| “Every one of us – every man, woman
and child in Maine – needs and deserves affordable, quality health care that we can
depend upon. That’s why on my first day in office I started the hard work to create
the Dirigo Health Reform. I said then that the road was long, the work was hard, but that
it was work that had to be done,” stated Governor Baldacci on March 15 when he
announced Dirigo’s next step: to self-insure. Nationally
82 percent of firms with 5,000 or more workers have plans that were partially or fully
self-insured.
“We want the option to self-insure because it allows
us to move more quickly to develop new, innovative and more affordable benefits; to cover
more people by expanding Dirigo’s reach beyond the small group of brokers who market
it today,” stated the governor.
In order to authorize Dirigo’s board to self-insure,
instead of contracting with a private company to provide coverage to the thousands of
Mainers, the measure has to be voted on by the Legislature.
If the state goes with a self-insured system, the middleman
is removed from the picture. Taking away the middleman creates savings which can be used
to pay for more coverage.
“If the Legislature enacts this proposal, we will have
the necessary options available to guarantee the best product at the best price and
effectively reach even more people,” said Governor Baldacci. “My message today
to every Maine citizen, to every business, is that we are serious and committed about
health reform. I will work with all the stakeholders to ensure that we meet our goals,
because this is the right thing to do.”
This new measure could insure Dirigo’s future and over
15,000 people who now are covered would breathe a sigh of relief.
“It’s peoples’ stories that make the
importance of Dirigo real,” said Peter Robbins who stressed the need for Dirigo to
continue last February. Robbins cofounded Steppingstones Home Builders with Jim Dinnan and
invited the governor to visit his business in Blue Hill to talk about health care. Fifteen
years ago Robbins, a graduate of Brown University, came to Maine for the quality of life,
to start a business, and to raise his family.
Jim Dinnan, a satisfied DirigoChoice
business owner greets the governor.
“We had always hoped to be able to provide heath
insurance for our employees. When Dirigo came along we found that we could. We had carried
health insurance for ourselves, but had not had a lot of luck getting the crew to fit into
a health insurance plan we felt was affordable for the company and that they could afford
to pay for,” Robbins said. “With Dirigo, it was easy.”
Health-care costs are forcing companies to relocate to
Canada. Insurance costs have skyrocketed with their own “tax increases” on
consumers. Too many people can only afford catastrophic coverage which has deductibles
that are in the tens of thousands of dollars — which amounts to a legalized
protection racket.
Baldacci took on the most important internal national issue
facing all Americans with Dirigo Health. Maine is being viewed as a national leader in its
attempt with Dirigo to cure the health-care crisis. Baldacci has been asked to speak at
various forums, and most recently at the American Medical Association meeting, about the
program. National publications and TV stations are reporting on Dirigo.
“A lot of people are watching Maine,” commented
the governor. “People are approaching us. They are interested in how we are handling
this national crisis.”
• Dirigo supports programs
that are geared to making Maine the “Healthiest State.” By ensuring people have
access to care and advice before they become ill, Maine is becoming healthier. Maine
recently became the number one state to reduce teenage smoking because of Maine’s
preventive measures.
• Dirigo covers hospital, physician
and specialist visits, prescription drugs, and no-cost preventive care. It gives discounts
based on household income that lower monthly costs and deductibles.
• Eighty percent of employees
enrolled receive discounts.
• In addition, Dirigo benefits
include: immediate coverage for preexisting conditions, Mental Health Parity, and the
Healthy ME Rewards program. Discounts can be as much as 100 percent of the employee’s
monthly payment, deductible and out-of-pocket expenses.
• Dirigo gives business owners
a better chance to compete in the marketplace as they save funds — savings that can
be put back into their enterprises.
Maine has a strong tradition of finding solutions
to health-care problems, which helped to make the creation of Dirigo possible. Maine
recently increased its ranking nationally to the eighth healthiest state in the nation,
taking 8,000 people off the uninsured rolls. Dirigo played an important roll in achieving
this ranking.
How Governor Baldacci created Dirigo is characteristic of
his leadership style. He has an inbuilt ability to build coalitions. Working across party
political lines, he brought together health insurance providers, health-care
professionals, hospitals, the Legislature, and concerned citizens to work on solutions. He
knew that there were enough resources within the health-care network to reduce overall
health-care costs, while working towards making Maine the healthiest state. He reasoned
that if hospitals streamlined their businesses, and if Dirigo could cover charity care and
bad debt cases, savings would be made, which has happened.
This collaboration between the state and private sector has
yielded savings and has helped keep insurance costs down. Maine’s insurance
superintendent ruled that Dirigo has saved insurance providers $43.7 million. “These
savings should be funneled back into the program, so that Dirigo could become
self-sustaining.”
However, Dirigo’s insurance provider, Anthem, does not
want to play its role in this health-care collaborative effort by giving the savings back
to Dirigo, despite the fact that they verbally agreed to when Dirigo Health began.
The governor said that Dirigo was always meant to grow and
change, as any business would, to make its product better. Becoming self-insured is the
next step.
For the first time, many of the 2,000 business with Dirigo
can finally afford to insure their workers.
For Steppingstones, Dirigo has had an economic benefit.
“It’s been easier to hire new people. We don’t have to worry about the cost
of expanding the crew with Dirigo, which makes it easier to take on bigger jobs,”
said Judy Robbins, Peter’s wife and Steppingstones’ bookkeeper. “We are up
for renewal, and we are able to cover seven people in 2006 for about what it used to cost
to cover four people. The premium increase this year is very modest. We’re really
pleased with the cost and the fact that we can offer it to more employees.”
One such employee was looking forward to switching from his
insurance that has a $15,000 deductible. “It’s highway robbery,” he said.
“I feel great that we have Dirigo. There were
some serious health issues we had to deal with; I found the Dirigo people very easy to
talk to,” Dinnan said. “My questions were answered, and they were
straightforward about what was covered. I’m pleased as could be with the
process.”
According to the census bureau there are 130,000 Maine
residents that are still uninsured. That’s 10 percent of Maine’s population,
which is below the national average of sixteen percent. The governor stated that the goal
of Dirigo is to expand access to all the uninsured or underinsured, and he won’t be
satisfied until the state reaches Dirigo’s goal.
In this gubernatorial election year many Republicans are
claiming this health program isn’t working.
“It’s hypocritical because some of them voted for
it but now that the election is around the corner they deny it could be good for Maine.
Dirigo has only been selling coverage since January, 2005; it should be given a
chance,” said Robbins. “I really commend Governor Baldacci for his determination
to continue the program.”
Baldacci said he wants Dirigo to move to a self-insured
system as of Jan. 1st, 2007. Anthem’s contract runs out December 31st, 2006.
Changing to a self-insured system could extend Dirigo
coverage to more people.
“By avoiding administrative costs and profits,
you’re able to stretch those dollars for more people to get affordable health
care,” said the governor. “Some propose to separate the wealthy and healthy from
the poor and the sick. I will have none of that. We are in this together. It’s not
good enough for some of us to be healthy, for some of us to have health insurance. Dirigo
Health reform is about all of us — working for the day when no one in Maine worries
about paying a premium or paying the heating bill — where every business knows it can
provide its workers with good coverage at a fair price, and where all of us work to
improve our health and prevent costly illness.”
The governor talks with business owner Peter
Robbins about Dirigo Health's progression
“Dirigo has to continue,” said Robbins.
“Just look at the rest of the nation. The governor is taking the lead. For
Steppingstones, I have to say,” Robbins paused, becoming emotional, “having
coverage has been literally a lifesaver for some of our people.” |
