Monday, May 5, 2008

Less for Childless Adults, More for Foster Children 

By John LaPlante

Categories:  Maine, Medicaid

As part of a publication (PDF) on how to address a state budget deficit, the Maine Heritage Policy Center says that the state can save up to $53.5 million a year by changing its Medicaid program.

Maine is one of only 10 states that provide Medicaid to non-disabled, childless adults. In addition, in Maine non-disabled parents can receive Medicaid benefits at incomes higher than those allowed in 46 other states.

If Medicaid income eligibility rates in Maine were standardized to those of the average state, some of the money spent on non-disabled adults could be saved, while another portion of it could be spent on care for the elderly, disabled, and foster children.

• posted by John LaPlante
• 9:58 am
• 0 comment

Sunday, May 4, 2008

Gold-Plated Benefits for State Employees 

By John LaPlante

Categories:  Maine

"The rich," wrote F. Scott Fitzgerald, "are different from you and me." So too are state government employees.

The average large company in Maine spends $3,929 annually for each employee's health insurance. The State of Maine pays much nearly double that amount, or $7,445, for each one of its employees.

State employees have it good in another way, with no coinsurance and only a $200 deductible. Employees at the largest companies, by contrast, have a $400 deductible and a coinsurance of 25%.

If the benefit package of state employees matched that of private sector employees--even those of the most generous companies--state taxpayers would save over $30 million.

As the Legislature considers making cuts that would affect the elderly and poor, it's unreasonable for state employees to have benefits that are 93% above those of the private sector.

You can find a more thorough accounting at $217 Million in Reasonable Spending Cuts to Close the Budget Gap (PDF).

• posted by John LaPlante
• 10:14 am
• 0 comment

Monday, March 17, 2008

Increasing Taxes for Additional Health Funding Would Hurt Maine Families 

By J. Scott Moody

Categories:  Maine

Tarren Bragdon, chief executive officer of The Maine Heritage Policy Center, testified before the Maine Legislature's Joint Standing Committee on Insurance and Financial Services on March 13, 2008 and presented reasons to oppose additional funding to prop up the failing Dirigo Health program. Mr. Bragdon commented, "Dirigo Health was started in 2003 with the goal of covering 128,000 Maine people in a self-supporting health insurance program which would need no further taxes or state funds after the first year." The bill, LD 2247- An Act to Continue Maine's Leadership in Covering the Uninsured, is before the committee currently and would increase taxes for addtional Dirigo Funding. "Today, the program covers only 4,466 Mainers who were previously uninsured, which is less than 4% of the 2003 goal, in a program that costs $45 million a year," noted Mr. Bragdon.

• posted by Scott Moody
• 1:48 pm
• 0 comment

Thursday, December 27, 2007

Maine Law on Prescription Drugs Overturned 

By John LaPlante

Categories:  Maine, Pharmaceuticals

A federal judge in Maine has, in the words of the Bangor Daily News, “overturned a new state law that restricts access by medical data companies to doctors' prescription information.”

Tarren Bragdon, of the Maine Heritage Policy Center, has previously criticized the bill by citing its potentially harmful effects on patient health:

Supporters of this law argue that restricting this prescriber-level data will block pharmaceutical sales representatives from using this data to persuade doctors and others to prescribing more expensive drugs.

However, the reality is that by knowing which physicians are prescribing particular medications is an efficient and confidential means in which to target those doctors treating certain types of individuals. By being able to identify physicians, those with patients who would benefit can be quickly contacted about new medications, the latest treatment research and innovation drug trials.

In response, the News ran another op-ed supporting the law by repeating the adage that profits are bad and new drugs are nothing but ways for pharmaceutical companies to fatten their coffers.

New drugs are not for every person in every situation better than old ones. But the alleged conflict between profit-seeking behavior and consumer health is best mediated by physicians and consumers consulting together—not by politicians.

• posted by John LaPlante
• 5:40 pm
• 0 comment

Wednesday, June 6, 2007

Index of Health Care Ownership is Out! Every State Ranked! 

Utah Top of the List, New York Bottom of the Barrel on 24 Measures

By John R. Graham

Categories:  Alabama, Delaware, Maine, Nebraska, New Jersey, New York, North Carolina, North Dakota, Utah, Vermont

PRI has released the Index of Health Ownership, which uses 24 variables to rank all the states according to their residents' freedom from undue government interference in health care.

Top 5: Utah, Nebraska, Delaware, North Dakota, Alabama

Bottom 5: New York, Vermont, New Jersey, North Carolina, Maine

I know SPN wants to collaborate in promoting this effort and I'll be in touch with John LaPlante on that.  Any SPN members who want more color or would like me to speak in their state please contact me.  This is something we intend to repeat periodically, hopefully annually.

Go forth and own your health care!

• posted by John R. Graham
• 12:22 pm
• 0 comment

Friday, April 20, 2007

"Universal" Care in the States Gets Wacky 

Massachusetts, Maine, and California

By Greg Scandlen

Categories:  California, Certificates of Need (CON), Maine, Massachusetts

Massachusetts. In Massachusetts it gets more interesting by the day. Many of our conservative friends who supported the Massachusetts legislation did so because they naively thought it would enshrine the idea of "personal responsibility." They skipped over the reality that people already have a "personal responsibility" to pay the bills they owe and creditors may already sue them and attach their wages if they fail to pay. Conservative supporters of the law also dodged the disturbing question of whether it is really "personal responsibility" if the government mandates the behavior - "I will tell you what to do, and you have a 'personal responsibility' to do it."

