MaineCare: There’s plenty of outrage to go around

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.

rrhoades@sunjournal.com

The opinions expressed in this column reflect the views of the ownership and the editorial board.

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Comments

Jonathan Albrecht's picture

Rates

Premium rates at our company increased about 23% this year. The year before and the year before that about 19%. Health care costs increased about 6% per year. The Republicans in the legislature passed a bill last year, LD 1333, which would allow insurers to radically increase rates. So does any of this surprise anyone. Average workers have not seen a raise in 5 years and in some cases premiums more than double in the last 5 years.
1. I would like to see a public detailed justification for insurance company premium increases.
2. As those increases make carrying insurance prohibitive for average workers, I would like to see Medicare expanded to included an income as well as age qualification. You get in if your income is less than x amount OR you are over a certain age.
3. Eliminate the immediate problem by restoring the Governor's tax bailout of the rich.
4. I would like to see any Medicare provider who defrauds the State/Federal program be mandatorily jailed on conviction.

 's picture

you first have to have people

you first have to have people charges, and in the case of our current Speaker of the House, his republican buddies decided to reward him with his position, instead of jailing him for his fraud.

FRANK EARLEY's picture

Medicare works

I'm on Medicare. I pay 148.00 right off the top of my benefits every month . I also am responsible for 20% of any treatment I receive. I have a medical issue so it can get expensive for me.
I feel educating folks on how to take what you get and make it work. Its not easy and really takes planning as well as education on how to shop for groceries. Ramon noodles and macaroni and cheese are not the answer.
I know everyone's going to say "ya easier said than done". Believe me it can be done and its not easy. I wish the state would consider this as an option, as apposed to just giving out money and saying, go have fun.

Steve  Dosh's picture

MaineCare: There’s plenty of outrage to go around

Rex, 12.02.26 5 pm
You've pretty much hit the nail right on the head ?
Health and education are similar to a lot of us ; you can never have too much
Now B4 y'all start getting your dander up , experience high blood pressure symptoms or experience an aneurysm , think of it this way - if you call 9.11 you really want to be helped , correct ?
Before you can blink an eye the Fire , EMS and Police services are at your front door . Thank goodness
Freedom ain't free . One must actually - pay - for these services
" Oh ! " one might be want to say , " We do not want to actually pay to be patched up . We want to live free and die !"
That's always an alterative ; New Hampshire
In this case you really can have your cake and eat it , too , curmudgeons . Call it ObamaCare , RomneyCare , MaineCare - whatever you like - you will not be turned away for lack of funds ( at least in Maine anyway ) . Canada , too
You'd be surprised what percentage of work that a doctor ( or lawyer ) does for ƒree , i . e ., pro bono - volunteer like - out of the goodness of her or his heart .
Happy Lenten Season /s, Steve Dosh

DONALD FERLAND's picture

So instead of taking people

So instead of taking people off MaineCare because they work at jobs that do not offer health insurance or the insurance is too expensive for them, why not offer them reduced rates and have them pay for their MaineCare.....then we get people covered by insurance, manage their health care plans, and keep people healthy. It also would bring in a revenue to DHHS...not everyone uses MaineCare abusively and I am sure there would be some coverage paid for and not used.

MICHAEL LEBLANC's picture

Open your eyes a little wider.

Clearly, not only poor but low-income families have been increasingly less able to afford health care insurance without an employer who helps.

Mr. Rhoades, I am upper-middle income, 63, self-employed, and a no-frills Anthem policy for my wife and me is $2400 / month. Instead we have "catastrophic" insurance for an "affordable" $700 / month, and hope for the best.

My premium is that high to make up the deficit caused by government mandate to provide "free" insurance to those poor or low-income families you care so deeply about. So far I have managed not to join their ranks. Under ObamaCare I won't have a choice because it makes everything more expensive and removes the few options remaining.

But my worries will soon be over. In two years I can climb on the Medicare wagon. Right? And if Medicare goes belly-up, ObamaCare will pick up the slack. Right?

As long as government is picking winners and losers, costs increase, options decrease, there will be ever more of the poor and low-income, and fewer of those who pay the tab. If you submit this script to Hollywood, they would reject it as too unbelievable.

