Don’t repeat others’ healthcare mistakes

Maine and Massachusetts are learning that doing the math carefully before passing legislation would have saved a lot of pain and suffering.

Remember the old FRAM oil filter TV commercial with the mechanic telling the viewers you can either pay me now or pay me later?

Well, taxpayers in those two states are paying through the teeth after their legislatures acted.

For example, through its Dirigo health reform plan, Maine lawmakers wanted to make quality, affordable health coverage available to every resident by 2009, while at the same time slowing the growth of health costs.

The plan’s centerpiece is an insurance subsidy program. Lawmakers promoted DirigoChoice as offering affordable health insurance to small businesses and families with low to moderate income.

However, DirigoChoice is proving to be a costly failure.

It has cost Maine taxpayers $100 million since 2005, and without a tax increase of between $57 and $72 million to prop it up, it’s headed for radical surgery.

According to The Ellsworth American, it costs taxpayers $2,977 per enrollee per year in premium subsidies, and as of April 2008, only 12,637 individuals were covered by DirigoChoice, less than one percent of the state’s population.

To pay for the increased costs of the plan, Maine lawmakers put its first-ever tax on soft drinks, doubled the existing taxes on beer and wine and levied a 1.8 percent tax on healthcare claims paid by insurers and third-party claims administrators.

The meltdown comes as a group of citizens called “Fed Up with Taxes” circulated a petition to repeal the taxes.

It needed 55,000 signatures to qualify by July 17; the Maine Secretary of State received 90,000 signatures, which is pretty impressive for a state with 1.3 million people.

In Massachusetts, the state’s “connector” health plan may not be connecting either. Grace-Marie Turner, president of the Galen Institute, a healthcare think-tank, is closely monitoring the Massachusetts model, which set up the state as the broker of health insurance policies utilizing a new state bureaucracy referred to as the connector board.

Turner raises some of the same concerns as in neighboring Maine.

The plan is a strain on the state budget in Massachusetts. Gov. Deval Patrick (D) has asked for $869 million next year to fund the plan, but budget writers say the true costs are likely to be $1.1 billion.

On top of that, the state is bracing for another 30,000-40,000 enrollees who have job-based coverage now but could be added to the subsidy rolls as well.

The majority of the newly covered are heavily subsidized by taxpayers. Of the 330,000 new enrollees, at least 232,000 are getting free or heavily subsidized coverage, and health insurance rates continue to rise.

The state just approved a 12 percent rate increase for next year.

That alone could drive more people to seek state subsidized coverage which, in turn, will have a snowballing impact on the state budget.

Some safety-net hospitals in Massachusetts are threatened with bankruptcy because they are still treating large numbers of uninsured people.

The problem is their compensation rates have been cut by the reforms.

Finally, state officials are having a hard time convincing people who don’t get the subsidy to buy insurance, especially as rates go up.

The government is even telling people what they can and cannot afford and threatens fines as much as $1,824 for a couple who don’t buy the mandated insurance.

For example, if your family income in Massachusetts is $70,001, the state says you can afford to spend $550 a month, or $6,600 a year, for health insurance.

Try spending that much if a family has three or four children.

Again, if you don’t buy it or don’t get a waiver, you fork over $1,824 in fines, which will increase next year.

Washington lawmakers ought to take note of what is happening around the rest of the country before they launch a new grand healthcare reform scheme like they did in 1993.

They need to “do their math” and project what these programs will actually cost. They must ask the question, “Will they solve the problem without bankrupting the state or triggering a tax increase?”

We all want people to have access to quality healthcare and affordable insurance plans.

There is a role for government and a role for private insurers in providing healthcare. Finding the proper balance is key.

We need to build on what is working and fix what is not.

Don Brunell is president of the Association of Washington Business.

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