Achieving Dirigo health care goals

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Obviously, the “Dirigo health program is in serious trouble…” and “Baldacci’s desire for Dirigo to be his legacy will make it hard for him to admit the program is broken and commit himself to fixing it.”

– Lewiston Sun Journal, “Fix it or nix it,” Feb. 1

Even early supporters like Sen. Peter Mills and Rep. Richard Woodbury, a Harvard-trained economist, are actively engaged in designing improvements for the failing and discredited Dirigo initiatives.

We’ve all experienced the Baldacci administration’s inept mismanagement of the MaineCare billing system; read their inaccurate and patently false press releases; tried to figure out the convoluted Savings Offset Plan; and been angered by the shroud of secrecy over the operations of DirigoChoice.

When we look outside of Maine, we see that any Mainer can find a better and less expensive health insurance by shopping for one over the Internet.

Any Mainer can visit New Hampshire and see why their “high-risk pool” works, and understand why health insurance costs nearly 30 percent less.

Any Mainer can visit Vermont and learn how their “health savings accounts” are so wildly successful. But because all of these reforms are now prohibited or greatly discouraged by Dirigo, you can’t get to Dirigo’s goals “from here”; so our costs of health care continue to skyrocket.

Our reforms will achieve Dirigo’s goals of reducing the cost of health care and expanding coverage for less money.

. Health savings accounts

The Christian Science Monitor recently proclaimed, “HSAs are not all bad. They can help give patients a greater sense of responsibility and control over their health and health care…” A new study (Health Affairs, December 2005) found that “widespread national adoption of individual HSA plans is possible” and [they]”are a viable alternative to existing plans [like P.P.O.’s].”

They also determined that the new Bush administration proposals, besides creating ‘health wealth’ for young Maine families and workers; would also “reduce the number of uninsured” including “reach[ing] the low-income uninsured.”

So for the price of a DirigoChoice policy a worker can get a lot more -health insurance, a growing pot of money to spend on a wide array of health care options not covered by Dirigo, and have some change left over to spend on their family.

We find it unconscionable that the present Democratic administration in Augusta would deny healthy Mainers and their employers’ these obvious benefits in the name of partisan politics!

. Repeal the Dirigo “tax” – the savings offset payment.

We agree with Sen. Mills that this method of paying for DirigoChoice is “flawed, controversial, fraught with uncertainty and, ultimately, counterproductive” since it places the burden of financing he program on those employers and people who struggle to afford their own health insurance.

Now Maine is being sued by insurance companies over the SOP tax dollars diverted into what is probably a losing defense against the testimony of health care finance experts who will prove the claim of $43 million is an illusion.

Not only should financing come from the general fund, but it must be coupled with a firm Legislative mandate on who DirigoChoice will serve; which small businesses will receive this benefit as a subsidy; and that all operations will be fully ‘transparent’ and open to immediate public scrutiny.

. Create a “high-risk” pool by passing Rep. Josh Tardy’s bill, LD 1945.

Federal funds are now available to subsidize those people whose expensive health care is beyond the reach of current health insurance plans.

Just like every other form of insurance, some people pose such a high risk of exhausting the benefits that they are denied conventional insurance. Mainers prefer to have car insurance rates kept low by allowing insurers to screen out bad drivers.

Not only have they worked in 34 states to produce far lower premiums; but some states like New York and Iowa, have tapped tobacco settlement funds to pay for the unusually high medical bills of small business employees. This has the worthy advantage of retaining Maine’s best workers as productive employees.

. Reform the lucrative malpractice industry.

Even Democratic “think tanks” like the Progressive Policy Institute acknowledge in “Third Way Medical Malpractice Reform”(Health Policy wire, vol. 4, no. 4) that aggressive malpractice lawsuits force doctors to practice defensive medicine and drive up the price of their malpractice insurance into the hundreds of thousands of dollars. They recommend reforms like ‘health courts’ and capping awards.

We join hands with them in a bipartisan approach and think it only fair, that if hospitals have to live under “caps” and a 2 percent profit margin; why shouldn’t trial lawyers?

. Adopt interstate insurance regulations

We believe Mainers now have the power through our internet connections to shop for the best insurance policy and health care services; if only the Dirigo “nannies” and their backers in the State House would roll-back regulations. Mainers are not competitive with other states in the area of health and this hurts us in many ways.

Even worse, Maine has become a “Medicaid magnet” attracting people from other countries and out of state because of lack of safeguards on eligibility and guarantees of coverage for even the most expensive operations and care. Just one family can run up a bill of more than a million dollars under the present system.

Once the barriers are torn down and people experience the power of a fully competitive marketplace, we can design a reasonable set of subsidies, co-pays, health care vouchers, and thresholds for low-income and high-risk population groups that are less expensive and more effective then the current Dirigo initiatives.

Frank J. Heller, MPA is from Brunswick. Rep. Ken Lindell, R.-Frankfort, represents District 41.