As Congress finalizes health care reform, Maine’s representatives have, in their hands, the power to determine whether we see true, fundamental reform or stay on the current path to insolvency for the many and health care for the few. Currently, we have some of the finest health care services in the world, but they are out of reach to many because they either have no insurance or they have coverage in name only — with such high deductibles and premiums they are essentially self-insured.

In Maine, we have almost no insurance options. Anthem, a subsidiary of Indiana-based Wellpoint, holds 78 percent of the Maine market. However, Maine is not unique in this regard. Nearly every state in the country is dominated by one or two insurers. Decades ago, Congress exempted insurance companies from the nation’s antitrust laws and the insurance industry has responded as expected — they have divvied up our state and nation into monopolies in which they win and consumers lose.

In the case of Anthem, even a monopoly isn’t enough. Earlier this year, they asked for an average 18 percent rate increase for certain lines of insurance. Maine’s superintendent of insurance, Mila Kofman, after holding hearings in which consumers gave input and after considering all the information in the record, denied that rate  and allowed Anthem an average of 10.9 percent increase.

Anthem’s response? They sued the state to ensure a guaranteed profit margin. Average Mainers don’t have that luxury in a recession. Anthem has shipped over $152 million in Maine profits in the past two years to its parent company, whose CEO is paid around $10 million a year. Anthem management in Maine is very well paid also.

Wellpoint and other insurers have used profits derived from Maine and across the nation to lobby Congress to oppose health insurance reform. They and other vested interests are spending over $1 million each day to keep the status quo because the system works for them. But what about us? What about the people of Maine who have either no insurance or, more common, have coverage with deductibles of $5,000, $10,000, or even as high as $15,000? As one Maine health care provider asked in a recent news story, “With deductibles that high, are you really insured at all?” Lack of affordable health insurance is stifling economic development, and small businesses pay 18 percent more than larger groups.

An option would make the difference.

Anthem and those of its ilk have most vociferously opposed the creation of a public health option. The insurance industry has hundreds of lobbyists working the halls of Congress and sponsored millions of dollars of ads — many of them here in Maine — to stop our having that option.

Why? Because they are feeding at the trough of the one government-sponsored option of they do support — a system in which guarantees them monopolies and stifles any meaningful competition.

As Sen. Olympia Snowe and Susan Collins, and Reps. Chellie Pingree and Mike Michaud, work to reform the system, I hope they will remember that here in Maine and across the nation, people are literally begging for change. In convenience stores across our state, people place jars and cans to solicit the spare change of their neighbors and strangers because a family member or a neighbor has suffered some form of medical catastrophe.

Most have insurance. What they do not have is adequate, affordable coverage.

And therein lays the problem. The current system encourages the insurance industry to offer high-deductible, low-quality coverage. That is why an affordable health insurance option is so vitally important. It will spawn true competition and drive costs down, making coverage more affordable. Like another popular government-sponsored health insurance option, Medicare, it will use more of its dollars for actual patient care and less in administrative overhead. Medicare runs a 4-5 percent overhead and Anthem runs 18-21 percent. Those upper management salaries and gold plated benefits add up.

The opponents of a public health insurance option argue that it would drive private insurers out of the market and make coverage harder to get. That is absurd. How can one drive competition from a market that has none today? How do you stifle competition where none exists?

The time to act is now. Our delegation needs to support meaningful health insurance reform that removes the antitrust exemption for the insurance industry and which includes a strong, vibrant public health insurance option. We have the best health care delivery system in the world, but a medical miracle is just a mirage if you can not afford it.

Phil Bailey is state director for SEIU-Maine Change That Works and an employee of the Maine Democratic Party. E-mail: [email protected].