June 18, 2018
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Seizing Maine’s opportunities for health care

By Eliot Cutler, Special to the BDN

Health care? Let’s get to work. President Obama came to Maine last week to celebrate passage of the new health care legislation. Some of us cheered; some of us jeered. Clearly, the national debate over the effectiveness and affordability of this sweeping new law won’t end soon.

While politicians argue, we have an extraordinary opportunity right here in Maine to innovate with new, much better and more affordable forms of health care delivery. Let’s not blow it.

To get it right, we first should understand the shortcomings in our existing system. Then we need to get smart and make the system work better for all of us.

Two facts describe in stark terms what’s wrong with today’s system. First, health care is organized around insurance companies, not patients or the people who provide the care, and the new federal law failed to change that. Insurance companies grab more than 20 percent of every dollar we spend on health care, yet they take no real risks nor provide any meaningful cost controls.

Second, the current health care system is focused almost entirely on treating disease and too little on preventing it. Sixty percent of what we spend on health care goes for the treatment of chronic illnesses that were preventable.

Thus, our whole system is focused on paying insurance companies hefty fees to collect skyrocketing premiums from each of us and then to use some of that money to pay for expensive procedures that people need because they are sick.

Obviously, it’s important that we get the medical attention we need when we get sick. But we also need to put the focus on what we know makes more sense and would cost us much less money — paying to keep people healthy. Doctors and hospitals are paid much more money for performing almost any medical procedure than they are paid for spending an hour counseling us about what we can do to avoid the need for the procedure in the first place.

The incentives in our system all run the wrong way.

Maine is a relatively small state of 1.3 million people. We have 38 hospitals — all of which are nonprofit and most of which are organizing themselves around our three large medical centers in Bangor, Lewiston and Portland — plus many smaller, community-based organizations such as Penobscot Community Health Care in Bangor, which serves thousands of people effectively and efficiently. Most primary care doctors in Maine are now employed directly by those hospitals and health care centers and pretty soon nearly all of them will be.

Coupled with the new federal law’s encouragement of demonstration projects, this unusual concentration of nonprofit hospitals and clinics and employed physicians comprises valuable assets that give us a once-in-a-lifetime opportunity to create a new model that works for Maine people and businesses. No other state is so well positioned and we in Maine may never have a better chance to get it right. So let’s buckle down and get to work.

Let’s build our health care system in Maine on this framework of strong hospitals and dedicated providers, paying them fairly and directly to help each of us to stay healthy — as well as to take care of us when we are sick. We can preserve competition and consumer choice, while providing essential health care services to every Maine citizens at a cost that we can afford and that is far more sustainable than our current system.

Let’s follow the example of Cianbro, Hussey and other Maine employers whose highly successful programs have succeeded in controlling costs while improving the health of their workers and their families. They have demonstrated that you can dramatically lower health care costs by promoting wellness and providing strong incentives for people to stop smoking, to lose weight and to take better care of themselves.

Let’s learn from successful community health care providers like PCHC. Nearly 75 percent of their patients are MaineCare or Medicare participants. They serve more than half of the population of Greater Bangor, including 15,000 children, adolescents and teens, and their main clinics are open seven days a week, which helps reduce costly emergency room visits. And they do all this while keeping administrative costs under 8 percent!

Look around. All the pieces are here in Maine, and now we have a new federal law that, regardless of its flaws, offers us the flexibility, encouragement and financial assistance to innovate and create a health care system for Maine that puts people first.

Partisan politicians in Washington and in Maine can organize petition drives and fight about who’s right and who’s wrong regarding the merits of the new health care law. I am ready to roll up my sleeves and get to work creating a health care system for Maine that will be the envy of every other state in America.

Bangor native Eliot Cutler is an Independent candidate for governor of Maine. His campaign Web site is www.Cutler2010.com.

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