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Wednesday, November 10, 2004
Conference confronts health care woes
Copyright © 2004 Blethen Maine Newspapers Inc. | ||
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A worsening shortage of doctors, insurance premium costs growing faster than incomes, a gray and sick population scattered over a rural state - darker days lie ahead for Maine unless a sea change takes place in its health care system, hospital leaders and lawmakers said Tuesday. Mirroring national trends, thousands of Mainers have been priced out of the insurance market, and those with coverage can't always see a clinician when needed, speakers said during a conference in Portland sponsored by Maine's largest health insurer, Anthem Blue Cross Blue Shield. "I live in an area where it's a six-month waiting list to get somebody into counseling," said Anne Perry, a Democratic state representative and a nurse practitioner from Calais. Dr. Eric Steele, vice president of patient services at Eastern Maine Medical Center in Bangor, noted that just one urologist in Maine takes pediatric patients on Medicaid, and that there are nights when only one oral surgeon is on call for the entire state. The problem, he said, is that physicians' incomes are on the decline, with both private insurers and government programs cutting reimbursement for services by 20 to 40 percent over the years. At the same time, doctors are dealing with high malpractice premiums and student loans exceeding $100,000. "If we don't come to appreciate Maine's physician work force as a precious commodity, it will not be there," Steele said. The latest and most broad-reaching response to Maine's health care challenges is Gov. John Baldacci's Dirigo Health act. Passed last year, the law calls for reforms to expand health care coverage in Maine, improve its quality and keep health care spending down to make insurance more affordable. The initiatives include a new health insurance program called DirigoChoice, to be subsidized in part by an annual fee from insurers and a Medicaid expansion next spring. "I'm going to fight for the implementation of Dirigo Health . . . I think it's the best game that we've got right now," said Lisa Pohlmann, associate director of the Maine Center for Economic Policy. But not everybody is a fan. Among the most controversial of Dirigo Health's initiatives is one attempting to contain costs by capping hospital spending as part of a statewide health plan. "Quit blaming the hospitals for all the health care woes and issues," said Jud Knox, president of York Hospital. "That's like blaming the police for crime or firemen for fires." Knox said that hospitals must contend with low reimbursement rates for services and often buy physician practices and nursing homes that "go belly-up because of unfulfilled reimbursement promises." Sen. Karl Turner, R-Cumberland, a critic of Dirigo Health and Medicaid expansion, said he prefers to drive down costs in the health care system by promoting preventive care and personal responsibility for one's health. "We would save tons of money and have people healthier as a result," he said. Speakers said revamping Maine's health care system will be particularly difficult in a state where sprawl has cast an aging population farther from service centers. In 2000, 14 percent of Mainers were older than 65. By 2025, that number will grow to 21 percent, said Laurie Lachance, former state economist and president of the Maine Development Foundation. "We have to consider the rural nature of Maine in how we are going to prepare to take care of this aging population," Lachance said. Keynote speaker Paul Ginsberg, president of the Center for Studying Health System Change, said it appears that "the inability to afford health insurance is working its way to the middle class" in Maine and other states, and is calling people to action. That could "energize the government to deal with this problem, but is it going to give government more resources to deal with it? I'm not sure." Staff Writer Josie Huang can be contacted at 791-6364 or at:
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