Wednesday, April 23, 2014
WATERVILLE — Sharp differences emerged over health care, taxes and spending when the five gubernatorial candidates on Maine's November ballot met Tuesday morning at a forum sponsored by the Maine Association of Area Agencies on Aging.
9 a.m.: Shawn Moody will tour Coastal Enterprises in Wiscasset.
Noon to 6 p.m.: The Biddeford-Saco Chamber of Commerce and Industry will host its sixth annual Business Expo, with all five gubernatorial candidates on the ballot scheduled to attend a forum starting at 5:15 p.m.
LePage: The new federal health care overhaul, known as the Affordable Care Act, would take $500 billion in funding out of Medicare and Medicaid.
Fact check: According to the website PolitiFact, a project of the St. Petersburg (Fla.) Times, the law does not take $500 billion out of the current Medicare budget, but attempts to slow the program’s growth by “curtailing just over $500 billion in future spending over the next 10 years.” The nonpartisan Congressional Budget Office projects that Medicare spending will continue to increase, reaching $929 billion in 2020, up from $499 billion in actual spending in 2009.
Cutler: About 25 to 30 cents per dollar spent on health care goes to insurance companies.
Fact-check: According to the Pharmaceutical Manufacturers Association, the breakdown of each dollar spent on health care in the U.S. is: Hospital care 31 percent, physician services 21 percent, pharmaceuticals 10 percent, nursing homes 8 percent, administrative costs 7 percent, and other services such as labs and pharmacies 23 percent.
Mitchell: Among the benefits of the federal health care overhaul is that it will close the Medicare coverage gap known as the “doughnut hole.”
Fact check: According to the website PolitiFact, the doughnut hole won’t be closed immediately, but will be phased out over the next decade as federal subsidies enable the patient’s share of the payment to be reduced gradually.
Moody: While there are about 100 auto insurance companies in Maine, there’s predominantly only one health insurance company, so more competition is needed.
Fact check: According to a February study of health market shares by the Maine Department of Professional and Financial Regulation, there were three main companies in 2009 that provided individual insurance coverage: Anthem Blue Cross and Blue Shield (49 percent), MEGA Life & Health (33 percent) and DirigoChoice/Harvard Pilgrim (16 percent).
Scott: Prosecuting elder-abuse cases in Maine should involve the same standards as prosecution involving child abuse, and there shouldn’t be a distinction among the “vulnerable” populations.
Fact-check: According to the Kennebec County District Attorney’s Office, state law prescribes more standards for child abuse, requiring more mandatory reporting of such cases and more descriptions of what constitutes child abuse, than for elder abuse. Even so, both forms of abuse are typically prosecuted with the same rigor, according to the district attorney.
Before more than 100 people at the Spectrum Generations Muskie Center, which provides services and activities for senior citizens, each candidate had about two minutes to respond to questions addressing issues facing the elderly.
Not surprisingly, all of the candidates – Republican Paul LePage, Democrat Libby Mitchell and independents Eliot Cutler, Shawn Moody and Kevin Scott – voiced strong and repeated support for helping seniors with issues of affordable housing, high living costs, access to health care and preventing physical and financial abuse.
But the candidates disagreed on key details. Asked to explain the health care benefits to seniors under the new federal Affordable Care Act, the candidates offered distinct views.
"Nothing," LePage said flatly, asserting that the new law would take $500 billion in funding out of Medicare, hurting coverage for seniors. "We need Medicare and Medicaid to work for our elderly. It's time we the people of America stand up to Obamacare."
Mitchell said many benefits of the new law won't be known right away, but one example is it that closes the Medicare coverage gap known as the "doughnut hole," in which prescription drug costs are not reimbursed.
extending health insurance to millions more Americans, the law endorses the idea that health care is "a right, not a privilege," she said. "This is a hugely important step forward."
The unenrolled candidates offered mixed views of the health care overhaul. Moody said he would have preferred legislation targeting $400 billion in wasteful spending in the health care system. Another problem for Maine, he said, is a lack of choice among health insurance companies.
"It's not a competitive situation," he said. "We need that free-market system."
Cutler said that 25 to 30 cents per dollar spent on health care goes to insurance companies. He said that LePage's approach is to rely solely on insurance companies. "The answer does not lie in reliance on more health insurance," he said.
Scott said, "I haven't read the 2,800 pages" of the bill, but when money is shifted around there are "always opportunities." He suggested getting money to community groups that serve people in need.
"I'm certain there are serious deficiencies in that legislation, but I can't put my finger on them," Scott said.
The forum's organizers said the demand for services for elderly people will grow, with Maine's aging population. The state's median age is 41.5 years, which is the highest in the country, according to the latest census figures. The national median age is 36.7.
After the forum, several audience members said they enjoyed listening to the candidates and appreciated the respect they showed for the elderly, but thought the answers were short on specifics.
Esther Landry, 75, of Bucksport said she was there as a member of the Seniors Resources Committee in her town and generally liked what she heard.
"We're here because we're interested in what approach they'll take to keeping seniors in their hearts," Landry said. "I learned a lot, but I wanted to hear more details, more on community-based services."
Though they spoke mostly in generalizations, the candidates did offer some specific proposals:
• Scott cited his plan to reform welfare, saying he would create a program in which people seeking general assistance would work with seniors. He said he also would create a public registry of people convicted of abusing the elderly.
• Mitchell said she would seek to empower elderly victims of abuse by creating support councils.
• Moody suggested the creation of a blue-ribbon commission, like one that has addressed workers compensation, to look at how to attract more insurance companies to the state and offer more insurance choice.
• Cutler said he has a plan, called MaineWellness, to ensure that "everyone in Maine" has access to essential health care services, to make health care affordable, and to emphasize prevention and wellness by paying consumers for healthy behaviors and providers for quality care.
• LePage proposed a halt to state taxation of pensions.