Thursday, September 25, 2008

Is it time to reconsider Dirigo health?

Thursday. Senior Fitness day at a local physical therapy center is one of the highlights of my Thursdays. Tuesdays, too. We had a fun beginning today as a little fun was poked around waiting for an authoritative person to arrive and let us into the gym area. It always amazes me when we can sit in the waiting room waiting and talking about everything and anything that comes to mind, and, like today, even poke some friendly fun at each other and then head into the gym area and the workout becomes serious. We have a mighty fine group of seniors doing this thing.

The Red Sox’s regular season is all but over. They did win last night, but so did Tampa Bay, the division leaders. The Rays’ magic number is now one. Any Sox loss or Rays win puts Tampa Bay into a place they’ve never before been. The Sox will play the Angels in the first round of the World Series playoffs.

It might appear that the state’s foray into universal health care insurance may be on the skids. We won’t really know the fate of the Dirigo health plan until the Legislature meets next year, but the Dirigo light may be dimming. The state’s insurance commissioner Mila Kofman set the Savings Offset Payment (SOP) at $48.7 million. That’s two-thirds less than requested by the Dirigo board but 50 percent higher than last year.

The SOP is theoretically the amount of money Mainers saved as a result of Dirigo. I use the word “theoretically” simply because very few people know how the figure is determined, where the savings allegedly came from, or how a plan that serves only eleven thousand people could generate that many savings. Now I’m sure that somewhere out there in that vast emptiness we call cyber space where all the information ever uttered or known to man floats aimlessly there is something that might explain just exactly what the SOP has accomplished. I haven’t been privy to it, yet.

In my opinion Dirigo has been a disaster ever since it was hatched by Governor Baldacci more than five years ago. By the fifth year the plan was suppose to be insuring 150 thousand previously uninsured Mainers. Five years after its inception, it’s insuring 11 thousand five hundred, most of whom were previously insured with private insurance. The program was supposed to be self-sustaining but several hundred million of our dollars has been poured into Dirigo, some from premiums, some from grants, some from taxes, and some from diverting funds from other programs.

The SOP itself is a tax as a 1.8 percent surcharge is paid by insurance companies on paid claims. Who is na├»ve enough to believe that cost isn’t passed on to rate payers? Dirigo also borrowed several million dollars from the general fund which it says it will pay back. During a very late night session as the last Legislature came to a close, the Democrats, along with one or two Republicans passed a 75-million dollar tax on most beverages Mainers consume and on paid insurance claims.

Mainers rebelled. A citizens’ petition drive to get that tax on the November ballot succeeded by a huge margin. The people didn’t want more taxes, especially after the Legislature and governor had promised there wouldn’t be any. With many Mainers concerned about winter heat and car gasoline as well as food and other items rising in prices, they simply didn’t want more taxes. The money crisis has grown with the financial institutions problems.

Because of the likelihood of the tax increased being repealed by the referendum, Dirigo funding will continue with the SOP. But there’s even a chance that will once again be challenged in court.

What’s the answer to the manmade disaster called Dirigo and the high cost of insurance to Mainers which Dirigo didn’t help? First, Dirigo should be permanently mothballed. Most of the people who have stuck it out with Dirigo could return to the private plan they previously held. The Legislature should look to states all around us and all over the country that have competitive insurance companies without the massive restrictions put on companies in Maine to see why their insurance costs are so low. Folks in New Hampshire, for example, pay about half what Mainers pay.

Insurance companies must be allowed to become competitive. It was the “reforms” back in the early ‘90s that drove all but two companies that offer private insurance out of the state. Without competition and with many mandates, prices in Maine rose beyond affordability. Universal single payer health care has only been marginally successful in countries where it has been tried. People who don’t get sick love it; people on months-long waiting lists for care hate it.

Some Democrats in the Legislature are now privately saying it’s time to pull the Dirigo plug. Most Republicans want to see it disappear. Perhaps the time has come to end this very expensive experiment.

I’ve only touched upon a small part of the Dirigo situation as I see it. The best way to understand it is for you to do your own research into the program. No doubt it’ll get another mention here sometime in the future.


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