When the federal building in Oklahoma City was bombed the blame was instantly placed at the feet of Middle Eastern terrorists. There is a parallel with Maine’s health care crisis.

A congressional candidate says it’s the drug companies. Our public policy wonks say it’s private health insurers. Doctors say it’s the hospital administrators. Right wing conspirators have inside information that it’s Hillary. It all compares to the current anthrax investigation. Everyone is looking for a villain. And, as with anthrax, it is imperative that we think and search in new and often counterintuitive ways.

Brush away the static and there are some interesting anomalies in the Maine health care scene. Consider, Maine spends a smaller proportion of its health care dollar on hospitals and drugs than do other states. Consider, Maine already has a single payer healthcare insurer. It’s called Anthem Blue Cross and Blue Shield. Consider that a federal employee can choose between hundreds of insurers while Maine state employees and teachers have no choice at all, it’s Anthem or nothing.

Consider that Maine spends $6 billion on health care each year of which 25 percent or $1.5 billion is spent on administrative/regulatory costs and, if only one-tenth of this regulatory expense could be eliminated the savings would exceed the revenue from the state’s corporate income tax. Consider the Byzantine maze of certification and licensing barriers to practice created by dozens of health professions under the guise of patient protection but arguably more often to create oligopolies with inherent undermining of competition and productivity.

Ask yourself if the certificate of need is more effective as a tool of existing health providers for keeping new competitors out than it is as a tool of state agencies for directing health care investments and eliminating excess capacity. And, since we all know that hospitals, for example, must provide charity services yet are not allowed full Medicaid reimbursement, is not that $150 million annual short fall a major cause for everyone else’s health insurance premiums going through the roof.

In all these counterintuitive examples the underlying villains are monopolistic practices, constraints on entry and trade. Our nationalized health, public-single-payer policy advocates suggest that socialized health and rationing is the blessed solution yet it seems that such a strategy could simply reinforce the very trends that are causing our current problems.

There is, of course, an alternative. Simply allow state employees and teachers and their families to go into the health care market, and the private health care market would blossom for them, small business and individuals alike. Sunset licensing and certification of health professions and create a new approach which assures relevant standards and allows health professions to move freely throughout the health arena based on demonstrated competence. Eliminate the certificate of need and similar state-sponsored anti-competitive barriers to entry. These and similar steps would improve service, promote productivity and innovation, while advancing quality at lower cost.

As we observe the battles among doctors, nurses, administrators, insurers, and regulators, one might get the impression we are simply shuffling the deck chairs on the health care Titanic. Perhaps, instead, we might consider replacing the heavy hand of government and monopolists with the free market’s invisible hand.

William Beardsley is president of Husson College and served on

the Governor’s Blue Ribbon Commission on Health.