November 08, 2024
Column

Single-payer health care not best plan for Maine

Anyone trumpeting the merits of government-run or single-payer health care should look no farther than Maine’s recent descent into chaos over payment for Medicaid, or MaineCare services. Recent news accounts over critical mistakes made while managing Medicaid claims should give Mainers real pause over the way Maine government is run.

Imagine yourself as a health care provider who has agreed to include treatment for low-income and elderly patients as part of your practice. Maine state government reimburses you for the care you provide, only one day they stop paying you. That day happened more than a year and a half ago, and still has not been adequately fixed.

Recent estimates point to some time in 2007 before the system will be fully functional.

Your government-run single payer put in a new claims management software in January 2005 that didn’t work. No one properly tested the new software to see if it would run properly, or ensured it was compatible with the needs of MaineCare providers. The switch was flipped on the new software, and the whole system promptly came crashing down. Doctors and nursing homes just didn’t get paid.

That is unacceptable.

How long could you work without pay? Are government bureaucrats the people we want to run our precious health care system? Promises were made about getting the system fixed by March 2005; deadlines came and went without relief. Millions of extra taxpayer dollars were spent on additional consultants and auditors to try and straighten out this mess.

What ails our state’s Department of Health and Human Services is part and parcel of what ails Maine, and one need look no farther than to the governor’s office to find where that mismanagement begins. The failures to correct the problems and weaknesses in accountability and internal controls are indeed weaknesses, problems and failures of one-party rule in Augusta .

Even today providers are getting a number of their claims rejected, paying off loans they needed to take out to stay afloat due to lack of reimbursement, or paying precious dollars to extra staff to audit their dealings with the state government because our friends in the Bureau of Medical Services cannot reconcile their temporary payments with actual claims.

If low reimbursement was reason enough for doctors to stop accepting Medicaid patients, certainly this catastrophe and a bumbled government response to their initial error would convince even the most well-intentioned physician to take a pass on accepting more MaineCare patients.

If state government cannot adequately administer a federally subsidized health care program for the poor and elderly, why would so many in our great state want to jump on the bandwagon of single-payer health care?

Single-payer health care will not stop the double-the-inflation-rate yearly increases in health care spending in our state or country. There are more effective solutions which hopefully will appear as bills in our next Legislature. In the meantime, let’s learn from history and not repeat the same mistakes in our quest for health care reform.

The problems facing DHHS and the MaineCare program are an embarrassment to our state, and were entirely avoidable. Strengthening MaineCare, not weakening it by allowing it to rapidly and unsustainably expand, while following through on the important commitment of paying hospitals and health care providers in this state, would go a long way in helping cure what ails the health care system in Maine.

Gov. John Baldacci and his one-party government had a chance to do better. Maine deserves, and can do better.

Bob Walker, M.D., is a candidate for the House of Representatives in District 44, comprised of the communities of Appleton, Hope, Islesboro, Liberty, Lincolnville, Morrill and Searsmont.


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