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Maine Group Calls for Single-Payer Health System
01/09/2014   Reported By: Patty B. Wight

According to some health advocates in Maine, there is a serious illness in the state: the health care system itself. The group Maine AllCare says a single payer health system is the cure, and today, the Bureau of Insurance and Financial Services considered a bill that would establish such a system in Maine by 2017. But as Patty Wight reports, opponents say government should concentrate limited resources on providing health care for those who truly can't afford it.

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Julie Pease, Charlie Priest, Philip Caper

Julie Pease, Rep. Charlie Priest and Dr. Philip Caper at a news conference today to promote a single-payer health care system in Maine.

Why push for health reform in a system in the midst of change under the Affordable Care Act? Dr. Philip Caper says after 45 years of practice in medicine and health policy, he already knows the answer:

"That incremental reform doesn't work," he says, "because incremental reform doesn't deal with what we physicians call the underlying pathology of the health care system."

The Affordable Care Act, says Caper, merely treats symptoms of a sick health system, not the root cause: handling health care like a business instead of a right.

"I think it's safe to say that it has not controlled costs - we now spend twice what the average of all other western and industrialized countries spend," Caper says. "It has not improved access. We have more people uninsured, and a larger percentage of our people uninsured, than any other wealthy country in the world, and the performance of our heath care system is not very good."

A single-payer system, on the other hand, says Democratic Rep. Charlie Priest, is far simpler and more efficient. Priest is sponsor of the bill, which would provide health care through a single entity - the state.

"Which will cover everybody," he says, "which will provide benefits for everybody, which will provide one set of rules for coverage so everyone will know what's covered and what's not, which will be much more affordable than the system we have now."

It would be more affordable, proponents contend, because health care would not be based on profit, and it would eliminate the administrative overhead of the current system. Just how would the system be paid for? The t-word. Taxes. But Democratic Sen. Geoff Gratwick, who is a practicing physician, says taxes will replace premiums.

"We're already paying for it," Gratwick says. "And that's the major point, is that we're paying for it. So we're paying for it through our private insurance. Through other ways, we fund this."

The vast majority of those who attended the public hearing testified in favor of the bill. Dan Bernier of the Maine Insurance Agents Association says he agrees with proponents that health care is a right. But he says just because it's a right, doesn't mean everyone should cover the costs.

"I'm here to ask you not to provide free health insurance for lawyers, lobbyists, and insurance company executives, but rather to concentrate your limited resources on the poor, the elderly, and the disabled."

Another representative for the insurance industry, Sara Vanderwood, who testified on behalf on Harvard Pilgrim Health Care, says single-payer does not have consumers' best interests at heart.

"A competitive market of licensed carriers helps to create an incentive for innovation in the delivery of health care coverage, and limiting that selection of consumers to a single payer option would eliminate choice," she says.

But proponents point to other industrialized countries who use a single-payer system, or similar models, and have better health outcomes. This bill in Maine would use current health reform as a tool. In 2017, states are allowed to eliminate the mandates of the Affordable Care Act if they establish a program that provides at least the same level of benefits without additional cost.

But whether Maine meets that deadline or not, Sen. Geoff Gratwick says he's sure a single-payer system is in Maine's future. "This is going to happen whether we get it now, two years from now, 10 years from now," he says. "It's inevitable because our current system is broken."

One other state is already starting a path: Vermont is currently establishing a single-payer system, with a goal to fully implement by 2017.

Photo: Patty Wight


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