (it has not been made public yet) allow for different kinds of insurance; the governor is not dumb enough to stick his hand in the political propeller of a single-payer health insurance system. That would mean a state-run, taxpayer-funded health insurance program, and pitching private insurance companies such as Anthem and Aetna over the side sans life rafts. Rather, the plan will probably use Medicaid for the unemployed and working poor, Medicare for the elderly, and private insurance for those who want it. Traditional employer-based insurance will continue for those who can get it through their work, and there will be some state-supported option for those who work but whose employers do not offer health insurance. Everyone will have a guaranteed package of comprehensive health care benefits.

The Baldacci plan is also likely to call for multiple methods of controlling health care costs, because the issue of universal coverage cannot be solved without addressing the issue of unsustainable increases in the cost of that coverage.

In an ideal world, Capt. Baldacci should sit down and wait for the federal government to come up with a national plan for universal coverage.

Alas, Adm. Bush and his USS Congress crew are nowhere to be found on this issue. Maine’s health care ship will be a fish condo on the ocean bottom before Washington comes up with a workable plan. Maine and other states must sink or sail on their own.

If the governor’s health care plan has any merit it should put a few sharp barnacles on all of our hulls. There is no painless plan, and a perfect plan for any one member of the crew means forcing another member to walk the plank. A good plan, however, will provide collective gain that is greater than the collective pain. In response we can all mutiny at the governor’s plan because it is not perfect, thus sinking it (and us) in a sea of self-interest, or do the right thing by working together to make the plan as good as it can be.

Maine’s doctors, hospitals, health insurance companies, business leaders and lawmakers guide our health care destiny and must work collectively to avert a destiny of disaster. They owe it to Gov. Baldacci and the people of Maine to work with him on refinements to his plan, night and day if necessary, until they hammer out an agreement on universal insurance coverage. The day after it is released they should stand together in front of the news cameras and commit collectively to making it happen.

If Maine’s health care crew leaders refuse, and simply continue to set their individual sails in different directions, the ship is going only in one direction, that being down. Sinking us all in righteous disagreement is not a solution or a leadership act; working with the governor to make his plan the basis for success is.

Sail or sink together, Maine, and soon. The bow is buried in the wave.

Erik Steele, D.O. is a physician in Bangor, an administrator at Eastern Maine Medical Center, and is on the staff of several hospital emergency rooms in the region.