December 13, 2018
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Health advocates: Axing community anti-smoking programs ‘like killing Peter to pay Paul’

Mario Moretto | BDN
Mario Moretto | BDN
Jessica Scheno, a senior at Maranacook Community High School, speaks with reporters Monday at the State House, where she and dozens of other students, doctors and health advocates decried Gov. Paul LePage's proposal to gut funding for Healthy Maine Partnerships and school-based health centers, both of which work to prevent teen smoking.

AUGUSTA, Maine — Health groups, doctors, students and others turned out in force Monday at the State House to oppose a budget initiative that would take away roughly $20 million in funding for community-based smoking cessation and prevention services.

The plan, part of Gov. Paul LePage’s two-year budget proposal, would see that money used instead to continue funding heightened Medicaid reimbursements for primary care providers in the state.

During a media event organized to decry the shift, Dr. Daniel Onion, a primary care doctor in Augusta, said that tradeoff is like “robbing Peter to pay paul, or really, killing Peter to pay Paul.”

Onion and others — including the Maine Public Health Association, American Lung Association, Cancer Action Network and American Heart Association — said that by pitting community health organizations against primary care doctors, LePage offers lawmakers a “false choice.”

It’s not about whether doctors or community-based groups are better at keeping Mainers from smoking or helping them quit, but about how they work together, said Doug Michael, president of Maine Public Health Association and Chief Community Health Officer at Eastern Maine Health Systems in Bangor.

“Primary care is only one piece of the puzzle that keeps us healthy and reduces cost,” he said.

The $20 million represents not taxpayer dollars, but settlement money from the state’s landmark 1998 lawsuit against the tobacco industry. The money is spent on 27 local nonprofit groups known as Healthy Maine Partnerships, which fight smoking, obesity and other chronic diseases, as well as on school-based health centers that provide counseling to teens. That program would be eliminated if lawmakers accept LePage’s proposal.

Jessie Scheno, a senior at Maranacook Community High School, home to one of those health centers, said Monday that if Maine students had only doctors to turn to, there would be a “marked increase” in teen smoking.

A policy brief prepared by the state Department of Health and Human Services stated that the missions of the Healthy Maine Partnerships — reduction of smoking rates and the prevention of obesity, substance abuse and chronic disease — are better left to doctors.

DHHS Commissioner Mary Mayhew has said the initiative is a means for targeting smoking cessation and prevention dollars where they’re most needed. About 43 percent of patients in the Medicaid program, known here as MaineCare, smoke. That’s about twice as many as in the regular population, according to the Healthy Maine Partnerships.

The department has also argued that Healthy Maine Partnerships have been ineffective, citing figures that show Maine ranks seventh nationally for smoking cessation spending but that its smoking rate largely mirrored the national average, with about one in five adults smoking.

“It is imperative that we aggressively support the funding of direct services within the primary care physician office as one of the most effective forms of clinical preventive services,” she told legislative budget negotiators on Monday.

Follow Mario Moretto on Twitter at @riocarmine.


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