While we await final arguments by both sides, nothing heard in five hearings changes our original position that the exclusive deal worked out between MaineHealth and Anthem Blue Cross and Blue Shield is ultimately meant to simply move money from here to Portland.

The state’s largest hospital system and its largest insurer can say they are doing this to promote efficiency and cut costs, but make no mistake — this is strictly a business decision.

Efficiency and lower prices were the same rationalization used by John D. Rockefeller when he used every tactic possible to squeeze competitors more than a century ago.

The nation’s largest oil producer simply colluded with the nation’s largest railroad to run each of their competitors out of business.

Eventually the U.S. Congress decided competition rather than monopoly control better serves the public interest.

Which is what we believe Maine Insurance Superintendent Eric Cioppa should decide as well.

The proposed plan would require a number of customers in Anthem’s individual policy market to use Maine Medical Center and its affiliated hospitals rather than competing hospitals in Lewiston, Rumford, Bridgton, Brunswick and Portland.

That means people covered by such policies in the L-A region would be allowed to use doctors at St. Mary’s Regional Medical Center but not Central Maine Medical Center.

Currently, they have a choice of hospitals and physicians.

The goal is clearly to reduce competition rather than promote it.  Instead, MaineHealth initiated secret talks with Anthem designed to reduce competition.

All hospitals are clearly struggling to attract customers as in-hospital treatment declines and the government reduces reimbursement rates for Medicaid and Medicare.

That makes acquiring new customers a priority for Maine Medical Center, which has been losing millions of dollars annually.

The fair way to do that is usually head-to-head competition. In other words, to offer higher-quality service more conveniently and at a lower price.

Then customers can best select which doctors and hospitals, or combination of hospitals, they believe best serves their needs.

Under the Anthem-MaineHealth program, customers in northern Maine will have that choice, because MaineHealth doesn’t compete there and Anthem is offering a different type of plan.

Not so in Southern Maine, which has actual hospital competition, the kind of competition that usually leads to better care and lower costs.

On the one hand, Anthem says this won’t affect many of its current policy holders, a number it puts at about 8,000 out of 17,000 in Maine.

On the other hand, it must believe the number of people switching physicians and hospitals will increase its volume enough to lower its rates.

Unanswered is how this exclusive set of providers can even serve the thousands of Maine snowbirds, people who live here half of the year and in warmer climes the rest.

And who is to say the lower rates being offered will even last. Could this be a short-term break, a sort of introductory offer, simply meant to induce people to change doctor and hospital allegiance?

Maine’s insurance commissioner should have one overriding concern in evaluating this proposal: to decide what best serves the people of Maine.

At five public hearings now, ordinary people have spoken clearly and overwhelmingly.

They want more choice, not less. They want to select equally from among local family physicians and specialists. They want to choose when they will be treated locally, and when they will travel to Portland or Boston.

Many have spent generations with the same hospital, and decades with the same doctor.

Those are valuable two-way relationships built over time that cannot be easily or quickly re-established.

And with health care approaching one-fifth of our economy, Western Maine can ill afford to export high-paying health-industry jobs to other towns.

You can believe this: The only purpose of this plan is to move more money from here and other small towns to Portland.

Period.

rrhoades@sunjournal.com

Copy the Story Link