Conferees warn single-payer health
debate to be divisive

By Michael O'D. Moore
OF THE NEWS STAFF

     AUGUSTA- Part of the coming debate over whether Maine should have
a single-payer health insurance plan will be over what issues are really important,
speakers at a conference on universal health care said Monday.
     Several told the more than 300 people gathered at the Augusta Civic Center
that the relevant questions won't be the ones often raised by insurance companies
and other naysayers.
     Dr. Lawrence Wallack of Portland, Ore., is a member of the Institute of
Medicine's committee studying insurance matters.  He invoked the words of nov-
elist Thomas Pynchon who wrote in "Gravity's Rainbow" that "if they can get you
asking the wrong questions, then they don't have to worry about the answers."
     One red herring, said Dr. Jonathan Ross of Toledo, Ohio, who is past president
of Physicians for a National Health Program, is focusing on why people are sick.
Getting people to live healthier lives won't solve the problems of people lacking
health insurance, he said.  Even those who think they lead healthy lifestyles become
sick.
     Some speakers said the important questions deal with how a universal system
could be cheaper and provide better care.
     The answers to those questions, they say, show that money can be saved by 
eliminating expensive insurance company administrative duplication, and profits, and
by providing preventative care to everyone to reduce the number of minor ailments
that develop into complicated and expensive problems.
     They say a core issue that for-profit health insurance is offered with an eye toward
eliminating customers who have become sick and are using insurance.
     "We're up against fear.  We're up against sound bites," and up against the insur-
ance industry that will do anything to protect its profits, said Joseph Ditre, executive
director of Consumers for Affordable Healthcare, the organizer of the conference and
supporter of single-payer model.
     "Everything we hear is 'you have a plan and we're going to attack it and we're not
going to offer anything as an alternative,'" Ditre said.
     A single-payer system would eliminate the patchwork of government and private
insurance plans with a single government-run program.  A single-payer approach is
one proposed way to get to universal health care coverage.  Others favor expanding
the current public and private system to ensure that no one lacks insurance.
     Today, there are more than 40 million uninsured in the country, Wallack said, and 
most of those are middle-class people, since the poor are covered under Medicaid.
     Peter Gore of the Maine Chamber of Commerce said most Maine businesses are
against single-payer.  During an interview during a break, he responded to some of the
ideas coming from the podium.
     He said single-payer opponents do support some proposals, including two that got
shot down recently in the Legislature.  
     One would have allowed insurers and employers to pick where to send patients for
care to get the least expensive quality care.
     Another would have freed insurers of some regulations in order to give them the op-
portunity to create new insurance programs that might bring healthier people who'd
dropped coverage in the face of rising premiums back into the insurance system.
     Gore said Consumers for Affordable Health Care fought both.
     He rejected the idea that businesses opposed to single-payer ask the wrong questions.
He said most businesses want to know:
What is a single-payer system going to cost?
How will it be financed?
What services will it cover?
What are the true reasons behind rising health insurance premiums?

     "There's a tremendous amount of skepticism [to single-payer] in the business com-
munity," Gore said.
     There was strong support in the Legislature last session for a single-payer system
for Maine.  Ultimately, the Legislature agreed to study the idea, creating a commission
that will report back this fall.  The commission has hired a consultant to study the feas-
ibility of a single-payer system for Maine.

September 24, 2002

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