January 5, 2013

Turns out there IS a doctor in the House

Well, three, actually, and another in the state Senate. Together with other medical professionals, they make up a powerful bloc as Maine confronts its health care future.

By Kelley Bouchard kbouchard@pressherald.com
Staff Writer

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There are four medical doctors serving in the State House in the coming legislative session: top, Rep. Ann Dorney, D-Norridgewock; above left to right, Rep. Jane Pringle, D-Windham; Rep. Linda Sanborn, D-Gorham; and Sen. Geoffrey Gratwick, D-Bangor.

Contributed photos

“It’s hard to find a better person than Rep. Sanborn to be our spokeswoman on that committee,” Eves said.

BUILDING A CAUCUS

The caucus will be intent on working with Republicans as well as Democrats, Eves said, “in part, because we have to, but also because it’s the right thing to do. We all understand that we have to find ways to improve the system and control costs.”

The administration of Republican Gov. Paul LePage has similar goals but can be expected to have a different approach than the four physicians, each of whom favors some form of universal health care.

“We can all say that we want to work across the aisle,” said Adrienne Bennett, LePage’s spokeswoman. “Until we see the legislation, we won’t know if we have true compromise.”

A high priority for LePage is paying $186 million in MaineCare reimbursements that are owed to Maine’s 39 hospitals and date back to 2009 – a move that would free up $298 million in federal reimbursements to the medical centers.

Facing a $100 million revenue shortfall in the current Medicaid budget, LePage also wants to further reduce the number of Mainers covered by MaineCare. So, he’s expected to continue his opposition to expanding Medicaid coverage as funded by the federal government under the Affordable Care Act.

“We want to move toward developing a sustainable safety net that protects all Mainers,” Bennett said. “We can’t afford what we have now. How are we going to afford more down the road?”

Sanborn, 61, understands the downside of out-of-control health care costs. She retired in 2007 when it became financially impossible to maintain a private practice.

Sanborn questions the governor’s plan to further reduce the number of Mainers receiving Medicaid benefits, noting that his efforts so far have resulted in a $100 million budget shortfall. She believes greater investment in preventive medicine for high-cost users is the best way to make health care less expensive and more effective.

She noted that 5 percent of MaineCare users account for 55 percent of costs, and 20 percent of MaineCare users account for 80 percent of costs. She views the Affordable Care Act as a “step in the right direction” and regrets that LePage refused to create a state-sponsored online health insurance exchange for Mainers who qualify for subsidized plans.

“We need to implement the ACA as fully as possible and make sure Mainers have coordinated access to the federal exchange,” Sanborn said. “We need to cover everyone, and the only way to get there is to make it more efficient and effective.”

Sanborn believes social and mental health services should be considered in concert with medical coverage because they are usually linked. She said increasing the number of Mainers on Medicaid would reduce the amount of charity care that Maine hospitals are required to provide.

AGREEMENT AMONG DOCTORS

Pringle, 67, agrees with Sanborn on many counts. She retired in November after serving as the director of medical clinics at Maine Medical Center for more than a decade.

Many of her patients were on MaineCare or had no insurance. Many had mental health and substance abuse issues. In the end, she focused on the most challenging cases, known as “superusers,” who were chronically ill largely because they didn’t receive adequate health care in the past.

“I know first-hand the unfairness and the lack of effectiveness of our health-care system,” Pringle said. “Sure, we have amazing innovation and treatment in this country, but if you can’t afford it, you don’t get it.”

Gratwick, 69, served on the Bangor City Council for nine years, so he understands the political landscape of Maine and how state spending impacts municipal budgets. But he bristles when health care becomes a political issue.

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