Two years ago today, Gov. John Baldacci vowed to pay Maine’s hospitals the $330 million they were owed for MaineCare. Hospitals were cautiously optimistic that this outstanding debt would, at last, be paid.

Today, this optimism is fading. Not because Baldacci broke his vow – he’s paid hospitals as promised – but because the payments can’t keep pace with MaineCare costs. The state is making minimum payments on a credit card with a stratospheric interest rate. It’s paying, sure, but the debt grows, nonetheless.

MaineCare coverage could cost $540 million in 2009, for example, though the state anticipated only $472 million in its payment calculator. And this gap, says Brenda Harvey, commissioner of the Department of Health and Human Services, is only getting worse. One hospital administrator estimates it’s growing by $10 every minute.

What’s ironic about this is that an oft-proposed solution – further expansion of health insurance coverage – is regarded as its cause.

Hospitals blame expansion of MaineCare coverage in 2002 for helping spark the reimbursement lag. Eighty-thousand people were added at that time – about one-third of MaineCare’s current enrollment – which started the snowballing trend of costs growing beyond the state’s ability to pay.

The response has been more coverage, like DirigoHealth, which also covers those eligible for MaineCare. Yet savings from Dirigo have failed to meet expectations and enrollment has been capped. It doesn’t have the money.

And what savings it creates isn’t enough to re-open its rolls.

Expansion of insurance is apparently not reducing costs, but driving costs. Absent equitable, universal coverage, these half-measures create an unfair system, under which one group – largely the privately insured – pays a premium to cover the care of others.

Surcharges on private insurance claims to fund Dirigo is a prime example. Under the current formula, the surcharge is about four percent. If the new funding formula survives the People’s Veto, it would be 1.8 percent.

This circle is vicious: expansion of subsidized insurance puts costs beyond ability to pay. More insurance is pushed as the answer. The privately insured pay for these programs. Their costs increase. Unpaid bills mount. Providers charge those with ability to pay more for services. Costs rise.

And so it goes and goes and goes.

Both presidential candidates espouse plans to expand coverage as a strategy for cutting health-care costs. But there is strong evidence that additional insurance only exacerbates the problem.

In Maine, we don’t need more insurance – we need to control costs so the insurance we have is more affordable, for both public and private varieties. It’s senseless to have private insurance that’s too expensive, subsidized insurance that’s become unavailable and free insurance that cannot pay its bills.

Yet this is exactly what we have.