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By Rep. Lisa Miller
September 15, 2008
I have worked for years as a program officer for a health foundation, helping nonprofit agencies improve organizational viability and program effectiveness. I can tell you that one of the few incentives nonprofits have for attracting quality employees to their important work is the promise of health care benefits. Unfortunately, over the past several years, insurance rates have increased so dramatically that many nonprofits and small businesses are struggling to provide insurance to their employees. The burden of uninsured and underinsured Mainers is taking its toll on our economy.
The 123rd Maine Legislature sought to address the issue of rising insurance rates by both attracting younger people into the insured pool and addressing skyrocketing health care costs. We passed a bill in 2007 extending insurance coverage for young adults up to the age of 25, if they were covered previously as dependent children in a family’s policy. In 2008, within the Dirigo Health Program bill, we put in place market reform initiatives aimed at bringing more young people into the market and creating better medical habits in this insurance-vulnerable population.
Bringing more young people into the insurance market creates a win/win situation. This is a largely healthy population, so costs can be spread out over a wider base, and insurance rates will go down—a “win” for those of us who are insured. But these young “invincibles” also have a lower perceived need for insurance. Unfortunately, this lack of perceived need often creates bad habits – they are less likely to seek preventive care, follow up on health issues that do arise, and follow through on treatments that are prescribed. If something does happen to an uninsured young adult, the financial burden that results could set him or her up for a lifetime of debt. By entering into insurance coverage, young people have protection against such risks, which is a “win” for them.
With regard to high health care costs, we enacted legislation in 2007 that will look into the cost drivers behind high health care costs and identify savings. A committee of legislators and health care experts is examining large numbers of reports and data to get at the root of our spiraling costs in Maine, looking at hospital care, physician services, ER use, pharmaceuticals, mental health services, administrative costs, and other cost centers. They are charged with making recommendations on bringing rate of increase in health care costs down to the level of the cost of living.
Their work depends on a growing trend in health care—transparency. To effectively control health care costs, purchasers of health care (consumers and businesses alike) can benefit from a more transparent pricing system. Unlike every other product we purchase – groceries, clothing, even vehicle repair – medical prices are far more complicated to obtain. If we are given more information about the comparative costs and effectiveness of varying treatments, then we can make better decisions about the care we purchase, opting away from unnecessary treatments and reducing overall costs of health care. The Dirigo Health Program has done some good work around cost transparency, requiring hospitals and providers to disclose the average charges for 15 different in-patient and 20 different out-patient services. But much more needs to be done.
The Legislature this past session also passed an important cost-control measure for consumers related to medical errors. Thousands of Americans die each year as a result of medical errors that are preventable, resulting in millions of dollars of expense. Maine, in step with a handful of other states, passed LD 2044, which prevents hospitals from charging patients for a specific range of medical errors. While such errors are few, this law nevertheless shifts the burden of payment from the victim back to the providers responsible for the care. Hospitals and other health care providers will need to be more judicious in implementing accepted protocols and systems of care that will help prevent these medical errors in the future.
Whether or not you agree with the idea of health care being accessible to everyone, there is no argument against making health care affordable for everyone. Reducing health care costs and making health insurance more accessible is good for the economy, it is good for small businesses, and it is good for Mainers.
Rep. Lisa Miller represents House District 52 and is a member of the Legislature’s Health and Human Services Committee.