November 24, 2024
Editorial

A HEALTH CARE VOICE

One thousand Mainers are expected to meet tomorrow in a high-tech version of a town meeting to help decide the future course of health care in Maine. They will spend the day at 10-person tables – 30 to 35 tables at three different sites: Jeff’s Catering in Brewer, the Civic Center in Augusta and Southern Maine Community College in South Portland.

Their purpose of this “Tough Choices” project is to supply popular input for the drafting of a state health plan due this coming summer, as required by the new Dirigo Health Reform. They have been selected to provide a representative cross section of Maine’s population, with the same proportions of men and women, educational levels, income levels and the different parts of the state.

Discussions at each table will be led by a facilitator, from a group of 100 selected by the University of Maine and called in for training sessions this week. A “theme team” in Augusta will guide the whole daylong project, monitoring input from the laptop computers on all the tables and opinions expressed by individual participants by clicking electronic keypads. The central team in Augusta will suggest topics for discussion from time to time and prepare a brief preliminary report to be handed to each participant at the end of the day.

If gathering and processing all the opinions and conclusions expressed at all those 100 tables sounds like a huge challenge, the system has been invented and refined and conducted many times by America Speaks, a nonprofit organization founded and directed by Carolyn J. Lukensmeyer. She will be on hand Saturday to help guide the project. And if the whole operation sounds expensive, at about $300,000, the state of Maine is not paying for it. The money comes from private contributions by foundations, other nonprofit groups, and individuals.

A 28-page booklet of background material being distributed to the participants explains four strategies to be discussed: Make Maine Healthier, Reduce Costs, Increase Access to Coverage and Improve quality. The idea is to get citizens thinking on how these goals can work together and be accomplished. Sponsors emphasize deliberation and collaboration as preferable to partisanship and the usual adver-sarial approach.

In addition to the broad themes, the discussions may produce valuable insights into what this sample of Maine public opinion demands in the way of health services and what it may be willing to postpone or give up in the interests of economy and practicality. For example, the participants could deal with the question of how much to consolidate hospital services vs. the traditional decentralization that caters to community pride and doctors’ and patients’ convenience.

Overhanging the day’s discussions will be the troublesome fact that many employers are restricting or discontinuing health benefits because of the rising expense. As a result, many individuals who lack health insurance or can’t afford the high initial exemptions they accepted to keep the premiums lower simply go to the emergency room, at the ultimate expense of those who pay. Saturday should be an interesting, and we hope productive, day.


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