Wednesday, April 23, 2014
PORTLAND - Maine has a rich tradition when it comes to efforts to provide health insurance coverage to its children and adult citizens, to improve the quality of health care and to moderate its costs.
ABOUT THE AUTHOR
Jo E. Linder, M.D., of Falmouth is an emergency medicine physician and president of the Maine Medical Association.
While these efforts have not always been successful, successive governors and both Republican and Democratic legislators have worked together toward the goal of moving a very fragmented health care delivery and financing system to a comprehensive, patient-centered, well-integrated system that works for everyone.
The recent effort by the Joint Select Committee on Health Care Reform, Opportunities and Implementation organized by the 124th Legislature to look at opportunities for Maine in the federal Affordable Care Act (ACA) is an excellent example of this bipartisan approach. Another is the Report of the Advisory Committee on Health System Development entitled "Options and Opportunities for Implementing the ACA in Maine" (December, 2010).
Given this history, the recent statements by both Gov. LePage and Attorney General Schneider that they support the state joining a lawsuit to repeal the ACA is both disappointing and perplexing.
The Select Committee and Advisory Committee identified many opportunities and benefits for the state, its citizens and its health care professionals in the law. Among these are the following:
• People with Medicare will have no out-of-pocket costs for most preventive care, like annual physicals, flu vaccines, and screenings for diabetes and cancer, as of Jan. 1.
• People with Medicare will have improved Part D prescription drug benefits if they fall into the coverage gap (a $250 rebate in 2010 and discounts on brand name drugs in 2011).
• Staying healthy will be easier with more no-cost preventive care like immunizations, diabetes and cancer screenings, and help quitting tobacco.
• Reform of the health insurance industry, eliminating many of the most egregious practices of the past, such as imposing lifetime caps and denying coverage to patients with pre-existing conditions.
• A requirement that insurance companies pay 85 percent of the premium dollar for health care benefits.
• Primary care services for Medicaid patients being reimbursed at Medicare rates beginning in 2013.
• Establishment of an enhanced online insurance exchange to help small businesses as well as families research and purchase more affordable insurance.
Eventually, over 30 million Americans currently uninsured (with their costs shifted to others) are expected to be insured under the law.
Most of the opposition to the law is centered on the requirement that individuals either purchase coverage (with appropriate subsidies provided) or pay a penalty.
The 3,500-member Maine Medical Association has supported this so-called individual mandate since 2003. A copy of our White Paper on Health System Reform can be accessed on our website at www.mainemed.com.
Virtually all citizens receive health care at some level in this country; why should everyone not be required to participate in the financing of that care?
The State of Massachusetts now has coverage at 98 percent by utilizing a coverage requirement.
Given the assistance the law will provide, and is today providing to Maine's Medicare patients and others, why on earth would the state want to spend our tax dollars to join a lawsuit to repeal it?
I'm not a lawyer, but I am a physician who cares whether or not my patients and other Mainers have access to affordable health care of high quality. The Affordable Care Act is not perfect, but it moves the ball forward toward that goal.
The Association recently surveyed its physician members regarding their opinion of the ACA.
Fewer than 15 percent of the membership favored repeal.
The remainder either supported the law and its implementation or expressed the opinion that the Association should work to retain the good portions of the law (38 percent) and work to change the bad (47 percent). That is precisely what we expect to do.
Going backward should not be an option. Let's keep the ACA and work to amend those parts of it that need fixing.
- Special to the Press Herald