When Mainers return home from outside the state we are greeted by signs along the highway that say, “Welcome to Maine, the Way Life Should Be.”

By many measures this may be true, but for the 254,000 Mainers who went without health insurance at some point in 2001-2002 life here has not been the way it should be. Reports of factory and mill closings, the higher rate of unemployment, the unraveling individual and small group insurance market in Maine, and the weakening U.S. economy occur with disturbing frequency and can only serve to expand the pool of uninsured Maine residents.

Also troubling is the fact that Medicare covers only half of the total health care expenditures for seniors and disabled individuals who are enrolled. Medicare does not cover prescription drugs, routine office visits or the first $840 of a hospital stay. More than one in three Maine seniors with Medicare lives with income below 200 percent of poverty, or $1,497 a month for an individual. The cost of adequate supplemental coverage is beyond the reach of many people with Medicare.

Nothing positive can be said about large numbers of people living without health insurance. People without coverage get sicker and are more likely to die sooner than others. In a study spanning nearly two decades, adults who lacked health insurance at the outset had a 25 percent greater chance of dying than did those who had health insurance. In another study of more than 28,000 patients, those without insurance were more likely to be diagnosed with skin, colorectal, breast and prostate cancers at a later, more dangerous stage than those with insurance. All of these cancers can be detected earlier through regular screening. Uninsured women with breast cancer are 49 percent more likely to die from the disease than privately insured women.

The cost of providing care for uninsured individuals is higher than for those with insurance because they tend to have more frequent emergency room visits and longer hospitalizations than others. This is due to the fact that more than 4 in 10 of our neighbors without health insurance postponed seeking medical care, one-quarter of them could not afford the prescription drugs necessary to manage an illness, and yet another quarter did not get the medical care they needed at all.

When these bills are unpaid – health care costs are the second highest reason for personal bankruptcy in this country – the costs are then passed to other patients using the facilities. This results in higher overall health care costs among those with coverage. As costs increase, more individuals and employers drop coverage, thus increasing the ranks of the uninsured.

To reverse this trend, it is incumbent upon all of us to become informed citizens with regard to health care services. Through its MaineCare program, the state of Maine provides free or low-cost coverage to working families, seniors, people with disabilities and other individuals who meet program guidelines. Many uninsured Mainers do not recognize that they are eligible for MaineCare.

This week trained staff at most of Maine’s community health centers and hospitals are welcoming community members to their facilities, explaining MaineCare and helping with the application process for those likely to be eligible. In addition to reducing the number of uninsured people and its effect of lowering overall health care expenditures, increasing MaineCare enrollment to full capacity will bring more federal dollars to the state – every state dollar spent for MaineCare services is matched by $2 or sometimes $3 of federal funds.

Beyond maximizing MaineCare enrollment, it is essential for all citizens to become informed and take part in the health care debate. We need to recognize that a person’s access to quality health care depends greatly on having full health insurance coverage. We need to recognize that restricting health care access for 254,000 of our neighbors, co-workers and family members is unjust and simply wrong. And we need to press our legislators and policy-makers to solve this problem in a swift, fair and permanent manner.

It is ironic that travelers entering Maine are informed by highway signs that life in Maine is “the way life should be,” when in reality life is now shorter and more complicated than it needs to be. This can change.

Kevin Lewis is the executive director of Maine Primary Care Association.