Dangerous
scramble to
pass reform
There are some really good concepts in Gov. Baldacci’s Dirigo Health Plan.
There are also some really destructive ideas.
It’s tough to discern the difference, though, in the rush to get this thing passed.
The governor deserves credit for holding true to his campaign promise to reform health care, but his zeal to zip hurry-up legislation through does nothing to honor that pledge.
The governor presented LD 1611 publicly May 5. He is pushing for approval within the next two weeks. That’s too fast for adequate scrutiny and this “pass it now, fix it later” sentiment in Augusta is just plain wrong.
Does Maine need health care reform? Absolutely. But absolutely not at any cost.
The increased reporting mechanisms worked into the plan are valuable tools for patients and we certainly do need a state health plan. However, the legislation is crafted on a wish and a prayer and we need greater structure than that.
There are so many concerns raised by so many stakeholders that Maine’s only choice is to table the legislation, get commitments from several hospitals, insurance companies, businesses and private physicians – in writing if necessary – to model the plan over the summer and return to Augusta in the fall in a special session devoted to health care reform. That would ensure serious scrutiny in what is supposed to be a thoughtful process.
The major and most obvious obstacle is how to pay for the plan.
Revenue will spring from voluntary membership in Dirigo Health, an industry insurance-paid tax on premiums and greater leverage of federal funds that Maine will attempt to keep hush-hush.
If the governor’s predicted membership rates hold, there would be enough to cover 180,000 presently uninsured Mainers. But, if businesses even sniff a less expensive insurance option they may halt their own insurance plans and flood the market with thousands more uninsured workers. The governor’s office has waved off that concern, saying it believes employers will do the right thing and maintain coverage.
There may not be a beltway around Augusta, but that is beltway thinking. In the real world, businesses are not going to continue offering high-priced insurance to employees if there’s a cheaper way to go. They’re in business to make money. And, the belief that small businesses not currently offering health care to their employees will eagerly line up to sign on to Dirigo is wishful thinking in the current economy when they’re eking out a living as it is.
Finally, to think that the U.S. Department of Health and Human Services isn’t going to instantly notice that Maine is billing for higher refunds is just ridiculous. The sneak attack may also endanger whatever goodwill we have to cajole Secretary Tommy Thompson into supporting Maine Rx.
So, the basic revenue structure is overly optimistic.
More importantly, though, is the very concept that government should take over the enormous responsibility of dispensing health care. This is the same government now struggling with a massive deficit, missing funds in the Department of Human Services, false claims for payment of services in the Department of Education and myriad other indiscretions.
While we may have dozens of studies on the state of health care in Maine proving that something must be done, we have nothing proving Dirigo Health is the solution. Without realistic models it is exceptionally likely that what we end up with will be far worse than what we now have.
jmeyer@sunjournal.com
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