"Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including . . . medical care . . ."
Article 25, Universal Declaration of Human Rights adopted by the UN on December 10, 1948
Big News! Legislature Approves LD 1345 as Amended
A Resolve to produce 3 design options for creating a universal system of health care in the State
Augusta – On Wednesday, April 2, 2014 the Maine State Senate passed LD 1345. The vote to approve the bill was 20 to 14, along strict partisan lines. Every Republican Senator voted against the resolve "... that all Maine residents have access to and coverage for affordable, quality health care." This followed action from the previous day when the House passed LD 1345 by a 91 to 52 majority vote; four Unenrolled and three Republican members of the House of Representatives voted in support of the bill.
Further, "The amendment requires the joint standing committee of the Legislature having jurisdiction for insurance and financial services matters to solicit the services of one or more consultants to propose design options for creating a universal system of health care in the State. The resolve requires the consultant or consultants to submit a proposal by December 2, 2015 containing at least 3 design options that comply with the federal Patient Protection and Affordable Care Act." In other words, the Legislature wants to have solid data in hand, based on a current comprehensive study of all aspects of our health care financing and delivery system.
The next steps will see the bill move back to the House, then onto the Governor. You can find more detailed information about the House and Senate actions, amendments, roll-calls regarding LD 1345 here. Additionally, Maine Public Broadcasting Network reporter Patty Wight has an excellent radio summary of the April 1, 2014 House debate on the bill.
We at Maine AllCare want to thank everyone who came to testify in support of this health-care-for-all-Mainers bill on January 9th, and to those who called and emailed your Legislators – you made a difference! We want to say special thanks to Representative Priest, sponsor of the bill, and to Senator Gratwick our champion in the Senate. And thanks to all the members of the Maine House and Senate who understood the economic and human advantages of moving to a simple, state-wide health financing system that covers everyone and costs less than what we're paying today. We hope that those who are not yet convinced, and even those who are adamantly against it, will review the hard date to be produced by the proposed study and join us in in making Maine more healthy, prosperous and competitive. Let's do the right thing, please support health care for all us. Thank you.
The Maine AllCare Board
Good news for Healthcare for Everyone in Maine! Our support is growing.
The results are in: Single-payer 64 – Current system 36
On Monday, March 10th the Maine Medical Association (MMA) released the results of their recent survey on their members’ “attitudes and opinions about the directions which reform of our current healthcare system should take...” The crux of the 462 responders’ message was a resoundingYES in support for universal, single-payer coverage of all Mainers.
12-point Increase in Physician Support of Single-payer Health Care in Maine between 2008 and 2014
The survey, a repeat of one completed in 2008, was the product of a resolve introduced by Drs. Petzel, Dillihunt, Maier and Maine AllCare president Pease during the MMA’s annual meeting in October 2013. You can read more about the complete results here, as it appeared in the MMA “Spotlight” feature, online.
Universal, Single Payer Bill Introduced in Maine Legislature
Citizens from around the state gathered in Augusta on January 9th 2014 to testify in person before Insurance and Financial Services committee in support of a publicly funded health care system that would cover everyone in Maine. The proposed bill, LD 1345, will create a single Maine Health Care Fund. The Fund will be managed by an independent Board.
The Board will have total responsibility for the collection and disbursement of all funds related to health care services within our state. This approach will replace the current, complex, for- profit, insurance based system. In effect, the Fund will be a state based Medicare-like system of health care financing, with full accountability.
Dover-Foxcroft hosts Maine AllCare film and community dialog on health care for all
The Center Theatre in Dover-Foxcroft advertising the Maine AllCare sponsored The Healthcare Movie and community conversation. Maine AllCare vice president Dr. Phil Caper and board member Joe Lendvai were on hand to answer questions from a small, but diverse audience that included physicians, political candidates and small business owners. The community dialog included a brief presentation by Erin Callaway, Healthy Community Project Coordinator, about the Piscataquis County health survey she is conducting on behalf of the UMaine Center on Aging.
With Hippocratic Oath, doctors pledge allegiance to patients, not profits
By Dr. Philip Caper
Special to the BDN
March 20, 2014
The Maine Medical Association recently updated a 2008 poll of their members that asked the question, “When considering the topic of health care reform, would you prefer to make improvements in the current public/private system (or) a single-payer system, such as a ‘Medicare-for-all’ approach?” In 2008, 52.3 percent favored the Medicare-for-all approach. In the updated poll, released last week, that number had risen to 64.3 percent.
It’s pretty unusual for two-thirds of a group of doctors to agree on something as controversial as a single-payer health care system. Until recently, doctors formed the core resistance to “government-run” health insurance in the U.S.
A number of factors account for this impressive change, but the huge administrative burden on practicing physicians created by our plethora of private insurance schemes is certainly near the top of the list.
The other day, I spoke with a Maine physician nearing retirement and looking forward to it. She was recently returning home after a long day in her practice, carrying her “homework,” a pile of administrative paperwork several inches high. Her husband asked her how she got so far behind in her paperwork. “I wasn’t behind at all,” she replied. She did this much paperwork, mostly insurance forms, at least twice a week.
American physicians spend at least three times as much time, money and effort on administrative work related to payment and insurance coverage as our Canadian brethren, with their single-payer system. Administrative hassle is a major factor driving more and more American doctors to sell our practices to large corporations that take care of the back-office work. The Affordable Care Act has only added to that burden. Sixty percent of doctors now work for corporations, and that number is growing.
Working for a corporate provider of health care services is a mixed bag. He who pays the piper calls the tune. As both for-profit and nonprofit health care corporations have become increasingly focused on the bottom line, doctors working for them have come under increasingly subtle and not-so-subtle pressures to generate revenue for their employers.
Some tests and procedures are more profitable than others. Increasingly, doctors’ “productivity” is measured by the amount of profitable revenue we produce rather than by the results we get for our patients. But in health care, profitability is a very unreliable measure of value because doctors’ fees and other health care prices are often set arbitrarily.
When we graduate from medical school, most of us take the Hippocratic Oath, swearing our primary allegiance to our patients. Young doctors tend to take their oath very seriously. Most doctors truly want to do what’s best for patients, not their insurance company or our employers’ bottom line.
But in today’s corporatized and increasingly monetized health care environment, the demands for generation of profit often directly conflict with our clinical judgment. The belief that doctors and other healers act as stewards for our patients’ welfare has long earned us a special place in society and the trust of our patients. That position and that trust, so critical to healing, is now threatened.
This conflict has made many doctors very angry. Practicing a profession that has traditionally been a calling has become a business. Doctors today are caught in a system corrupted by an excessive focus on money that is forcing us to behave in ways that conflict with our professional ethics. We are growing very tired of being told how to practice medicine by insurance company bureaucrats and corporate MBAs.
This is another major cause of the burnout experienced by increasing numbers of doctors. Many older doctors are now simply looking for a way out. Others are calling for systemwide reforms that will allow them to return to focusing on the welfare of their patients. Hence the results of the recent MMA poll.
In an excellent new book called “What Matters In Medicine”, longtime Maine family doctor David Loxterkamp points out that medical care, while often using scientific jargon, methods and tools, is at its core a profession about relationships, not profits. That’s something the bean-counters and policy wonks who have become increasingly influential in determining the nature of our corporatized health care system seem unable to understand.
It’s time to remove corporate profit from the financing of health care, and perverse financial incentives from the direct provision of services. It’s time for improved Medicare-for-all.
Physician Philip Caper of Brooklin is a founding board member of Maine AllCare, a nonpartisan, nonprofit group committed to making health care in Maine universal, accessible and affordable for all. He can be reached at firstname.lastname@example.org.