Gov. Paul LePage used his weekly radio appearance on WVOM on Tuesday to discuss health care in Maine and how we could all have access to it — with massive reforms to the system from the ground up.

“I think everybody should, can and will have it,” said LePage. “The problem is, we say that we’re a free-market system except that hospitals and insurance is a monopoly and we don’t really truly want to sit down and fix it. Everyone talks about access, access, access and talks about government, government, government paying for it and no one wants to sit down and talk about what’s a fair price for a fair service.”

LePage bemoaned wide gaps between what various hospitals in Maine charge for the same procedures and that Maine’s health care system, overall, is expensive compared to neighboring states.

“We have the quality of care but what we don’t have is the affordability,” said LePage, who then pivoted back to a familiar talking point for his administration. “We’re trying to lower the cost of education for our youth so they have more money to contribute to health care and the direction of our economy.”

LePage, a staunch opponent of virtually any expansion of taxpayer-funded health care, said he favors preventative medicine and public health initiatives that will keep people healthier and save money.

“If you’re sick, we pay doctors to get you healthy instead of paying doctors to keep you healthy. … I think we’d want to keep a society healthy instead of treating illness,” said the governor. “It’s not going to happen overnight.”

LePage’s comments somewhat contradict some of his moves against disease prevention and public health efforts. His administration is moving to reduce the role of Healthy Maine Partnerships, a consortium of 27 groups engaged in public health issues including tobacco use, drugs and obesity. The groups are funded by roughly $5 million from the Fund for a Healthy Maine, which derives from the proceeds from a 1998 class-action lawsuit against tobacco companies.

LePage proposed cuts to the partnerships in 2015 and is poised to alter many of the Healthy Maine Partnership Contracts when they expire next month. Earlier this year, his administration released a 75-page request for proposals aimed at shifting some of the tobacco settlement money toward preventing the use of alcohol and drugs.

While that focus is in reaction to a historic drug overdose epidemic in Maine, it is a change from the prior RFP for the Healthy Maine Partnerships, which called for programming and education around tobacco use, physical activity, nutrition and weight loss, substance abuse and chronic disease prevention, including cancer.

LePage said he views hospitals as businesses, not unlike department stores where the goal is to “attract people and then you get them on the upgrades.”

“If you keep them healthy, then the overall cost drops and the need for the infrastructure drops,” said LePage. “We have 39 hospitals sitting there waiting for people to get sick instead of working with people to keep them healthy.”

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