The debate over health care reform has been one of the most vitriolic in recent memory. Politicians have noted the U.S. spends twice as much on health care as any other industrialized nation and gets less comprehensive care for its money. Republicans have denounced more government control of health care, with some saying it could lead to socialism.
Maine Sen. Olympia Snowe is a member of the Senate Finance Committee and the “Gang of Six,” a bipartisan group of senators working toward a health care reform bill. Snowe is seen as one of the few Republican senators willing to work with Democrats on health care reform and has been heavily courted by the Obama administration.
On Sept. 16, Sen. Max Baucus, D-Mont., unveiled a bill aimed at pacifying both sides, but Democrats lamented the lack of a public option and Republicans said the bill still gave the government too much control.
In its original form, the bill would have increased eligibility for Medicaid and established an insurance exchange that would function like a co-op for health insurance.
Snowe has not endorsed Baucus’s package, but has said she remains committed to the idea of a bipartisan plan. In a statement, Snowe said “deliberations were prematurely concluded without agreement.” The finance committee started debate and revision of the bill Tuesday.
“The reality that crafting the right approach is arduous in no way obviates our responsibility to make it happen,” Snowe said in a press release. “Everyone has differing opinions on how to tackle this historic challenge. Yet, virtually every person I’ve encountered — throughout Maine and America — understands unequivocally, even if they have health insurance, that the current system is broken and that this is not a solution in search of a problem.”
During her Sept. 3 visit to the University of Maine, Health and Human Services Secretary Kathleen Sebelius commended Maine’s public health care system and announced a $42.5 million grant over five years to help expand health care for uninsured Mainers.
Trish Riley, director of the governor’s office of health, policy and finance, said Maine already follows most of the federal proposals laid out in health care reform packages, but it could use more money.
“The federal reform basically would revise insurance regulations to make it impossible for insurance companies to deny … coverage or to increase premiums based on your age or sickness,” Riley said.
The federal government wants to give a tax credit to families making less than three times the poverty level, which is about $66,000 for a family of four. These credits would be used to purchase health coverage.
“We already provide that in Maine on a limited basis through the Dirigo Health Plan,” Riley said. “It provides discounted health coverage for people at the same income levels. So much of what is proposed we already have. The difference is, we have a very limited capacity because of limited resources. … With federal money, more people would become eligible and the federal government would require people to have coverage. So there’d be an individual mandate.”
Riley also touted the state’s guaranteed issue law, which says insurance companies can’t turn away enrollees with pre-existing conditions.
Martin Sheehan, director of communications at The Maine Heritage Policy Center, said guaranteed issue is part of the problem.
“A Blue Cross plan with a $1,000 deductible, for a single guy, 30 years old … in Maine is 760 bucks a month,” Sheehan said. “In New Hampshire, across state lines, it’s $120.”
“The problem with [guaranteed issue] is that you can basically wait until you’re sick to buy insurance. Which is not the whole idea of insurance. … I like to use the example of, it’s like calling Allstate from the body shop and saying ‘Hey, I need collision insurance.’”
Sheehan said the current reforms proposed are “way too much. The health system does need to be reformed, but there are much better ways to do it than basically destroying the whole health care system and starting anew with government-issued [system]. What we would advocate is that plans be available for purchase across state lines.”
Sheehan said public plans are a bad idea because they do not require the efficiency of a private company. He cited the U.S. Postal Service as an example of an inefficient organization that, in the private sector, would not be able to compete with FedEx and UPS.
“If the public option loses money, so what? They have their hands in your pockets,” Sheehan said. “If the post office was a business it would have been gone a long time ago.”
Democratic 2nd District Rep. Mike Michaud “strongly supports health care reform,” said Michaud spokesperson Ed Gilman. “He supports a public option. The question that remains to be answered is what the final bill will look like that we’re asked to vote on. And the congressman wants to see a final bill before he makes his final decision, obviously, because he wants to see how that bill would affect the state of Maine and Mainers in general.”
“Right now the Baucus bill is still at the committee level. It’s an unfinished product that looks like it will change during their markup and potentially on the floor of the Senate through the amendment process,” Gilman said. “With regard to the house, the leadership has mentioned that we could potentially take up a bill within the next few weeks, but no final plan has been presented to the members of Congress.”
Federal law requires hospitals to treat any patients who need care, regardless of their ability to pay. Erik Steele, chief medical officer for Eastern Maine Healthcare System, said member hospitals charge patients on a sliding scale based on income.
“Federal law says if you take Medicare reimbursement … you have to take anyone who walks through the door. And you have to work out the ability to … provide free care,” Steele said.
EMHS, which is the parent organization for seven hospitals, including Eastern Maine Medical Center in Bangor, provided $32.5 million in free care last year, according to Steele.
EMHS doesn’t have a position on any proposed health care reform. Steele said EMHS supports the agenda of the American Hospital Association, which says, “Every individual must have and contribute to the cost of health care coverage.” Steele did say his organization supports expanded health care.
“Everybody should have health insurance,” Steele said. “I think, in our hospitals, in our organization, we would love to see that. We think it’s important for people’s health — people without health insurance often … end up sicker, because they don’t have the health care they need. We know that people without health insurance are more likely to die of serious illness. If you have cancer, and you have no health insurance, you’re less likely to get the treatments that you should, you’re more likely to die prematurely. If you have high blood pressure and no health insurance, you’re less likely to get well controlled, more likely to have a stroke. If you’re a child whose family has no health insurance you’re less likely to get all the vaccinations that you should.”