Steve  Dosh's picture

Mike , Sunday night ". .

Mike , Sunday night
". . ....there will be ever more of the poor and low-income, and fewer of those who pay the tab . "
Probably not
The US population has gone from ? 215 million to 300 million over the past 25 years , most of them productive workers . Employers help ? Medicare ( and Social Security ) will not go belly up . Join http://www.aarp.org , it's a worthwhile organization that protects our rights
Happy Oscar night :) /s, Steve

RONALD RIML's picture

What is really unbelievable...

What is really unbelievable is that you complain about expensive "Insurance' knowing all the time we merely need a 'Single Player Plan' as every other 1st World Industrialized Country does.

As long as folks settle on the Insurance Company 'Cost-Added Mob-Racket Model' as you do, Mike... you'll keep getting stuck. How's the view from your 'Petard?' ;)

PAUL ST JEAN's picture

"And we will all go down

"And we will all go down together", said Mr. Joel as he sang, "Goodnight Saigon".

CLAIRE GAMACHE's picture

That doesn't sound correct

Health insurance premiums paid from tax money for low income or poor citizens does not add to the cost of your insurance premiums because their care is paid for by premiums paid for by tax dollars. What is adding a huge amount to your health insurance premiums is the cost of the uninsured. They are hugely expensive because their care is not managed. They end up in the emergency room for stuff like earaches or sore throats or problems from unmanaged diabetes or they don't get health care at all until they have advanced cancer or heart disease or catastrophic accidents. All of this is unnecessarily expensive and the costs get passed on to hospitals and insurance companies. They in turn pass in on to you in your premium. It is worth noting that the recent cuts to DHHS will be adding 30,000 uninsured people in the State of Maine alone. Hospitals and insurance companies have already added up the costs and you can bet they will be passing it on.

Steve  Dosh's picture

. ...Claire , You've

. ...Claire ,
You've highlighted the value of preventative and prophylactic medicine + education very well
An once of prevention is worth a pound of cure
† y v m /s, Steve

JOANNE MOORE's picture

One payer health care for all.

Private health insurance takes about one third, 33 cents, off the top of every dollar spent. Wouldn't it make more sense to have a one payer system that only takes about 6 cents off every dollar spent? We have that system already set up, it's called Medicare.

But don't mandate it. Let people enroll if they wish, and let those who are opposed to government run programs continue to enrich the insurance companies (with their history of denying coverage) and Big Pharma.

MARK GRAVE's picture

In 2010, the U.S. spent about

In 2010, the U.S. spent about $523Billion on Medicare. In 2010 there was an estimated $60Billion in Medicare fraud. That equates to over 11% fraud, which is greater than 6% overhead that you claim. This is fraud alone before factoring in program administration. Moreover, the government’s reported administration cost does not include the cost forced on the provider for compliance.

Here is a short article from Forbes that sums it up:
http://www.forbes.com/sites/aroy/2011/06/30/the-myth-of-medicares-low-ad...

Your argument appears to have used worse case and best case numbers to make your point without deeper examination of the data. The disparity between 33% and 6% is so extreme is should serve as a red flag to skepticism.

MARK GRAVE's picture

All is well with oBcare - right?

Why all the outrage? Don’t we now have obamaCare – all is well isn’t it?

 's picture

I don't remember anyone

I don't remember anyone passing anything remotely called obamacare, so you are obviously mistaken, as usual

PAUL ST JEAN's picture

Sure you do. What do you

Sure you do. What do you think that bill that Pelosi said had to be passed before we could find out what was in it, was?

 's picture

I don't remember anything

I don't remember anything called 'obamacare', so it is a real bill, or is it your racist attempt to slur the monumental Affordable Care Act?

Joe Morin's picture

Fact:

Dan, Racism is the belief of an inherent genetic superiority of one race of people over another. A dislike of someone because they are "different" would make someone a biggot. To be prejudice would require you to prejudge people due to some stereotype you have of them. I know you like to throw around inflammatory terms but you can't determine your own definitions to words. Agreeing to definitions of words and then putting them in a dictionary is how we communicate as a society. With that said, the term "Obamacare" is not racist.
You on the other hand are hateful. I'll also throw in obnoxious.

