Wednesday, April 23, 2014
Jim Miller, president of WoodenBoat Publications in Brooklin, wants the decisions about how to provide health insurance for his employees taken out of his hands.
“I hate playing God,” he said. “Every spring I am forced into that position.”
Spring is when his company’s health insurance policies come up for renewal and he has to balance rising costs against being fair to his 30 employees.
Miller supports a legislative proposal for Maine to adopt a system that would replace employer-sponsored health insurance with a government-run program.
Starting in 2017, states can adopt such single-payer systems under the Affordable Care Act, using federal funding that now goes to states for programs such as the health insurance marketplace.
Maine’s bill will be discussed by a legislative committee Thursday in Augusta.
“The ACA is the first step toward a single-payer system,” said Rep. Charles Priest, D-Brunswick, the bill’s sponsor.
Priest concedes that it will be hard to get the bill passed this year, with opposition from Republican Gov. Paul LePage.
“Obviously, it’s a new concept for Maine,” Priest said. “I look at now as a time to educate people about single-payer.”
While there are many ways to create a single-payer system, a simple analogy is that Medicare would be expanded to everyone. Other countries, including Canada and the United Kingdom, operate single-payer health care systems.
Priest said details for the funding and operation of Maine’s single-payer system would be worked out later, if the bill became law. Vermont has already approved a single-payer system, but has not yet decided how to implement it.
Miller, at WoodenBoat Publications, said he would rather spend time on his core business – which includes publishing magazines, operating a mail order business and running a sailing school – than on health insurance paperwork. He was one of about 50 people who testified in favor of the bill before the Legislature’s Insurance and Financial Services Committee on Jan. 9.
But Rep. Joyce Fitzpatrick, R-Houlton, a member of the committee, said she doesn’t believe it’s a good idea. She said she doubts the system would save money, despite advocates’ claims that a streamlined system that de-emphasizes insurance companies would be more cost-efficient.
“We all know how much things cost when the government gets involved,” Fitzpatrick said.
Considering all of the work being done to get the Affordable Care Act working properly, she said, it would be unwise for Maine to switch gears and install a massive new system.
“I think there’s too much going on in health care to try to do something different,” Fitzpatrick said. “The ACA is the law of the land, so why would we try to re-create the wheel?”
In a single-payer system, insurance companies would be eliminated or greatly reduced. The Maine Medical Association, an advocacy group for physicians, has reservations about that.
“We support universal access to health care coverage,” said Gordon Smith, the association’s executive vice president. “We’re not prepared to throw the commercial insurance carriers, at this point, out the door.”
Representatives of the insurance industry testified against Priest’s bill, arguing that single-payer systems limit competition, and choice for consumers.
Smith noted that doctors are reimbursed at higher rates for patients with private insurance, making up for lower reimbursements for patients on Medicare or Medicaid. A new system would have to smooth out the discrepancies and ensure that doctors are paid fairly for their services, he said.
But Joe Lendvai of Maine AllCare, an advocacy group that supports a single-payer system, said he believes that businesses would flock to states with single-payer systems because they would no longer have to carry insurance for their workers.
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