*~KindredSouls~* Healthcare Solutions

[Guest guest]

Healthcare Solutions NOW t r u t h o u t | Programming Note PBS Airdate: Friday 24 February 2006 at 8:30 p.m. on PBS (Check local listings at http://www.pbs.org/now/sched.html.) NOW reports on an innovative healthcare system for the uninsured.

Healthcare costs are skyrocketing, millions are uninsured, and the price of health insurance is crippling some of the biggest companies in the US so why is one innovative solution being derailed by partisan politics? On Friday NOW profiles a controversial plan in Maine that could be an answer for the state's working poor, but has come under fire from conservatives who say it's a waste of taxpayers' money and big insurance companies that say it just passes costs onto their customers. The report goes inside the debate and examines what it means for the future of healthcare in America.

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from PBS:

 

 

Maine's Dirigo Health Reforms In June 2003, Maine Governor John E. Baldacci signed into law the Dirigo Health Reform Act, with the goal of providing all Maine's citizens with access to healthcare by 2009. The Governor's hopes for the plan are high "Our goal is quality care for everyone at a price we can afford." The Governor wanted Dirigo to control costs, improve the quality of healthcare and extend insurance coverage — a tall order. The act included measures to control hosptial and health-care costs and created a new health plan, DirigoChoice, which provides discounted health insurance coverage to Maine businesses with 50 or fewer employees, the self-employed and individuals. DirigoChoice operates on a sliding scale. Enrollees obtain a comprehensive policy from Maine's largest insurer, Anthem Blue Cross/Blue Shield, but pay what they can afford according to an income index. The difference is covered by the state. About 8,000 Mainers are covered under DirigoChoice. The legislation included plans to expand the program to larger companies. How was Maine supposed to pay for all of this? The state paid $53 million to launch the program. Further funding was to be found from the cost savings by Maine's hospitals and to insurance companies — from fewer E.R. trips by the uninsured among other savings. The plan called for an evaluation of those savings and then for the insurance companies to pay that cash back into the Dirigo system. Maine's independent insurance commissioner did evaluate the program, calculating that $43.7 million had been since the program started. Hospital budget reforms appear to account for much of the total, in part because far fewer people have taken advantage of Dirigo than the Governor anticipated, 8,000 instead of 30,000. The Governor contends that those savings benefited the insurance industry and has called for payment. The insurance industry counters that the assessment is erroneous and contend that if they are made to pay the $43.7 million bill, they will pass the costs on through higher premiums for consumers — constituting what the plan's opponents call "The Dirigo Tax". The Maine Association of Health Plans has filed lawsuits challenging a $43.7 million assessment, contending it is "arbitrary or capricious," and that any savings they have seen are outweighed by the fee.

According to the Governor's Web site, "Dirigo Health won unanimous support from the Joint Select Committee on Health Care Reform and 2/3 majorities in both chambers of the Legislature." But support for the plan is not quite as overarching today. Indeed, as the Governor faces re-election Dirigo has emerged as a major campaign issue. Read more about the plan, and the debate, below.