Candidates air views on public health care

Posted Sept. 12, 2010, at 8:34 p.m.

BAR HARBOR, Maine – Libby Mitchell wants to see a dental school become a reality in Maine. Kevin Scott says more education is key to driving down teen smoking rates. Shawn Moody argues that funding for mental health services cannot be cut further without jeopardizing the public health safety net. Paul LePage says “proven science” is needed to establish effective environmental policies in Maine. And Eliot Cutler promises to set a good example to overweight Mainers by losing 30 pounds if he’s elected to the Blaine House come November.

The five gubernatorial candidates spoke in a friendly public health panel discussion Sunday morning at the annual meeting of the Maine Medical Association in Bar Harbor. It was only the second time this campaign season that all the candidates have been in the same place at the same time.

Standing at identical lecterns on a low stage at the front of a packed conference room, the candidates took turns fielding six prepared questions posed by MMA’s incoming president, Dr. Jo Linden, an emergency physician from Portland. The questions, which were available to the candidates before the panel discussion, addressed public health issues such as Maine’s growing rate of teen smoking; the appropriate use of money in the Fund for Healthy Maine; environmental issues such as toxic exposures and climate change; the shortage of physicians in Maine; the obesity epidemic among Maine adults and children; and the state’s higher-than-average rate of attempted suicide among high school students.

Video of the forum (two parts):

Each candidate had two minutes to answer each question, with no cross-talk or back-and-forth debate allowed. The event, which was open to the public as well as to MMA members attending the meeting at the Harborside Hotel and Marina, drew about 200 onlookers. The atmosphere in the room was serious with only occasional bursts of humor and no real criticism among the candidates or from the audience.

Independent Cutler briefly mentioned Republican candidate LePage’s recent comments that the Maine Department of Environmental Protection exercises too much regulatory power and contributes to an anti-business atmosphere in Augusta. Speaking in response to Linder’s question about environmental safety and health, Cutler referred to the pro-environmental legacy of U.S. Sen. Edmund Muskie and said Maine must do more to promote environmental protection.

“Our rivers and lakes in Maine are relatively clean,” he said, but some are seriously contaminated with mercury from years of industrial waste dumping. Cutler said he also is concerned about childhood exposure to lead paint in older housing and air quality problems related to wood stove smoke and to the accumulation of toxic contaminants from coal-burning power plants in other states.

For his part, LePage said Maine’s congressional delegation should be more attentive to the air quality problem, but that the state must exercise “common sense, the best technology, and proven science, not someone’s emotional testimony” in developing appropriate environmental regulations.

Four of the candidates said they would be hesitant, at least, to raise cigarette taxes in order to drive down teen smoking rates.

“Absolutely not,” said Democrat Mitchell, citing hard economic times and the need to avoid burdening already-struggling Mainers with more taxes. She called for more anti-tobacco education in schools and workplaces, and praised state policies that prohibit smoking in most public places, including state parks and beaches.

Independent Scott, however, said he would support increasing the tobacco tax, so long as any funds raised were funneled into the Fund for Healthy Maine, a public health fund that receives about $50 million a year from the tobacco industry.

All the candidates agreed the Fund for Healthy Maine, which has been raided from time to time, should be protected from legislative pressure during lean budgetary times. They also agreed that spending from the fund to counter smoking, obesity and substance abuse and to develop a stronger public health presence in Maine should be subject to scrutiny.

“Have we had a return on our investment? Has it worked?” said LePage. “If not, we need to rethink it, rework it so the funds are used properly and effectively.”

The candidates offered various strategies for attracting more doctors to Maine, a matter of consuming interest to the medical profession.

“It’s got to be profitable,” said Moody. “The state has to start paying its bills.”

LePage said more young people from rural Maine should be encouraged to set their sights on a medical career. Cutler, who boasts a number of physicians in his immediate family, said the state must develop a health care delivery system that provides professional support and financial opportunities to practice here.

Scott said reforming Maine’s medical liability laws would give the state a competitive advantage in attracting new doctors. Mitchell said medical and dental education programs, including a proposed dental school at the University of New England in Biddeford and a medical school partnership between Tufts University and the MaineHealth system in Portland, are critical to beefing up the state’s supply of health care providers.

After the discussion, medical association Executive Vice President Gordon Smith said the event offered two-way benefits. Not only did physicians and others in the audience have an opportunity to meet and assess the gubernatorial candidates, but the candidates also obtained insight into some issues of importance to Maine’s medical community, he said.

“Our members would probably say the biggest issue before us now is responding to the new federal health care law,” Smith said. “But it’s not fair to ask these folks how they feel about something that complex and divisive.”

“There are limits to this kind of format,” agreed Eric Steele, vice president and chief medical officer for Brewer-based Eastern Maine Healthcare Systems. Steele also writes a biweekly column for the Bangor Daily News.

“People here want to look for the broad themes,” he said. “Do [the candidates] even get the basics about health care? Will there be a role in their administration for the organized physician community? In the end, they’re all going to be stuck with the same political realities.”