Legislating must build public trust, not cynicism

Posted Dec. 25, 2009, at 7:25 p.m.

David Axelrod’s nose grew 3 inches the other day. President Barack Obama’s senior adviser said that the single-state and special-interest ornaments hanging from the Senate health care bill are par for the course. “That’s the way it has been. That’s the way it will always be,” he told CNN.

In Maine we know he’s wrong.

Understanding that the legislative process must create a foundation for public trust runs in the DNA of Maine senators, from Margaret Chase Smith to Edmund Muskie to Olympia Snowe.

Sen. Smith blew the whistle on Sen. Joseph McCarthy’s abuse of Senate process with her Declaration of Conscience speech.

Sen. Muskie won unanimous Senate passage of both the Clean Air Act and the Water Pollution Control Act, two of the most consequential statutes that the Congress ever has enacted. There wasn’t a single special-interest provision in those acts — nor, for that matter, in the War Powers Act or the Budget Act. All were landmark laws shepherded by Muskie, one of the master legislative craftsmen in American history.

Measured against the Smith-Muskie-Snowe standard, the Senate’s health care bill is a disgrace.

“The credibility of the process will determine the credibility of the outcome,” Sen. Snowe said in a news release issued by her office. In this case, neither the Senate process nor the outcome was credible.

Additional Medicaid money was a special Christmas gift for Nebraska. The Dakotas, Utah, Wyoming and Montana got increased Medicare payments, while a single medical school in Pennsylvania received $100 million. Higher Medicare payments became stocking stuffers for hospitals in three Iowa counties, and our neighbors in Massachusetts and Vermont found hundreds of millions of dollars for expanded Medicaid coverage under their trees.

Santa Claus was even kinder to the health insurance industry, whose premiums in Maine have risen nearly five times faster than our household incomes over the last decade. Insurers hijacked the debate in the Senate and made out like bandits. They got 31 million new customers with premiums subsidized by the federal government, no competition from a public option and an exemption from antitrust laws.

You and me? Lumps of coal.

Indeed, the legislation won’t contain consumers’ soaring costs of health insurance and medical care, because there are few provisions to discourage payments for procedures or to require the kinds of reforms that can contain health care costs. And if you’re a woman covered by subsidized health insurance and you want to protect your freedom of choice, you’ll have to write a separate check of your own for abortion coverage — whether you can afford it or not — and states can prohibit insurance companies from offering abortion coverage at all.

When I am governor, we will do better in Maine. Health care in Maine can work for all of us, if we make some changes in how we provide it and pay for it. For starters, we need to reject the idea that our health care system should be organized around the health insurance industry, according to their rules and designed to safeguard their profits.

We can bring health care costs under control in Maine by ending Dirigo and MaineCare and instead providing essential health care services for all Maine residents through a new statewide framework providing coverage and care at a price that Maine businesses and taxpayers can afford. We should adhere to these three principles:

1. All Mainers should have access to essential health care services.

2. The program must be financially sound and sustainable.

3. Because many of the diseases we pay to treat are preventable, we must reward healthy behaviors and pay for healthy outcomes, de-emphasizing payments for procedures.

Cianbro, Hussey Seating and other large Maine employers have succeeded dramatically in controlling costs and providing incentives for people to stop smoking, to lose weight and to take better care of themselves. We can work with employers, hospitals and groups of providers to build a system that stresses proper incentives, cost-effective performance, quality outcomes and accountability on all sides.

The Senate has allowed itself to be railroaded by a group of special interests singularly intent on profiteering.

Don’t give up. We will put in place in Maine a program that is built for Maine, that Maine can afford, and that contains costs and delivers real reform.

Eliot Cutler, a Bangor native, is an independent candidate for governor. He was a legislative aide to Sen. Edmund Muskie. His campaign Web site is www.Cutler2010.com.

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