by Ralph W. Sarty, Jr
For almost a year now the hottest debate in Washington politics has been focused on health care and health care insurance. Considering the Clinton Administration attempted to take on this issue when they entered the Whitehouse and we still don’t have a national health care plan seventeen years later, certainly indicates what an extremely complex and difficult challenge health care reform represents. It is also very obvious the tactics and infighting that seemed to diminish a transparent, honest effort toward reform has once again stalled, if not actually killed, another attempt to address this serious issue.
The same can be said for state governments inability to move toward health care and health care insurance reform. Although the debate in Maine is not as dramatic as Washington, Augusta politicians have also blatantly failed to move forward toward reform that could reduce the cost of health care insurance at the state level. During the last Legislative Session Rep. Jon McKane (R-Newcastle) put in a bill which would have taken a major step toward health care insurance reform in Maine. This bill would have opened up our state to all “qualified” health care insurance providers, created a competitive market and would also have abolished “guaranteed issue” and replaced it with an established “high risk pool”. Coincidentally, both of those conditions are also part of the Democrats national health care plan being deliberated in Washington.
When Rep. McKane’s bill was presented and debated on the floor of the House the Democrats spoke against it. Rep. Sharon Treat was the leading Democrat presenting lengthy testimony as to why we should not consider the McKane bill. At the very end of her testimony her final remark acknowledged our health care insurance costs in Maine, although very high, offered good coverage and why rock the boat now as the Obama Administration would be passing health care reform in Washington. The vote on the House floor was 82 against McKanes health care reform bill and 63 for it. Just 10 votes blocked the State of Maine from finally moving forward toward health care insurance reform. How much longer can Maine people wait for Washington to actually do something??? This year Maine’s largest health insurance company has requested another significant increase - 23% for individual policies and there appears to be no end in sight.
Even if the current effort in Washington is passed by the House and Senate - the program currently on the table will start BILLING Americans NOW and yet the program will not actually begin for THREE YEARS.
We can and should pass health care insurance reform at the state level. It almost happened a year ago. Waiting for Washington has been about as productive as sitting around watching paint dry. If they can ever begin to work together and take rational affordable steps toward putting together a National Health Care Plan in Washington, Maine like the other states can easily make a transition into such a plan. However, in the meantime we would be irresponsible to continue to ignore the options that are available
at the state level that could significantly lower health care insurance costs for all Maine people. If you are a Democrat and the State Legislator in your area is a Democrat - put the pressure on them to stop blocking this option and help make it happen. Representative McKanes bill was far from perfect but it did represent a “giant step” in the right direction.
Also in relation to health care insurance - Just this week there was a web site posting indicating the states teachers union (MEA) has taken the position that the State Legislature has limited their (MEAs) ability to seek out more affordable health care insurance for their members. That’s a bunch on “bunk” (for the lack of a better word).
MEA knows that Maine State Law (Title 20-A Sec 1001) allows individual district school boards to seek out competitive insurance plans (including health care insurance).
In fact the statute says school boards SHALL do so on at least a five year cycle. There is a provision to waive the bidding process if the school board votes to do so.
For years MEA has selected a company that controls roughly 70% of the health insurance market in Maine as their health care insurance provider and the rates have skyrocketed. Recently, many school district superintendents have started talking about the option for a school district (through their school boards) to consider bidding out health care plans for their respective districts or RSUs. By law, this has been an option for years. I mention this to make it perfectly clear to our states school teachers that this is not new Legislation and has always been an option for your school district going back many years.
As a Legislator, I think looking into a bidding process for health care insurance for individual school districts is worth considering. If the process failed to offer coverage acceptable to the teachers and there was no cost savings, simply stay in the current plan.
If the State Legislature would pass a bill opening up our state to the hundreds of qualified health care insurance providers out there and not just the handful of currently approved companies, Maine would become a highly competitive market - everyone in Maine would benefit with lower premium costs, including teachers who make up our states largest employee group. Tell your State Legislators to get their “heads out of the sand” and do something - while we all wait and wait and wait for Washington.
Ralph W. Sarty, Jr
State Representative
House District 99
Very good article! I agree with it totally.
Having owned an insurance brokerage firm in Oregon in the early 70's it was my pleasure to broker sixteen companies handling life, health, disability, and long term disability programs. These "approved" insurance companies were approved and managed by the Oregon Insurance Commission in Salem, Oregon. All insurance brokers and agents likewise, had to pass a state insurance examination showing their pforiciency and their knowledge of Oregon State law. Any complaints or problems by customers were submitted to the same commission where they were reviewed for merit and handled by a board of examiners under the auspices of the insurance commissioner.
This procedure worked well and was managed effectively at the state level. Insurance was written for group (business) customers, personal/private (with prior evidence of insurability) or association (open enrollment once a year with no evidence). Local agents/brokers managed the bidding processes, administered the plans, and were the liasson for any problems in claims.
This process worked because all insurance written was either Blue Sheild owned by hospitals or doctor associations, and private insurers home officed all over the US.
If there is freedom to shop with a broad spectrum of approved carriers, everyone is kept honest. Add TORT reform, and we here in Maine have a running chance of affordable insurance that is well administered if the state will get out of the insurance business themselves. The only problem that keeps this from working is union and association opposition that seeks to employ their own brand of insurance kept and adiministered within their political structure(s).
This is simple, forthright, common sense, and most small businesses would jump at the chance to participate in small group (4 to 10 employees) or standard group (11 on up) group contracts.
The problem is where the non employed or welfare people have coverage. We wrote association group insurance through the Oregon Hairdressers Association or private banks for their depositors. I would think there a number of creative ways to address buyers that are not covered by an employer if good agents were given a chance to attack this problem in Maine.