Single-payer health plan in Maine would benefit everyone

By William D. Clark, M.D.
Portland (Maine) Press Herald, Letters, Sept. 30, 2014

Steve Mistler’s Sept. 17 article “Number of Mainers without health insurance rose 9 percent in 2013″ notes Maine is one of two states with “a rise in the number of people without health insurance from 2012 to 2013.” Thus, Maine’s uninsured comprise “147,000, or 11.2 percent of the state’s population.”

Mistler reports tactical comments from gubernatorial candidates. No one mentions covering every Maine person with a fair and economical single-payer plan. Can Maine accomplish single-payer, and who would benefit?

  • People benefit. Everyone is covered from birth to death – period. No premiums, no searching for the “right” coverage. No bankruptcy when hit by a car or cancer. Health outcomes improve.
  • Employers benefit. They escape from the tension between insurer negotiations and worker benefits versus salaries, and create more Maine jobs.
  • Health care providers benefit. Physicians reclaim their mission of healing. Hospitals and all providers get simple billing, prompt payment and fewer “authorization” hassles. Dramatic discrepancies in physician salaries disappear, but all make a decent living.
  • Maine benefits. Maine creates a patient care-oriented system, and more clinicians choose primary care. No Medicaid hassles, and no “hidden tax” to cover the uninsured. First-year savings of $1 billion (as estimated by health care policy expert Dr. William Hsiao, who testified before the Legislature in 2010) bolsters Maine’s economy.

Maine could accomplish this. The Affordable Care Act allows states to insure their people if they provide coverage at least as comprehensive as ACA benefits, beginning in 2017. Everyone pays Maine a tax on income – when well, not when sick.

Decades of tweaking our profit-oriented system have failed, and our recent tweak drives people crazy and sends billions to insurance companies. They return useless paperwork while maximizing profits. Trying to reward competition excluded 147,000 Mainers and made the ACA prohibitively expensive and dauntingly complex.

Dr. William D. Clark resides in Woolwich.