Lawmakers should examine the experience of other states before reshaping the health care system.

The adoption of the Dirigo Health plan, I believe, is a step toward the final objective of a Maine state single-payer plan.

In 1996, I was invited to speak to members of the U.S. Senate and House of Representatives about health care coverage, and the lack thereof, in Maine.

The Dirigo plan is just exactly what the Democratic legislative doctors ordered – literally.

This plan is expanding our Medicaid program in principle. Democrats are determined to move forward with a single-payer plan in this state even if they have to dupe their constituents.

I recently held a conference with state Sen. Beverly Daggett about cuts to services for the specials needs associated with children with autism. Her response to the cutting of such necessary services was to convince “the people” of the need to increase taxes to pay for our never-ending budget. No mention was made of the vast amounts of money that disappear from state agencies.

Maine has been touted for the last two years in the national media, along with several other states, as moving toward a Clintonian-type, single-payer health care plan. Maine is falling to the demands of 30 years of Democratic dictatorship.

Universal health care has been on the table for many years now, and the push from the White House began when I testified in Washington, D.C., in the mid-1990s. I have had an inside opportunity to learn firsthand about such single-payer plans. Here are some facts:

Proponents of a single-payer health system argue that such a plan would provide all citizens with high quality, comprehensive health coverage. In reality, single-payer systems deny care to those who need it most.

Statistics from other states that have implemented single-payer systems underscore this point. Single-payer plans have been implemented in several locations around the United States with disastrous results. It would be irresponsible not to carefully examine the experiences of these other states before attempting to implement a single-payer plan elsewhere.

In 1993, Washington state legislators enacted a single-payer insurance program to provide coverage for certain uninsured persons that were similar to the universal coverage program proposed by the Clinton administration. The program resulted in increased taxes, increased costs and increased regulation. Consumers were subject to less choice and reduced quality services. The number of uninsured increased by 20 percent.

Due to premium caps, the number of available health care plans, doctors and hospitals was reduced, and consumers suffered as a result. Washington legislators were forced to repeal their “reforms.” The repeal went into effect in 1995. Currently, no health insurance carriers offer individual coverage plans in Washington state.

In 1994, Kentucky state lawmakers adopted reforms similar to the Clinton health care plan. The reforms included a government-sponsored health insurance plan, mandated benefit standardization and higher taxes on health care providers and hospitals. The tax on health care providers and hospitals ranges from 2 percent to 2.5 percent of gross revenues. Forty-five insurance carriers have left the Kentucky market. Kentucky Kare, the state insurance plan, lost $30 million over a 20 month period. Fewer state residents have health insurance coverage today than before the “reforms” were instituted.

Hawaii is the only state with employer-mandated health insurance coverage. State employers must pay 50 percent of full-time employees’ health insurance premiums. Many part-time workers, dependents, unemployed persons and low-income people are uninsured. Estimates range from 2 to 11 percent of the population. Between 1980 and 1991, per capita health care expenditures were higher in Hawaii than for the nation as a whole (Hawaii, 9.8 percent; U.S., 9.4 percent). Hawaii has some of the highest health care administrative costs in the country. The state ranks No. 1 nationwide in hospital costs as a percent of total hospital spending. The employer-mandate has caused serious trouble for Hawaii’s small businesses.

In 1997, Hawaii ranked 49th in income growth rate, 43rd in employment growth, first in business bankruptcies and 48th in new business growth.

Employers have restricted wage increases, reduced benefits and raised prices in order to offset health care costs. Employers are also hiring more part-time workers. Between 1986 and 1993, the number of medically underserved areas (where the physician-patient ratio is considered to be low) grew from two to 12. Hawaii’s patients are beginning to feel the effects of health care rationing. The state is short on acute care hospital beds and nursing home beds. Furthermore, in 1997, the state only had one MRI scanner per one million people. The MRI scanner shortage in Hawaii is so severe, physicians encourage patients to fly to the mainland for immediate treatment.

Single-payer systems often allocate funds by global budgets to hospitals. I’ve heard anecdotes from some single-payer systems that suggest that those systems have engendered corrupt incentives: providers elicit under-the-table payments to jump the patient lines. These systems wind up as not quite as egalitarian as their designers intended.

I understand the governor has, in his short time as our state’s leader, raided the Transportation Department’s dedicated funding to cover our burgeoning budget shortfall. I am concerned that he will move toward cutting other services, which are already suffering, to fund this Dirigo project, after money appropriated for local school improvement projects was diverted to the laptop program.

In 1996, Lynda R. Berube was invited by the White House to meet with U.S. Senators and House members to discuss health insurance. At the time, she was uninsured and facing large medical bills. She lives in Auburn.