Maine spends $7.7 billion a year on health care and is just sick about it. The cost of care is too high, too many people don’t even get care, the steep increase for health insurance (up 77 percent between 1998 and 2002 while incomes increased only 6 percent) is harmful to business and to employees. The Baldacci administration is in the midst of a campaign to focus attention on improving this dismal situation and is conducting a listening tour, as it is calling it. That’s a good idea, but it should be followed by a political resolve tour of the Legislature.

The listening tour is part of Dirigo Health and has turned up ideas for healthier school lunches, better preventative care and improved delivery. For instance, Linda Belfiore of Columbia Falls, representing the Washington Hancock Community Agency, said many people living in rural areas with addictions need better transportation to urban medical treatment. Barbara Peppey, director of the Healthy Peninsula Program from Blue Hill, spoke about the concern with childhood obesity and the cost of care long-term. And, preparing for the tour to head his way, Gary Keilty of Readfield has been trying to get the public’s attention about the phenomenon of insurers dropping coverage, despite guaranteed renewal in Maine, to raise profits.

A report from the Governor’s Office of Health Policy and Finance is presented as background for the tour meetings. It looks at statewide trends and breaks Maine into three regions: the southern border to about Lewiston, a central region that goes north to Waterville and west to Franklin and Somerset counties, and everywhere else north and east.

When combined, the three regions make Maine a fairly typical state, with similar rating to U.S. averages for health status, smoking trends, diabetes and obesity. And while there are some differences with the nation – you are more likely to die of cancer in Maine but less likely to die of heart disease – the interesting distinctions show up when the state regions are considered separately.

Some of this could be predicted: residents in northeastern and central Maine are older, poorer, report worse health than the south and are less likely to have health insurance. They are also more likely to smoke and less likely to exercise. The health statistics show these residents have higher rates of diabetes, chronic obstructive pulmonary disease, cancer, heart attacks and deaths from heart disease as well as death from stroke, suicide and domestic violence.

Maine is already a very small place to try health care reform; treating it on a regional level is even more difficult. But the regions expose the major challenges of rural care that suggest the kind of program Dirigo is attempting to provide.

The past year has been taken up with Dirigo detractors saying the health plan was a failure even as it attracted more than 8,000 people to sign up, with more on a waiting list. It isn’t perfect – who expected it to be? – but it does target the kinds of problems coming up in the listening tour.

Legislators will note that more people are showing up to the tour meetings than attend the typical candidates’ night. Mainers care about this issue and they want lawmakers to cooperate to improve the cost and level of health care.

Rather than continue arguing, lawmakers would do better by showing bipartisan resolve for where they support and would modify Dirigo as it proceeds. That would demonstrate both that they understand the scope of the problem and are committed to acting on it. It would show they listened to the listening tour.