Tuesday, August 19, 2008

Dirigo Threatened by So-Called People's Veto

At the Lincoln County Dems' Lobster Feast Sunday afternoon, I asked House Majority Leader Hannah Pingree what had happened to her bill that deftly solves many of the financing problems for Dirigo, Maine's beleaguered attempt to bring health care to all that state's citizens.
Dirigo is meant to help fill the abyss between MaineCare's straight-up poor and those who have private insurance. In 2005, according to the Urban Institute's study linked below, there were more than 124,000 uninsured in this state. Does anyone think that number has dropped? According to the 2,000 census posted at Maine.gov there were 1,274,923 people in the state. (These numbers seem screwy to me. Way more than 10 percent of the people I know have no health care coverage.)
Pingree explained that the legislature had passed her bill in April, but that a People's Veto of the bill would be on the November ballot.
People's Veto, my wooden clog-encased foot. It will not be the people paying for the zillion dollar campaign sure to confuse and misrepresent the issues. Those hefty advertising bills will be covered by insurance companies, small business organizations and their lobbies, though I suppose the people will eventually pay and pay dearly.
The leader's bill asks for taxes on soda, beer, wine and privately paid health insurance (including employer paid insurance) to fill the gaps between the whining Anthem's foot-dragging support for the program and the discounted premiums Dirigo offers. Though any increase in the cost of private insurance is a problem pill, and taxes on soda, beer and wine are hardly progressive, the options for this program are limited. The logic, if I understand correctly, is that the pool is so small right now that costs are prohibitive, and if the pool could really embrace ALL those who need it--count me as one of these--the program would be much closer to self supporting.
The Sun-Journal has a wishy washy editorial about the referendum written before the signatures for inclusion on the ballot had been finalized yesterday.
The complexity of Maine's health insurance picture is laid out in a recent study by the Urban Institute. There's no doubt that available funds are not being accessed by those who need them.
Beyond the magnitude of the estimates, perhaps the major point to take away from this report is that the presence of large numbers of uninsured people and their inevitable need to receive health care has resulted in a complex mosaic of government programs and private initiatives to defray the costs of that care. In the absence of large public hospitals or subsidies to offset the costs of care to uninsured Mainers (such as those often provided as Medicaid DSH payments), understanding how providers in Maine serve uninsured patients will require further study.
Committing to a single gap-filling program--still making three programs, MaineCare, Dirigo and private insurance--would go far to simplifying this picture.
We can bet that the insurance companies, the Chamber of Commerce, restaurant lobbies and all manner of business organizations will support this so-called People's Veto--an ironic euphemism disguising a corporate veto of the peoples' best interests.
In the far corner, the Maine People's Alliance is gearing up to push for universal health care when they might be bailing Dirigo's boat to keep it afloat. In the other corner, the corporate wave. As this tsunami washes over the state of Maine, I wonder if the people will pull together to beat the tide?

No comments: