Dear Santa,

First, many thanks for the four- barrel potato gun – in my work I can use all the fire power I can get. What I really wanted to tell you, however, is what Maine needs for Christmas next year, that being health insurance for a lot of people who are going to lose theirs in the next 12 months unless you and some helpers get involved.

As you know, the economy has lost a bit of its steam of late, and businesses in Maine are likely to feel some of that pinch. At the same time those businesses have been hammered with big increases in the cost of the health insurance they buy for their workers, increases which have averaged about 20 percent. Next year will probably see similar increases.

A business I know of in my hometown is facing a $400,000 increase in the cost of health insurance for its workers this year. That has got to hurt more than a big keister going down a small chimney.

A slowing economy is going to cause Maine businesses to cut costs such as health insurance faster than you can say “Give Dad power tools for Christmas,” especially in the businesses whose workers can least afford health insurance on their own. Some businesses will have to choose between insurance for their workers and survival for the business. The year 2001 is likely to see thousands of Mainers lose their health care insurance.

In order to avoid this disaster, Maine needs a low-cost, bare-bones health insurance option for workers on the low end of the wage scale. The option must be one that Maine businesses can help buy for their workers without going off the economic deep end. It must be put together in such a way that every health insurance company doing business in Maine can and must offer it at a reasonable cost.

I know of some elves here in Maine who should help. This can only happen if the forces of Maine business, health insurance, health care, and government work together. If they do not, they should all get coal in their stockings for years to come.

The main elf you need is a guy in Augusta named King; I think his first name is Governor. Without him as the pit boss and winsome cheerleader, nothing is going to get done. He’s bright, knows business, does not have to worry about re-election, and is more popular than egg nog and indoor toilets. The preservation of health care insurance for Maine’s working class needs to be his Christmas present to us.

Maine’s Legislature has lots of elected elves just waiting for work. Their boss elf is a guy named Mike Saxl, who says health care is his first priority. They will need to make some changes in Maine law to allow all of this to happen, and must make it a special project on a fast track because people are already losing coverage. Maybe you could go up there, sit them on your knee, and tell them to get moving.

There are some other elves who could perhaps be helpful. Joe Baldacci and Chellie Pingree, for example, both have brains, energy, and big interests in health care. Both could then list successful participation on their resumes, should they be looking for work in Maine in a couple of years.

If Mainers want this present they are going to have to be very, very good this year. They can do so by accepting greater responsibility for their own health, a responsibility that will have to be expressed in the low-cost insurance plan. That plan should include negative and positive incentives for fitness, weight control, low cholesterol, kicking cigarettes, seat-belt use and other health habits. We cannot afford the luxury of insulating people from the health insurance costs of their bad habits any more, in this insurance option or any other.

All of this may cost a bit to pull together, I am sure, but I think there is a $100 million Christmas fund in Augusta that was established from the sale of ‘Our Own’ Blue Cross to those Anthem folks and might be available for this purpose.

In order to get this job done you and your Maine elves are going to need to make it your highest priority for the next six months. The low-cost insurance product needs to be ready for you to deliver no later than Christmas of 2001. No other solution for the rising costs of health care insurance will be in place soon enough to prevent a widespread shedding of insurance for Maine workers by Maine businesses in the new year. Perhaps some companies will hang on to current insurance policies for a while longer if they see help on the Christmas horizon.

So there it is, Santa, my Christmas wish list for next year. Even a new table saw in my stocking could not compete.

Erik Steele, D.O. is the administrator for emergency services at Eastern Maine Medical Center and is on the staff for emergency department coverage at six hospitals in the Bangor Daily News coverage area.