In an April 18 editorial the Sun Journal suggested that the cost of health care insurance in Maine could be reduced by increasing the size of the risk pool, thereby avoiding a single-payer system and possible higher taxes.

Some important issues weren’t addressed.

Increasing the risk pool by combining Maine’s insureds with those of other states doesn’t guarantee that the system will be administered fairly. There’s no effective regulation to prevent insurers from barring the chronically sick from the pool no matter its size, or increasing their premiums. Health care is always rationed. Do we trust insurance companies, driven by the profit motive, to ration it fairly?

The evidence so far from the pharmaceutical industry is not encouraging.

Is basing health care on employment the right thing to do?

Large employers are disadvantaged by global competitors with government-financed plans while small employers are often unable to provide any coverage at all, and the ranks of the uninsured unemployed continue to swell. There is a compelling argument for society at large shouldering this cost.

Will taxes rise or do we already have the resources?

Simple-minded appeals to concepts like “Tax Freedom Day” obscure the important debate over how our tax money and the burden are presently allocated along with the crucial definition of tax fairness.

Finally, if conflicting requirements among states make enlarging the risk pool difficult, there is an entity available to provide resolution: the federal government.

Ed Cundy, Paris

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