When Gov. Paul LePage first proposed cutting $221 million from the state’s Medicaid rolls, he said we had been generous to a fault. We had, over the years, added benefits that we could no longer afford.
As the legislative debate heated up, along with the governor’s temper, the chief executive took a different tack.
“Maine Medicaid programs have grown at an unsustainable rate,” he said, “and spending is out of control. I ask you, where is the outrage?”
That question — where is the outrage? — seems to have resonated with many Mainers and has come to dominate the debate, leaving the idea that something or someone has done something outrageous.
You could say that Maine was generous over the past 15 years. Indeed, we aspired to be a state that cared for its poorest residents and, compared to many other states, we largely succeeded.
But, we were also smart. People cannot work if they are not healthy, impoverished parents often cannot work without child care help and elderly people sometimes need help with medications to stay out of the hospital.
What’s more, the federal government put two or three dollars into these programs for every dollar Maine contributed.
The logical thinking at the time was that medical problems were cheaper to treat in the early stages, rather than when they become an emergency room crisis.
Much has been made of the fact that MaineCare enrollment has nearly doubled since 1998.
But so has the cost of personal health insurance over that time, while family incomes have barely budged.
Clearly, not only poor but low-income families have been increasingly less able to afford health care insurance without an employer who helps.
Without state and federal help, what are their options? Well, there’s this one: Go without care.
That means going without the colonoscopy or pap smear that might save your life. An estimated 22,000 people die each year in the U.S. simply because they had no health insurance and sought treatment too late.
Or these people can go to an emergency room in a crisis and simply ignore the bills, becoming part of that institution’s uncompensated charity care. That, in truth, simply means those with health insurance eventually pick up those uncollected bills in higher rates.
There is, indeed, outrage to be had.
Where is the outrage that 40 to 50 million people in this country work but yet have no health insurance? Meanwhile, nearly every industrialized nation in the world has figured out how to provide health care for all of their citizens.
Where is the outrage for the fact that we spend 18 percent of our GDP on health care, while the next-highest industrialized country spends 11 percent?
It’s no wonder people need help paying for health care: It is two to three times more expensive here than in other similar nations.
Here’s another outrage: Why are no Republican candidates for the presidency debating this issue?
OK, repeal Obamacare. But what then? We are simply back to square one with an unsustainable health care system. What’s the plan for that?
Maine may indeed have to trim its sails and now seems destined to do so. But it should be with regret rather than outrage, and with the knowledge that no money has truly been saved and people will suffer.
For more on this issue:
To read the testimony of some of the people who will lose health care coverage in Maine, scroll below.
Or order and read this 2009 book, “The Healing of America” by T.R. Reid, from which many of the facts for this editorial have been drawn. It can be found on the shelves of both the Lewiston and Auburn libraries, or ordered at Amazon.com.
The opinions expressed in this column reflect the views of the ownership and the editorial board.