Voters in Portland, Maine were asked in November if they wanted government-run health care. Nearly 52 percent (7,024) cast ballots in support of the non-binding resolution, while 48 percent (6,494) rejected it.
Last year, Maine lawmakers had rejected a proposal to create a $3.4 billion single- payer health care system, agreeing instead to form a panel to study the issue. The panel is expected to report its findings by March 2002.
November’s vote, while not a strong endorsement of government-run health care, will likely influence talks about the single-payer proposal when lawmakers reconvene in January. House Speaker Michael Saxl (D-Portland) told fellow supporters of the proposal, “If we are unsuccessful here in Portland, that will send a gigantic message to the rest of the state.”
Greg Scandlen, senior fellow in health policy at the National Center for Policy Analysis (NCPA) and assistant editor of Health Care News, disagreed. “The legislature is not likely to take it as a ringing endorsement,” Scandlen said. “In fact, there is a fair amount of resentment of Portland by the rest of the state, and even if it had won big, it would probably not make a big difference.”
The Campaign for Universal Health Care—driven by the Labor Party (a five-year-old political party with chapters in 26 states), Maine People’s Alliance, Maine AFL-CIO, Portland Democratic Committee, Portland Independent Greens, and Consumers for Affordable Health Care—backs a single-payer system.
Its efforts are opposed by Citizens for Sensible Health Care Choices—a coalition funded by Anthem Blue Cross/Blue Shield of Maine and members of the Libertarian Party. The group rolled out three television advertisements on network and cable stations to defeat the ballot measure, calling it “a publicity stunt.”
Daryn Demeritt, a Pierce Atwood consultant hired to lead the anti-resolution campaign, told the Portland Press-Herald, “We know that this is just an attempt to get the camel’s nose under the tent to enact a single-payer system on a statewide level. This is a tremendous battle.”
The Campaign for Universal Health Care says a single-payer system would provide less-expensive health care by eliminating the middle-man expense of insurance companies. Citizens for Sensible Health Care Choices disagrees, noting government red tape, rationing of services, and under-funding would hamstring a single-payer system and cost patients in taxes, quality of care, and stress.
“A Collective Obligation”
Dr. Duncan Wright, a member of the Southern Maine Labor Party who helped initiate the signature drive for the resolution earlier this year, called the single-payer system “mutual aid in an industrialized society.” Wright told the Portland Press-Herald, “It’s a collective obligation we have as a society.”
“We each hold up a little part of the weight,” Wright said. Health care should be a right, he contends, much like the protection citizens get from police, firefighters, and the Coast Guard.
Under a single-payer system, patients need only present a government-issued identification card to see the doctor of their choice, Wright explained. They would no longer pay insurance premiums, but would see higher taxes. How much higher is a question taken up by the state Health Care System and Health Security Board, which will report on the tax implications and other feasibility issues in March.
Wright said a single-payer system would benefit employers and employees alike. The former would no longer have to worry about budgeting for employee insurance costs and could focus on offering more competitive products and services. The latter would benefit because they’d no longer have to worry about losing their insurance coverage if they switched jobs.
By providing preventive care to all patients, Wright said, a single-payer system would improve the general health of its patients and reduce the need for expensive emergency treatment. He contended life expectancy and infant mortality rates are better in many industrialized countries with single-payer systems than in the United States.
Government would run a more efficient health care system than private companies do, Wright claimed, by slashing administrative costs and getting rid of six-digit executive salaries.
Single-Payer a “Death Blow”
Mark Cenci, co-chair of Citizens for Sensible Health Care Choices, predicted a government-controlled system would deliver a “death blow” to the state’s economy.
If the state controlled health care, a monopoly would be created, bureaucracy would explode, and taxes would skyrocket. “People will leave, businesses will leave, doctors will leave. It will cause the whole apparatus (the state economy) to fall in the hole,” he warned.
Canada has had a single-payer system since the 1960s, Cenci pointed out. That system has resulted in long waiting lists for surgeries and other medical care—even prompting some Canadians to come to the United States for care they must pay for.
While Cenci agreed some Maine residents—particularly the self-employed—are priced out of the health insurance market by high premiums, a government takeover of the health care system is not the solution. Better options, he said, would include pairing medical savings accounts with high-deductible, low-cost catastrophic care insurance. The state should also consider giving up the “meddlesome mandates” that either drive up premium costs or drive out insurance companies.
“Distorted Picture” Likely
NCPA’s Scandlen expects the political discussion in Maine to tilt in favor of single-payer in the months ahead.
“The legislative committee is supposed to make recommendations by March 2002. That means there will be a lot of hearings and meetings between now and then. Most Mainers will be pretty busy just keeping warm during this time. That leaves open-field running for the political hacks and academics who are in love with state-run health care. They can easily fill a hearing room, and they tend to be pretty rabid. It provides a distorted picture of what is the view of regular people.”
After a decade of ever-increasing regulation, notes Scandlen, there isn’t much insurance market left to defend in Maine. “It is down to essentially one health insurer, which makes it easy to switch from a private monopoly to a public one.”
“People who support community rating and other regulations should understand they are just stepping down the slippery slope that will lead to nationalized health care,” warns Scandlen.
“It isn’t just health insurance, either. The proponents in Maine are very clear they want single-payer to replace the health components of worker’s compensation and auto insurance, as well. If they succeed, a death benefit will not be far behind, making life insurance either irrelevant or illegal.
“The purpose is, frankly, to abolish a private insurance industry in America.”