Tuesday, October 20, 2009

Healthcare in Maine

I just spent 5 days in central Maine. It was cold, cold, cold, so in between preparing the veggie garden for winter, and household chores, we mostly huddled around the woodstove and read: books, magazines and the Maine newspapers.

Maine, like most states, has some pretty severe economic problems. Besides losing a lot of its manufacturing and agricultural industry over the years, it has recent budget shortfalls due to the bad economy. Our friends and neighbors in the central part of the state are hard-working and generally pretty tough yankee types; however, they get the rhetoric while Wall Street is getting the bucks: in bailouts and now, new profits from speculation (check out Goldman-Sachs, e.g.). The same speculation that doesn't create anything except wealth for investment bankers. Well, "as Maine goes, so goes the nation" (as they used to say pre-Roosevelt).

Maine is also one of the three states -- the others are Vermont and Massachusetts -- which have tried some version of healthcare reform. Unfortunately, Maine's has been largely a failure, though probably better than nothing since it has increased the number of families covered somewhat. But, it never had an "individual mandate" -- i.e. an enforced requirement that everyone have healthcare -- and it never could take strong enough action to rein in costs. One of the reasons for the latter is that there is very little competition among providers. More than 3/4 of Mainers with health plans get them through Anthem Blue Cross Blue Shield (ABCBS); another 10% are signed up with Aetna. There is no effective public option. Now ABCBS is not a terrible provider as for-profit providers go. It, along with 7 other "Blue Cross Blue Shield" providers, is a subsidiary of a giant corporation called WellPoint, which issues stock (selling in the mid $40s). ABCBS itself doesn't issue stock, but invests its profits to increase its revenue. However, in the past half-dozen years both its premiums and profits have soared, while its customer base has remained roughly constant. Partially, the increase in medical costs have contributed to the increase in premiums, but the increase in profits were a result of greed. Both WellPoint and ABCBS pay the usual overly-generous corporate compensation to their executives, and the parent company also supports a host of bribers ... I mean lobbyists, in Washington.

Maine's healthcare reform does allow a commission to review provider premium rates. This year the state, to its credit, decided not to allow an ABCBS requested rate increase of 18.5%. The company claimed it needed this to insure (!) profits of at least 3% -- at a time when Maine families were being kicked in the face by the dismal economy. Don't you love that? Mainers facing unemployment, increases in heating costs, and draconian state budget cuts, are being asked to guarantee profits. Anyway, ABCBS's big daddy WellPoint is suing Maine to preserve its proposed premium increase.

Senator Olympia Snowe is, of course, well aware of what's going on, which is why she is so involved with national healthcare reform. She is a decent person, but is bearing the terrible burden of being a member of one of the world's most reactionary political parties. I'm not sure why she remains a Republican. However, she has displayed more guts on this issue than either the President or most members of what passes for a Democratic "party." I believe that in her heart she favors "the public option" -- as does a solid majority of people throughout the U.S. I wonder when the Democrats will get the message.

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