The rationale I've heard most often for this dodge is "well, we don't really like this law, but we supported it to avoid something much worse." Oh, really? As The Connector board continues its deliberations, the program is morphing into precisely the Marxist dream of, "to everyone according to their need, from everyone according to their ability."

Specifically, for the first time ever in the United States health insurance premiums under The Connector will be based on income. According to the Boston Globe, The Connector has adopted a sliding scale "Maximum Affordable Premium" that goes like this for singles -

Income: $0 - $15,315 - Premium: $0
Income: $15,316 - $20,420 - Premium: $35
Income: $20,421 - $25,525 - Premium: $70
Income: $25,526 - $30,630 - Premium: $105
Income: $30,631 - $35,000 - Premium: $150
Income: $35,001 - $40,000 - Premium: $200
Income: $40,001 - $50,000 - Premium: $300

The standard is "affordability." If a resident of a particular income can't find coverage that is "affordable" they don't have to comply with the mandate. The Connector estimates that 20% of the uninsured will not have to buy coverage, so it is no longer using the expression "Universal," it has switched over to "Nearly Universal."

Right now, the affordability standard stops at $50K for an individual, but why stop there? Is it fair for an individual who makes $60K to pay the exact same premium as someone who makes $120K or $240K or $360K? Of course not (the argument will go), that is "regressive." The higher income people can well "afford" to pay 3 or 4 or ten times as much for their coverage. After all, they are required to buy whatever The Connector tells them to buy, and pay whatever The Connector tells them to pay, so the goal of "Nearly Universal" will not be violated, but "fairness" and "affordability" will reign. Even better, why not scrap all these clumsy mechanisms and pay for health insurance through the income tax system?

SOURCE: Boston Globe. See also: New York Times.

Maine. What's a Politician to do? Four years ago Maine's newly elected Governor John Baldacci rammed a massive bill through the state legislature that he promised would save the health care system in that state. It clamped down on capital investment with an expanded Certificate of Need program, controlled costs through price controls, and created a state program called Dirigo Health that was supposed to cover all of the uninsured. Because all the uninsured would be covered, hospitals would have no more bad debt and insurance companies would not pay extra to cover those unpaid costs. The program would be financed with the "offsets" from all these savings. Yahoo!

The governor became an instant celebrity in the national media for his visionary reforms. Commentators everywhere said that Maine is finally living up to its motto - Dirigo! (Latin for "I lead.")

Today, Dirigo Health covers a mere 13,400 people, most of whom were already covered by private coverage. The state paid $43.6 million in subsidies for these people last year - over $3,000 per person. Health care costs are higher than ever. By any standard the program has been a failure.

So now the governor has introduced "Dirigo 2.0," which amounts to a gubernatorial temper tantrum. He is saying to the people of Maine, "You didn't do what I wanted you to do four years ago, so now you'll be sorry!" He wants to raise taxes (ooops, I mean "savings offset fees") and make coverage mandatory. As a sop to insurance companies he would slightly loosen the community rating restrictions (allowing a 30% variation based on age instead of the existing 20%), and create a "reinsurance plan" to subsidize high claims. But he would also have the state take over administration of Dirigo Health, essentially creating a state-owned insurance company.

(The state already runs its Medicaid program and pays doctors 53% of what Medicare pays. Gotta wonder if it would do the same for Dirigo Health).

SOURCE: Village Soup. See also: the Maine Heritage Policy Center..

California. In California, it has recently dawned on union leaders that Mr. Schwarzenegger's idea for mandatory coverage might disadvantage union members. An article in the L.A. Times reports on that the governor is thinking about how to enforce his mandate. The article says that refuseniks "could be tracked down by the state or a private contractor, enrolled in a plan, and fined until they pay their premiums." Sort of a Bounty Hunter approach, I guess. Maybe you'll be able to watch the show on Fox with blood hounds tracking the uninsured through swamps until they are caught and have an insurance ID number tattooed on their forearm.

But a lobbyist for the Service Employees International Union is concerned because "fines might be unfairly levied on people caught without health insurance because of circumstance beyond their control."

The article goes on to say, "The governor said he is studying as a possible model a new system that state Department of Motor Vehicles is using to locate drivers who lack automobile insurance." There ya go. Of course, the rate of non-insurance for mandatory auto coverage in California is 25%, while it is only 20% for voluntary health coverage.

What does any of this have to do with health care? It's only about enforcing the will of Governor Schwarzenegger.

SOURCE: L.A. Times

From Consumer Power Report #78, published by Consumers for Health Care Choices 

• posted by Greg Scandlen
• 8:46 am
• 0 comment

Sunday, January 28, 2007

Maine's Dirigo Plan: Not Quite Universal Coverage 

Goal for First Year: 31,000; Reality: 12,153

By John LaPlante

Categories:  Maine

Maine set off the recent round of "put everyone into insurance" frenzy that the states are engaged in. Arnold King points to an AP story that tells us that things haven't quiet worked out that way. Not only has enrollment fallen (far) short of expectations, but the plan will be subjected to further review and tinkering.

Check out the Maine Heritage Policy Center for more analysis of Dirigo, the one-year old universal coverage plan.

• posted by John LaPlante
• 3:44 pm
• 0 comment