Maine’s uninsured rate did not improve significantly between 2003 and 2006 despite a universal health care initiative passed in 2003, according to a report issued in late August by The Maine Heritage Policy Center.
In 2003, when the initiative passed, 126,000 people in Maine–11.8 percent of the state’s population–were uninsured, according to U.S. Census Bureau data. By 2006, the uninsured rate had fallen just one percentage point, to 10.8 percent, with 122,000 uninsured in a state whose population remained relatively unchanged over the period.
Narrow Focus
Tarren Bragdon, director of health reform initiatives and author of the new report, said the work is unique because it looks at the uninsured within a state, not across the nation.
“I think it’s important to understand these variations on the state level,” Bragdon said. “At the state level, it’s closer to the people.”
Bragdon said many people–for instance, the young, the healthy, and the single–don’t consider insurance a priority. Once a person gets married, he or she is about twice as likely to get insured, Bragdon noted.
Others can afford insurance, Bragdon said, but can’t find a plan to match their needs. Regulation aims to make insurance a higher priority for people, he noted, but “just because you tell people to do it doesn’t mean they’ll actually do it.”
‘Personal’ Insurance
“I was surprised how diverse the population really is and how much [the incidence of uninsurance] varies within different income categories,” Bragdon said, explaining states must strive to better understand the many reasons people go without insurance.
Perhaps the biggest problem, Bragdon said, is that insurance is already too “universal,” when in reality it needs to be more personal.
“Just like you want more than one brand of soap, you want [to choose from] more than one brand of health insurance plan,” Bragdon said.
The free market is the right environment to cultivate varied plans to match a diverse uninsured population, Bragdon said.
Greg Scandlen, president of Consumers for Health Care Choices, a health market advocacy group based in Maryland, said the report shows Maine’s current policies are not working.
“The uninsured are trying to tell us something,” Scandlen said. “Increasingly, we’re seeing they’re not low-income indigenous people. That’s an important signal we should not be ignoring.”
Dwindling Competition
Scandlen said state governments must encourage competition and innovation in health care. Instead, he said, Maine, like other states, is systematically and effectively decreasing competition by imposing cumbersome mandates on the health insurance market.
Politicians’ greatest concern is ensuring everyone gets the same treatment–even if it deprives some people of services they need, Scandlen said.
“There’s very much kind of an ideological priority put on leveling and doing the same for everybody,” Scandlen said, noting an emphasis on competition would help everyone find a plan that uniquely fit their needs.
Simple Difference
The problem, Scandlen said, may come down to the simple difference between politics and business.
For example, if a public policy survey shows fewer than 50 percent of people support a health care idea, politicians see it as a failure, but businessmen see it as an opportunity to target a particular market for a service, Scandlen said.
“Politicians come up with products that appeal to 50 plus one percent of the population and leave the minority out in the cold,” Scandlen noted.
Perhaps state residents can get the policy they want by advocating variety, Bragdon said, and he agrees variety can be achieved only in an open, competitive market.
Jillian Melchior ([email protected]) writes from Michigan.
For more information …
“Affordability, Accessibility or Priority?: Defining and Understanding Maine’s Uninsured,” by Tarren Bragdon, published on August 28, 2007 by The Maine Heritage Policy Center, is available through PolicyBot™, The Heartland Institute’s free online research database. Point your Web browser to http://www.policybot.org and search for document #22202.
