A bold health care approach

Maine AllCare is on a mission. About six years ago, a group of Mainers became the official Maine chapter of Physicians for a National Health Program, an organization representing some 20,000 physicians across the U.S.

The goal of the nonprofit Maine AllCare is no less than “achieving universal, high quality and affordable health care for the people of Maine.”

To Maine AllCare, that means devising a way for every Mainer to get health care without the risk of “financial ruin.” It means practitioners who are free from having “their clinical judgment second-guessed by insurance company bureaucrats.” It means “everybody in, nobody out.”

The board of Maine AllCare is diverse. There are five medical doctors and one osteopath. There are a nurse with a doctorate (Moira O’Neill of Surry) and a retired science professor, a realtor and an insurance broker, and four legislators, former and current.

There are four Maine AllCare chapters in the state; Hancock County’s is in Blue Hill ([email protected]).

For the health care providers, it could be the dream of a lifetime to create health care policy out of whole cloth, based on their education and experience rather than on politics. Well, not quite out of whole cloth. They do take for a starting point the Affordable Care Act and hope to devise improvements that will help meet their goals.

There is not a patient care provider in the country who could not recite a litany of war stories from the front lines of his profession. The paperwork. Wasted time and money. Cumbersome rules and regulations that deny patients the care their providers know they need. Yet every attempt to reform the system falls far short of the mark.

Some of this has to do with the fact that few policy makers have experience in direct health care. Their policy proposals may be well-intentioned, but they fail to meet the straight-face test with health care providers. Hence, the necessary engagement of the health care community in this work.

Then there are the powerful lobbyists from the insurance industry, the pharmaceutical industry, medical equipment suppliers and so many others who are making a fortune from each and every legislative advantage they can create, and would like to keep it that way.

The Affordable Care Act is undoubtedly not the legislation that its sponsoring president envisioned. It is the legislation that could pass, and did, replete with all the compromises with industry and members of Congress that afflict every major policy initiative.

There is some hope among reformers that the road to success, stymied at the national level, could happen state by state. To that end, Maine AllCare is supporting LD 1274, An Act to Promote Universal Health Care, Including Dental, Vision and Hearing Care.

Two Maine AllCare board members are bill co-sponsors: Sen. (and doctor) Geoff Gratwick (D-Bangor) and Sen. Troy Jackson (D-Aroostook County). Better known as the “Healthy Maine Act,” an entity would be established to finance and administer a health care program for all Mainers with a comprehensive list of required services.

There would be copayments for some services, but no deductibles. Beneficiaries would choose their own providers. The proposal would take effect in July of 2020. Maine AllCare has been working the grass roots, giving presentations on its proposal from one end of the state to the other to groups large and small.

This is big. It is nothing less than the chance to polish up our Dirigo chops and give the country a health care model that really is a step forward. No one is under the illusion that this bill will sail through, but the proposal has been fleshed out in sufficient detail that it can, and should, get deep attention from the Insurance and Financial Services Committee.

A few other states have entertained similar proposals. Financing is generally the obstacle. At this point, with the ACA having a bad case of the blind staggers and the only replacement proposal dead on arrival, the populace is nervous.

The ACA may have it flaws, but it did accomplish the goal of extending health care coverage to millions. So far, Republican proposals to “repeal and replace” have all involved a third R for “remove.” Their plans all contract coverage in one way or another, leaving some of the people previously covered by the ACA out in the dark again.

This is proving challenging for Republican members of Congress, especially in the House, who all will face re-election soon and do not relish the idea of showing up in their districts to face constituents who, thanks to them, just lost their health care.

House Republican nerves led to the embarrassing collapse of their health care proposal despite Republican control of the White House and both branches of Congress.

LD 1274 is a bill that will require extended study by the legislature. If the committee rises to the occasion, it could be the best piece of work the 128th Legislature produces. A dedicated committee with the staff resources to really dig into this could produce a magnum opus.

The public hearing on the bill is being held May 4 in Augusta. They are expecting a crowd.

Jill Goldthwait

Jill Goldthwait

Jill Goldthwait worked for 25 years as a registered nurse at Mount Desert Island Hospital. She has served as a Bar Harbor town councilor and as an independent state senator from Hancock County.

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