A decade ago, the League of Women Voters of Maine (LWVME) adopted a position on health care supporting a single-payer system that achieved cost control through increased regulation and an emphasis on preventive care. Since then, neither our nation nor our state has made any significant progress toward health care reform.
Unfortunately, during those 10 years, businesses and individuals have watched health care costs spiral out of control and have struggled to pay double-digit increases in health insurance premiums. State and local taxes are being driven up by the increased costs of health care insurance for government employees. Many working people have lost their health insurance coverage, and many others are on the brink of losing their coverage.
For all but the wealthy, the loss of health insurance coverage can be disastrous. Because health care is expensive, those without coverage often delay medical treatment until their conditions are very serious. Then, they must seek care from the one provider that cannot refuse to treat them – the emergency room. However, preventive care and early intervention in a physician’s office are undoubtedly more effective and less costly than last-minute treatment in a hospital.
For these reasons, LWVME supports Dirigo Health, the health care reform package that Gov. John Baldacci unveiled on May 5. We believe Dirigo Health represents a bold step forward for the citizens of Maine in increasing access to health care and in controlling costs. Therefore, we urge the Legislature to act promptly to implement Dirigo Health.
Until such time as a minimum basic level of quality health care is available to all United States residents at an affordable level of cost, a statewide program can and should provide such health care to the residents of Maine. Dirigo Health moves us closer to a very important goal – that of universal access. It also embraces other key elements of the league’s position: affordability, cost controls and an emphasis on preventive care.
We find Dirigo Health to be a well-crafted package because it addresses the issues of access, affordability, cost containment and quality simultaneously. It provides access to coverage for businesses with fewer than 50 employees, the self-employed and individuals without employment-based coverage; sliding-scale premium subsidies for individuals and families with incomes below 300 percent of the federal poverty level; a comprehensive benefits package with a low deductible and reasonable out-of-pocket costs; and coverage of preventive care, including nutritional counseling, smoking cessation, wellness education and cardiac rehabilitation.
In addition, Dirigo Health contains some carefully considered cost containment measures. While it permits current Certificate of Need (CON) projects to go through the normal review process, it places a one-year moratorium on new CON projects. It also asks health care providers and health insurers to voluntarily limit their price and rate increases to 3 percent over the course of the next year. In the longer term, it requires biannual state health plans to address major cost drivers in the health care industry.
Finally, Dirigo Health establishes the Maine Quality Forum to coordinate data and quality initiatives. It is directed to collect and disseminate evidence-based research; provide consumers with useable information to compare provider performance; educate consumers to allow them to make informed decisions and adopt healthy lifestyles; and to perform technology assessments for use in the CON process and the State Health Plans.
There are some who argue that the governor’s proposal would adversely affect their economic interests, and this may be true. However, the economic interests of many others have been and will continue to be adversely impacted if we do not act now.
We hope that Maine’s health care industry will join the governor and the Legislature in taking this bold step toward the future.
There are others who argue that the governor’s proposal should be studied at greater length. We contend that health care reform has already been studied and studied again and that the time for action has finally arrived. Further delay would provide time for more of us to lose our health care coverage as its costs continue to spiral upward. It would increase the problem without contributing to its solution. Tens of thousands of Maine residents will benefit from the enactment of Dirigo Health. For the sake of the uninsured and underinsured in this state, we cannot withhold support for something this good while we wait for something better.
Ann M. Luther, of Trenton, is the president of the League of Women Voters of Maine. The League of Women Voters of Maine, a nonpartisan political organization, encourages the informed and active participation of citizens in government, works to increase understanding of major public policy issues and influences public policy through education and advocacy.
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