A Lewiston public meeting gives both sides of the debate a chance to get answers.
By David A. Sargent
Special to the Sun Journal

LEWISTON – A crowd of about 100 turned out for an informational meeting on the Dirigo Health plan Saturday morning at the Lewiston Multi-Purpose Center.

Questions about several contentious issues in the proposed health care plan were raised, but there also was impassioned public comment urging lawmakers to move quickly. State Sen. Peggy Rotundo, D-Lewiston, who acted as moderator, kept strict control of a three-minute limit for comments or questions. She insisted on a courteous exchange of ideas on the issues and admonished the audience a couple of times for outbursts of applause.

Dr. David Stuchiner, director of emergency services at Central Maine Medical Center, said he believes the Dirigo Health plan is “really a system of rationing and closing hospitals.”

Trish Riley, director of the Governor’s Office of Health Policy and Finance, responded, “It’s our intention to ask people like you to get together” and talk about possible solutions and improvements. “At least we will work it out together.”

Riley acknowledged several times that cooperative planning and sharing of services is currently prohibited by anti-trust laws. She said the Dirigo Health plan proposed by Gov. John Baldacci would make it possible for hospitals to talk and plan together, and she emphasized her belief that such cooperation is vital for health care cost control.

Several speakers who identified themselves as employees of the local health care industry said they feel the plan is being moved too rapidly toward approval with too many assumptions about participation and support. Fewer speakers stood up in favor of the plan, but the ones who did made impassioned remarks about the urgent and immediate need to provide help for uninsured residents of Maine.

Sue Romero of Lewiston expressed concern that immigrants and their families would not get full benefit under the Dirigo Health plan. Riley said the plan has provisions that, after fulfillment of residency requirements, make all citizens eligible for help.

Ann White of Auburn, who said she has been a nurse for almost 30 years, said that she has “a concern with the credibility of government” running the health plan.

“Government is already underfunding the system,” she said. “You’re assuming that insurance carriers, doctors and nurses will stay here in the state” if the plan is implemented.

Evan Ramser, a Lewiston doctor, said smoking and obesity are two major factors in Maine’s health care crisis, and he asked how the plan would address these issues in an employment climate that already makes it difficult to recruit health care professionals to come to Maine.

“Where’s the personal responsibility?” he asked.

“It’s not our intention to do anything to hurt the infrastructure,” Riley said. She noted that the plan’s provisions for a Maine Quality Forum will ensure a high level of health care. She also emphasized that Dirigo Health will make Maine the first state in the nation to have a constitutional amendment that will protect the tobacco settlement dollars in the Fund for a Healthy Maine.

A questioner asked Rotundo to call for a count of those who represent a local hospital. About a third of the audience responded by raising a hand before someone shouted that it was “irrelevant” and the tally stopped.

Pam Hagerty, director of cardiac prevention at CMMC, made a forceful argument claiming “a real outcome” of implementing the Dirigo Health plan would be a”dismantling” of the state’s current system of quality health care.

When Riley disagreed, Hagerty replied, “But you have caps” on rates.

“No, we don’t,” Riley responded. “They’re voluntary caps.”

She also explained, “It’s a target for planning; it’s not a global cap.”

“But if they fail to accomplish anticipated control of costs,” Hagerty asked, “how long would it be until they become mandatory?”

Riley pointed out sections of the proposed legislation that set out steps for such an eventuality.

The panel hearing the public comments consisted of Rotundo; Riley; Rep. Margaret Craven, D-Lewiston; Rep. Richard H. Mailhot, D-Lewiston; Rep. Elaine Makas, D-Lewiston; Rep. Lillian LaFontaine O’Brien, D-Lewiston; Rep. Sonya G. Sampson, D-Auburn; and Adam Thompson, staff member for the Governor’s Office of Health Policy and Finance.

Also present were Rep. Deborah L. Simpson, D-Auburn, and Rep. Michael A. Vaughn, R-Durham.

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