AUGUSTA — As Congress debates the merits of the Affordable Care Act and its potential successor, some lawmakers think the time is ripe to create a single-payer health care system in Maine.
“Here in Maine many people are struggling to get the care they need when and where they need it. Universal health care ideally includes everyone in an equitable fashion,” said Rep. Heidi Brooks, D-Lewiston, sponsor of a measure that calls on the state to adopt a single-payer system by 2020.
The controversial Healthy Maine Act would finance health care for most Mainers. However, many of the details about how it would work are left to figure out later.
“Our current health care system is inefficient, too expensive, and unfair,” Sen. Geoffrey Gratwick, D-Bangor, told colleagues. He said that “much of it is geared toward profit, not health” and is “destroying our business competitiveness.”
But many businesses are none too keen on shifting to a system they fear will wind up costing too much. They point to Vermont’s failed effort to adopt a single-payer system as evidence that it won’t work in Maine either.
David Clough, state director of the National Federation of Independent Businesses, said the legislators pushing for the measure “may be proven right someday about this vision for the future of health care.”
But, he said, it’s likely the state would find “that the costs are far beyond what taxpayers and the Maine economy could support.”
That’s what happened in Vermont, which pulled the plug in 2015 on its bid to create a new system that would provide nearly everyone in the state with coverage. Eyeing an 11.5 percent payroll tax hike and an increase in individual income taxes, the state gave up on the idea.
A single-payer system, which is used in many countries, would eliminate most private insurance and instead have the government pay for health care services using tax money. Exactly what sort of taxes and how much money would be needed in Maine are not clear.
The proposal by Brooks and other legislators aims to do a lot, including the creation of a state-run pharmacy benefits management program, electronic medical records sharing and coverage that doesn’t require deductibles and covers all the costs for primary care.
The nonprofit Community Health Options told lawmakers it supports universal health coverage but doesn’t think a single-payer system is the best approach.
The Lewiston-based provider told the Legislature’s Insurance and Financial Services Committee that “competition amongst carriers produces a market imperative for higher levels of efficiency, improved service levels and constant pressure to reduce administrative costs while stretching the premium dollar.”
Legislators, though, are hearing from people across the state who are unhappy with the current system and convinced that single-payer is the way to go.
Kristi Clifford of Lisbon Falls told the committee that in a compassionate country, health care would be guaranteed for everybody.
She described how a family member’s health declined over the years “because she couldn’t afford to pay for preventative checkups and tests,” leading to costly emergency room trips and no way to deal with pain.
Medical bills would go unpaid, Clifford said, “because people need money to eat. Food or health care, hope your loved ones or you never have to choose.”
“The for-profit insurance companies and pharmaceutical companies are never going to be the answer to affordable health care for everyone. There is just too much money to be made by too few,” Clifford said. “All people should be taken care of when they are sick, not just those who are lucky enough to afford insurance or whose jobs pay for it.”
Renee Cote, a self-employed editor in Auburn, told lawmakers she’s simply going without insurance at age 59 because purchasing it would too costly.
Last year, she said, she paid $500 monthly for a policy “with a huge deductible and co-pays” and this year, it could be $750 a month for ever worse coverage. It would cost her $1,000 monthly for a decent policy, Cote told legislators.
Like many people her age, she said she is not willing “to devote a large part of my income to paying an insurance company for crummy coverage” and is looking for the state or federal government to provide an affordable, universal health care plan.
“In the richest country in the world, there has to be a better way to provide health care than to have this for-profit system that benefits very few people,” she said.
Many supporters point to Medicare as a model for what Maine could do for all of its citizens.
Lynn Cheney of Blue Hill told legislators that “many of the people I work with say they can’t wait to be 65 years old to enroll in Medicare and this makes me think that people shouldn’t have to wait.”
“With private health care premiums spiraling out of control, Medicare covers the oldest and sickest at a fraction of the overhead expense of free-market insurance,” she said.
Michael Bacon of Westbrook said his five years on Medicare have convinced him it “is the best model we have for true universal health care. Our long experience with it has proven that it works.”
“Some fear that a government-run insurance program would lead to a socialist state, in which freedom and personal ambition and energy would be diminished,” Bacon told lawmakers. He said, though, that “quite the opposite is true.”
“Having more security and less risk in our lives makes us freer to apply our talents and energies for the good of the economy and our communities. It also makes us happier. And we probably live longer,” Bacon said.
“The political will to fix our broken health care system does not exist now in Washington, but it could happen at the state level,” Cheney said, urging Maine to take the lead.
The committee plans a work session Tuesday to discuss the bill.
State Rep. Heidi Brooks, D-Lewiston