Mike Lachance's picture

Feel free to take a bow Joe.

Feel free to take a bow Joe. Excellent.

PAUL ST JEAN's picture

Amen, Brother...well stated.

Amen, Brother...well stated.

PAUL ST JEAN's picture

It might be affordable for

It might be affordable for those of you who will get it for free, but for those of us who work and will have to pay for our portion plus the cost of providing it free for the free-loaders, it may prove out not to be affordable at all. One thing that is clear to those capable of clear thinking is that it will prove financially unsustainable for the government and will probably bankrupt us. But, that's o.k.; at least we will be keeping up with the rest of the industrialized nations.
Your racist comment? If you'd take the teflon out of your Kool-Ade, maybe something would stick once in a while. Somehow you found a way of inserting racism in my use of the term obamacare. How about proving that? (crickets, please).

MARK GRAVE's picture

There you go Dan crying

There you go Dan crying racist again, and again I’ll ask you to provide the facts that you draw on to this conclusion – well where are the facts Dan?

 's picture

your, and your clan's,

your, and your clan's, attempt to mislabel the Affordable Care Act IS racist. That you don't see that just demonstrates your lack of moral compass. Sorry.

MARK GRAVE's picture

Dan, I simply don’t know how

Dan,
I simply don’t know how to respond to your nonsensical comment, but I will say that simply because a law has the word “affordable” in the title does not necessarily make it,…, well, affordable. The law as it stands imposes many mandates that will cost those who already pay for their healthcare.

Fortunately (or unfortunately) we are living this history, and we’ll see where it ends up.

 's picture

then don't respond. You

then don't respond. You quibble about the term Affordable, but at least that's the name of the bill. YOU use the racist term 'obamacare' to show your contempt for the President of the United States. This may not be the best bill, BUT it is DEFINITELY much better than anything which republicans have EVER proposed, which, of course, is easy, since republican REFUSE to do anything to help Americans. So crawl back to your conclave, and leave us patriotic Americans alone as we try to make this a better country.

PAUL ST JEAN's picture

My 7 year old granddaughter

My 7 year old granddaughter could not have expressed it any more clearly.

MARK GRAVE's picture

Oh, so one cannot show

Oh, so one cannot show contempt for the President without being racist – how nonsensical. How does ObamaCare differ from terms like “Bush tax cuts” or “Reagonomics”? Perhaps it does not differ.

If a measure of one’s patriotism is to push this country further towards bankruptcy, then I guess I rather not be a patriot. Like I said, we are living history, so let’s see how this all unfolds.

If historical performance is any indicator of future performance, then this will be just another boondoggle, similar to SSN, Medicare, prescription drugs, etc, etc.

Lastly, there is one key takeaway you fail to notice in my opinions. I rarely denigrate a single political party, and I hold pretty much all of the politicians in Washington in contempt. Moreover, your attempt to call people bigot or racist in order to control the discussion through intimidation will not work with me, so you can put that tactic back in your pocket.

Now go seize the day instead of seizing someone’s labor through taxation.

PAUL ST JEAN's picture

I like your references to

I like your references to 'Bush tax cuts' and 'Reaganomics', Mark. The one that used to get me was "Bush lied, people died". What they never mentioned was "Johnson died, people died". There may be more proof to suggest that Johnson was actually lieing to us as opposed to Bush acting on false or inaccurate information.

MARK GRAVE's picture

"According to the CBO, he

"According to the CBO, he would leave behind costs of $837 billion during his successor’s first term alone. If his successor were to serve a second term, he or she would inherit a cool $2.0 trillion in Obamacare costs — about six times its costs during Obama’s own tenure. This legislation is a ticking time-bomb."

Much like any other Government program, such as Medicare and Social Security, oBamaCare will grow in size, complexity, and cost to the point of unaffordability.

