Health care from the Wizard of Oz

By Rob Wasserstrom | Jan 14, 2020

When Paul LePage became governor in 2011, infant mortality in Maine tracked the U.S. average. Nearly 13,000 babies were born here each year and around 75 of them died before their first birthday. By the time LePage left office, infant deaths had risen substantially; in Lincoln and Waldo Counties, they almost doubled.

Infant mortality is a highly sensitive indicator of how our health care system – and our overall economy – are performing. But despite the alarming increase, LePage turned down federal money to expand Medicaid assistance for poor families. He also vetoed five expansion bills passed by the legislature and “kicked thousands of childless adults from the state’s Medicaid rolls,” as the Bangor Daily News reported. Even with $50 million in reserve, he said he didn’t know how we could possibly come up with the state’s small contribution to the cost. Unless, of course, rich people paid more of their fair share, which was apparently off the table.

Compared to other states, we’re now in the middle of the pack on infant mortality. In New England, though, we’re tied for last place. In eight short years, LePage took us from an average health care system to an F. Compare this with Massachusetts, which provides basic care for everyone. Over the past decade, Massachusetts has cut infant mortality by 25% – far below national levels.

LePage’s war on health care is having dire consequences for everyone in Maine. Many of us rely on rural hospitals that are struggling to survive. Last year, two of these hospitals filed for bankruptcy. Others have stopped providing basic services like obstetrics. Eight more remain at “high financial risk,” according to Navigant, a respected research firm.

Rural hospitals around the U.S. now depend heavily on Medicare and Medicaid reimbursements to keep their doors open. Where they close, average mortality rates rise by 6%. States that used federal money to expand health care under the Affordable Care Act have generally managed to fend off hospital bankruptcies. States that didn’t, like Maine, are paying a steep price.

The price keeps going up. Faced with collapsing revenues, ten small hospitals in Maine have joined the Northern Light Health hospital chain. Northern Light says that it can provide cheaper, better health care through “administrative efficiencies” and other savings. But as economist Glenn Melnick recently pointed out, chains like Northern Light Health survive by negotiating higher insurance payments and pass the cost along to us. No surprise, then, that the price of health care here is surging by 6% a year – the fourth highest rate in the country.

Mortality rates up, costs up, insurance premiums and deductibles up, health outcomes down. Now it becomes clear what LePage and his hatchet person Mary Mayhew were up to. They ran a Ponzi scheme that shifted the skyrocketing cost of health care to middle-income families while keeping poor people completely off the list. Who benefited? Corporate health providers and private insurance companies.

LePage got away with this largely by blaming the victim. They were bums, he told us, layabouts and drug addicts who deserved a kick in the pants. But that picture doesn’t square with what I recently heard from people I interviewed in Rockland. They had all lost their jobs and health insurance after becoming sick or injured. Months later, most of them are still trying to cut through the bureaucratic morass that denies them treatment.

How do we fix this awful situation? Single-payer health insurance is the obvious place to start. It would take our hospital system off life support and cut the 34% “administrative charges” added to our bills by $600 billion a year. It would cover the 30 million Americans without any insurance and another 30 million whose coverage is inadequate.

It would provide better care and reduce overall spending – including the things most current plans turn down – by $210 billion a year. Why? Because the additional taxes we’d pay for universal coverage are less than what most middle class families now shell out for deductibles, premiums, co-pays and other forms of legalized extortion.

“The average American is paying more than $2,000 a year for useless bureaucracy,” reports one highly regarded study. That’s four times what Canadians spend to run their system.

Meanwhile, political grifters in both parties echo that legendary con man, the Wizard of Oz. “Pay no attention to those corporations behind the curtain,” they tell us. “You can’t afford better care.”

Spend less, get more? Oh, my.

This column is a project of the Midcoast Branch of the Southern Maine Chapter of Democratic Socialists of America. The opinions express herein are solely those of the authors. Comments are welcome at midcoastmaine@gmail.com.

Comments (2)
Posted by: Jennifer Hill | Jan 15, 2020 12:48

Hear, hear! Voices in the wilderness. Please, grill your candidates about their support for single payer health care and vote accordingly.



Posted by: Ronald Horvath | Jan 15, 2020 06:17

"The U.S. health care system has been ranked as the worst among industrialized nations for the fifth time, according to the 2014 Commonwealth Fund survey 2014. The U.K. ranked best with Switzerland following a close second.


Although the U.S. has the most expensive health care system in the world, the nation ranks lowest in terms of “efficiency, equity and outcomes,” according to the report. One of the most piercing revelations is that the high rate of expenditure for insurance is not commensurate to the satisfaction of patients or quality of service. High out-of-pocket costs and gaps in coverage “undermine efforts in the U.S. to improve care coordination,” the report summarized."
https://time.com/2888403/u-s-health-care-ranked-worst-in-the-developed-world/?fbclid=IwAR1xWc5sTOINgA2LN4rc1wn587FvFRZ1rxRJxq5ZsQAqdFXwV5SQxnQ9Tlk



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