One measure of success for the Baldacci administration’s new health care plan is how well it accepts alternative proposals from interest groups while remaining steadfast in its core principles of lower costs, universal access and improved quality. The administration should be receptive to ideas from the groups – insurers, hospitals, patient advocates, doctors, employers – most affected because they have some legitimate concerns and because their help will be needed as various issues arise. But the governor’s primary message cannot be diluted: Health care costs in Maine are driving people into bankruptcy, crippling businesses and forcing too many to go without care, and the status quo must not continue.

The reason for the governor’s plan to overhaul health care in Maine is obvious to any business owner trying to pay health care bills. It is equally obvious to employees who contribute more and more to their premiums, to the uninsured who have few choices for care, to seniors who cannot afford medication or to the self-employed who see a third of their incomes going to pay for insurance. But for the numerical-minded, consider that Maine ranks 5th among states for health care expenditures as a percent of gross state product, spending $5 billion a year on care. Maine ranks 11th per capita in overall health-care spending, and where the federal government’s Hospital Cost Index rose 3.3 percent nationally in 2002, in Maine it rose 10.2 percent for that year. From 1990-2002, 60 percent of new payroll jobs were in health care, and as Trish Riley, director of the Office of Health Policy and Finance, commented last week, “health care is not an export business – it’s provided here and paid here from Maine citizens and businesses.”

Maine leads the nation in the growth of health care spending; where inpatient numbers dropped nationally last year, they rose here. Maine residents use health care a lot more than the national average, and while it is true the state has an older than average population to account for some of this, it does not nearly explain it all. For years, health-care experts have talked of coming crisis, in which businesses could not hire more employees, where entrepreneurs would not leave the health coverage of their current jobs to create new businesses, where the insured would pay exorbitantly to help cover the cost of the uninsured and still fall short. The day has arrived.

The day has arrived, and it is not the least surprising that the people who have grown rich off health care are now leading the charge against the governor’s plan, Dirigo Health. Already they are using scare tactics by telling health-care employees they’ll be fired if the plan is passed or telling the teacher’s union it will face a tax on its premiums. Besides being a stretch of the truth, this is precisely the wrong way to have this debate. Certainly there are tradeoffs with the governor’s plan and certainly it does not cover all issues that contribute to higher health care costs. But Maine has had enough threats over health-care reform; what it has lacked is solutions.

It was refreshing last week to hear calm and reason from Anthem, Maine’s major insurer, which supports much of the governor’s plan, but wants a broader base from which to collect the funding for the uninsured – a fair observation – and is worried about the amount of bureaucracy that could be created under the plan, also fair. It has made suggestions for improvements informally; it should pursue them in more detail with the administration.

Dirigo Health is the best shot Maine has at comprehensive reform. No health-care entity is going to like all of it, and Gov. Baldacci should be receptive to these concerns. But he faces the very real threat that so many interests will combine to weaken his plan to the point of meaninglessness. That can’t be allowed to happen.