 's picture

just as i thought, you cannot

just as i thought, you cannot answer my question, so you go off on a tangent with made up figures spiced with half truths. I don't need this crap today, go out and enjoy the day, it's nice and sunny.

Mike Lachance's picture

Patti, youd have a better

Patti, youd have a better chance of lighting a candle with an icecube than to expect your very reasonable request to be honored.

PAUL ST JEAN's picture

In the land of the blind, the

In the land of the blind, the one-eyed Jack is King.

MARK GRAVE's picture

Perhaps my spelling is off

Perhaps my spelling is off again – obummerCare – is that better?

 's picture

would you please supply the

would you please supply the bill number for 'obummercare?' I don't see it in the Congressional Record.

Bob Stone's picture

When a "Cut" is not a Cut

Rex... LePage's proposal seeks to bring spending, now out of control, into line with revenues, now declining rapidly in Maine. You need to understand that debits have to equal credits in state government financing. We cannot print money like Obama and the Congress can. The budget, by law, must be balanced in Maine. All of your hollow rhetoric about the uninsured wont get credits to equal (or exceed) debits.

It is easy to castigate LePage because a politician that wants to take free (as in "other people's) money away from any group is always going to be demonized. Pols that want to give other people's money to a group are going to heroes and heroines. It's human nature, like kids are to candy.

The reality is, Rex, that there are many thousands of Mainers who could have employer paid health insurance, where they have to kick in part of the cost, but chose not to. They would rather have the free Peggy Rotundo-Margaret Craven supplied brand. Why pay a monthly premium when you can get "Peggy Care" for nothing? The 65,000 that would have been "cut" from the Peggy Care rolls had an interesting average demographic...they were 41 years old, male and had no kids.

You have long championed the likes of Peggy and Margaret for leadership rolls in Augusta. You have championed the "Grand Experiment" of loading up our welfare rolls with thousands of "New Mainers." Well, the chickens are coming home to roost. The Grand Experiment is not working. It blew up in your face. High taxes and onerous regulation is not working. There are now 361,000 people getting free health care, and rising.

Lewiston and Auburn have the largest number of Maine's TANF recipients terming out after 5 years on "temporary" assistance. And yet millions and millions of state and federal aid have been poured into L-A since the "Great Society" came in to being and poverty is worse here than ever before. Why isn't it working? Why isn't the paper asking that question?

Taxpayers are leaving Maine in droves. Soon, there will be 400,000 on MaineCare and the Editorial Board will be wondering where the taxpayers went because you won't be able to hide it any longer. If the Democrats return to power this fall, we might as well turn out the lights because there will be no stopping the train to fiscal hell.

Steve  Dosh's picture

Bob ? . ." Taxpayers are

Bob ?
. ." Taxpayers are leaving Maine in droves. " How do you figure that ? My research shows that Maine's population has been ? one (1) million to 1,250,000 since about when the 1 9 0 0 ( nineteen hundred ) census was taken
Thisis also when children and pregnant women were still working in the Bates Mills of the greater L / A metropolitain area tending bobbins at night time by candlelight ( no OSHA or Unions )
The point is that nobody's moving in and nobody's moving out
And you think Maine is getting progressively poorer ?
The facts seem to indicate otherwise . Health is much better , too ?  http://factfinder2.census.gov
Alo'ha from Pahoa , HI , a state with a similar population , similar tax rate , yet the - best - longevity rate of any State in this blessed Union ( we live longer here :) /s, Steve

 's picture

Of course you failed to

Of course you failed to mention the REASON for the shortfall is that lepage and the republicans gave a massive tax cut to the wealthy during the last session. In fact that is the only reason, so using your logic, lepage and the republicans FAILED their duty to pass a balanced budget during the last session. So use all the indignation you want, this was a manufactured crisis, and hopefully the fall elections will bring sanity back to this state.

PAUL ST JEAN's picture

..."Meanwhile, nearly every

..."Meanwhile, nearly every industrialized nation in the world has figured out how to provide health care for all of their citizens."
True, but isn't it also true that most of them are going broke? The United States has a medical bankruptcy rate of 12%; Canada's is 15% and last I'd heard, they were one of those industrialized nations that had figured it out.

