During the past two months, there has been considerable media activity to discredit a new insurance product that will soon be available to this community and others around the state. I am referring to the recently approved Anthem Guided Access products for individuals and small groups, which will be offered for coverage beginning next year on the new MaineHealth insurance exchange, or marketplace. These products will also be available to individuals in small groups outside of the exchange.
Whether one agrees with the president’s Affordable Care Act or not, the intent is to create access and affordable insurance options for consumers. These new products, which were creatively designed by Anthem, meet that goal. Anthem is one of two carriers that will be offering products on the new exchange, and one of four carriers that will be offering products outside of the exchange.
Sadly, media accounts, public officials, editorials and websites developed by institutions not included in the new network for these new products have provided inflammatory and one-sided views, designed to derail the process.
The fact is that no individual or small group will be required to take this product; there will be other individual and small group options available. Likewise no one covered by these plans in Central or Western Maine will have to drive to Portland to get their care, any more than they have in the past. St. Mary’s and hospitals in Farmington, Norway, Augusta and Brunswick are all in the new network and are able to respond to patient needs. In addition, patients requiring emergency care can go to the nearest hospital, regardless of whether it is in the network.
Unfortunately, those opposed to this initiative have made claims of collusion and greed; that this is a deal from Portland to eliminate competition, and further, that the plan is really to help make up for the Portland hospital’s (Maine Medical Center) financial woes. Those comments are intended to fuel fear and distract the conversation from the real issues of lower insurance costs, quality and strong local access.
The facts about this new product need to be shared so that the public can make its own informed decision about this and other products available.
Anthem Guided Access products are new offerings by an insurance carrier using a network of specific providers. Some forget that a similar product was offered in 1997 by Central Maine Partners that excluded St. Mary’s. Although we, too, were anxious at the time, we survived.
Another disturbing observation is the convenient opportunity to criticize all things Portland, and in this case Maine Medical Center, MaineHealth and Anthem. In the process we, as a community, demean ourselves.
St. Mary’s Health System has been a proud affiliate of MaineHealth for more than 10 years, and we work cooperatively with all the hospitals in our region.
As one who has worked in health care all over the state for the past 30 years, my experience has been that Maine Medical Center has offered support and collaboration to any hospital in the state that asks, which helps all the boats rise in terms of quality patient care and improved population health. It is the largest tertiary hospital in the state with the greatest breadth and depth of services. We are truly fortunate to have this resource available to the residents of Central Maine.
So, in short, I would encourage the public to attend the public comment session at Central Maine Community College at 5 p.m. on Thursday, Aug 29, to hear the facts, not fiction, from the superintendent of insurance.
The public needs to decide for itself what is best.
Lee Myles is president and CEO of the St. Mary’s Health System/St. Mary’s Regional Medical Center in Lewiston.
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