^{Posted on May 9, 2003}

Support continues for single-payer insurance

By PAUL CARRIER, Portland Press Herald Writer

AUGUSTA — Gov. John Baldacci’s proposed health-care plan, which would retain a strong role for private insurers, has not silenced talk of creating a fully state-run insurance system in the years ahead that would leave no room for commercial insurance companies.

While many reformers are uniting behind the governor’s proposal, which is designed to expand access to health care and cut costs without eliminating private insurance, the state Senate gave near-final approval Wednesday to a separate bill that would continue an ongoing, long-term study of a single-payer system.

That ongoing study, which also has won preliminary approval in the state House of Representatives, now needs only final votes of enactment in both the House and the Senate. And even though Baldacci’s plan does not call for a single-payer system, his spokesman said Wednesday the governor will sign the study bill into law if the Legislature sends it to him.

The governor’s legislation, which he wants the Legislature to pass this session, and the continuing study of a single-payer system “work hand in hand,” said Lee Umphrey, Baldacci’s spokesman. “The introduction of (the governor’s) plan is the start of a process,” Umphrey said. He said supporters of that proposal and backers of a single-payer system should work together to develop the best plan for Maine people.

Even supporters of a single-payer system, which Baldacci opposes, are endorsing the governor’s package. They see the governor’s plan as a step in the right direction because, they say, it will insure more Mainers and help control the cost of health care.

The governor’s plan “can act as a transitional system to get us to single-payer,” said Paul Volenik, a former state representative who co-chairs the Health Care System and Health Security Board, which the Legislature created in 2001 to investigate creating a single-payer system. That’s the same board that the Legislature and the governor are now prepared to extend, so it can continue its work until November 2004.

The board released a preliminary report in January that said a single-payer system could provide coverage for all Mainers and save money. Such a system would insure Mainers through a standard benefits plan administered and financed by the state, or by a group under contract with the state. Insurers quickly attacked the report, saying it seriously underestimated the cost of a single-payer system.

“I’d like to see the conversation on single-payer continue” even though the main focus now is on Baldacci’s bill, said state Rep. John Eder of Portland, the lone Green Independent in the Legislature. Eder has filed a bill in the Legislature to implement a single-payer system, but the Legislature’s Insurance and Financial Services Committee quickly voted 9-0 against the bill Wednesday after holding a hearing on it.

Like other supporters of a single-payer system, Eder said he does not believe Baldacci’s plan has killed the idea of a state-run insurance program. Backers of such a system say the fact that the Legislature and the governor will allow the Health Care System and Health Security Board to continue its work will keep the issue alive, at least until the board issues its final report late next year.

Baldacci’s bill is “a major step forward” but it may not be the last step, Rep. Arthur Lerman, D-Augusta, a supporter of a single-payer system, said Wednesday during the committee hearing on Eder’s bill. “I still think that, in the long run, we may end up moving in this direction” of a government-run system, Lerman said.

Many disagree, including some supporters of Baldacci’s plan who believe it will meet a key goal of a single-payer system by assuring that all Mainers have health insurance. Baldacci says his package would provide universal health care in four years, by relying on a combination of public and private insurance programs, but some skeptics who support a single-payer system say Baldacci’s plan would not guarantee that everyone has adequate coverage.

“The governor’s bill really is front and center” and that places the single-payer system on the back burner, said Joseph Ditre of Consumers for Affordable Health Care, an activist group that backs Baldacci’s approach. Still, Ditre said, “it’s a little too early to tell how it’s all going to play out,” because key components of the governor’s plan would not even kick in until July 2004.

Sen. John Martin, D-Eagle Lake, who co-chairs the Health Care System and Health Security Board, said many people continue to support a single-payer system and it remains an option. “It’s not dead,” Martin said.

Staff Writer Paul Carrier can be contacted at 622-7511 or at:

pcarrier@pressherald.com