Randall Berry's picture

Thank you.

Thank you for looking beyond the rhetoric for a bit, though I must say your board seems more bipolar than bipartisan at times. This is a good editorial that connects the personal economics to health care. Too many Mainers continue to struggle at the lower levels of Maslow's Hierarchy of Needs. Securing food, housing, heat and safety are difficult even though people are working. The letters providing testimony are interesting. You might consider posting some of the testimony of the Chamber of Commerce and NFIB that they provide to committees on a regular basis to undermine the value of Maine's workforce. Decisions have been focused on reducing future costs and progress is undermined by the shortsighted efforts by our governor. Thank you again for this editorial.

AL PELLETIER's picture

No plans to fix anything.

Excellent editorial.
The two current front runners for the GOP presidential election are to busy thinking up one line zingers to belittle their opponents then coming up with solutions to THIS problem that would stand a chance of working.
If the GOP doesn't come up with a more believable candidate
they won't have a prayer in November, plus many of the "do nothing" Republican congress members will also be joining the ranks of the unemployed.

Betty Davies's picture

An accurate and informative editorial

Thank you.

 's picture

finally, sanity has returned

finally, sanity has returned to the SJ editorial department. Of course, you should have mentioned that this latest 'deficit' was created entirely by republicans, who enacted a massive tax giveaway to the wealthy. This same governor who claims we've run out of money, find money to take vacations to New Orleans, Florida and now Washington D.C., all on the state's dime. I hope that this new found SJ editorial sanity finds its way to the voting public this fall, so we can return to helping our neighbors, instead of the wealthy.

PAUL ST JEAN's picture

What is the financial

What is the financial threshold at which you consider someone to be 'wealthy'?

MARK GRAVE's picture

Paul, I’ve been there, I’ve

Paul,

I’ve been there, I’ve asked that, but I got no response either.

One thing that Dan must remember though is that he is too is wealthy in possessions and opportunity when we apply his criteria to global standards so why should we only charge Dan 2.76% in Federal income tax? How dare we allow the world’s rich to get by with paying so little in taxes?

Perhaps Dan will find his medicine a bit bitter to swallow.

PAUL ST JEAN's picture

Not bitter enough. 0O:-)

Not bitter enough. 0O:-)

MARK GRAVE's picture

I find it humorous how the

I find it humorous how the “tax the rich” crowd changes their tune when applying their standards to a global discussion on poverty. They get very uptight when the buck does not stop with them.

This is a simple litmus test to show they are perhaps just as greedy as they claim others are – or more so due to the hypocrisy of it all.

PAUL ST JEAN's picture

Same thing with the racist

Same thing with the racist and bigot name calling. Anyone who sees racism or bigotry in everything is themselves a racist and a bigot. It can be no other way, not to mention that it so dillutes the value of racism and bigotry that they become meaningless terms. I challenge Tron or anyone else to show me where the term 'obamacare' is racist. Does it make all of the alphabet networks racist? They use the term quite frequently. Or, perhaps in Tron's world, it all depends on whom is saying it.

MARK GRAVE's picture

I would not go as far as

I would not go as far as saying Dan is a racist or bigot.

My speculation is that he picked up this tactic watching some Democrats behave that way. The tactic is to defame the massenger and to dilute the argument as you point out.

PAUL ST JEAN's picture

You're being very kind. I'm

You're being very kind. I'm about ready to have him walk the plank. I agree with your assessment of the left wing tactic. They have a tendency, though, to call someone----(fill in the blanks), while they themselves engaging in the very same accusatory thing. By the way, your correct spelling of dilute did not go unnoticed. Thanks for not pointing out my misspell.

MARK GRAVE's picture

It is not respectful nor fair

It is not respectful nor fair to make those accusations without backing up one’s claim with sensible supporting evidence. All that we can do is to ask a writer to backup their claim when that occurs and challenge the nonsensical stuff.

PAUL ST JEAN's picture

Agreed, except that

Agreed, except that challenging the nonsensical is often like trying to reason with a schizophrenic.

MARK GRAVE's picture

I empathize.

I empathize.

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