February 27, 2011

MIKE TIPPING: State health care debate begins at LePage town hall meetings

Mike Tipping

The first time I visited the huge new Westbrook Middle School Performing Arts Center was during the 2010 primary campaign to hear the seven Republican candidates debate. The things I most remember from that night are candidate Paul LePage being dismissive of the idea of humans causing climate change and finding a Bruce Poliquin-branded ice scraper on my car windshield as I left.

Now, a year later, Poliquin is our state treasurer and is working hard to put his personal brand on state finances, and Paul LePage is governor and is looking to make Maine's laws reflect that same mistrust of environmental science.

Last week, LePage returned to that same auditorium, about a mile and a half down the street from my house, for the first of a series of town hall meetings to be held around Maine to discuss state issues. The LePage administration plans to hold 16 similar events, one in each county.

The event was carefully staged and scripted. It was announced only a couple days beforehand, and notice was sent out on LePage's campaign e-mail list, ensuring a supportive crowd. The governor's staff accepted questions only about a specific set of topics, and required the questions to be submitted in written form so they could be screened. My question wasn't chosen, for some reason.

Despite the strict rules, some good discussion did occur about some important issues, and I even found myself agreeing with LePage occasionally. His plan to socialize (probably not the word he would use) the Maine Turnpike Authority and put it under stronger government control, for instance, sounds pretty good.

My wife, Maggie, did get to ask a question, but wasn't very happy with the response.

Maggie works as an occupational therapist in an acute care hospital setting and spends her days helping people who are injured or have a disability regain their independence and get back to their lives.

Her question was about a problem she sees often: People being treated after a serious accident who aren't able to access rehabilitation assistance because their insurance company won't pay for it, or they don't have insurance at all.

Rather than a quick recovery, this means more time in the hospital and more difficulty returning to independence.

She is particularly concerned about a proposal LePage put forward in his supplemental budget that would increase the maximum time it takes to cover certain Mainers who apply for MaineCare from 45 days to 90.

In Maine's hospitals, this kind of change could mean that patients are stuck in an acute care bed for longer than usual before they're able to go to a dedicated rehabilitation center, harming that person's health, delaying their recovery and costing the system much more in the long run.

LePage's responded that he wanted to eliminate consumer protection mandates on insurance companies and reduce MaineCare eligibility (basically the opposite of what she was asking) but that he couldn't do it as quickly as he wanted because of the federal Affordable Care Act.

"I would urge you to think about the people who are stuck -- they've been in a car accident that is sometimes not their fault -- that are stuck with a new spinal cord injury and there's just nowhere for them to go," said Maggie, trying to get some traction.

LePage agreed it was an issue, but reminded her that "it is illegal for the governor of the state of Maine to print money," which I guess shows a good understanding of the jurisdiction of the U.S. Mint, but misses the point she was trying to make about better coverage leading to better outcomes at less cost.

While I enjoyed Maggie's question, it wasn't my favorite from the event. That honor goes to another question about health care, this one from an apparent tea party supporter in a "Don't Tread on Me" T-shirt.

He railed against "Obamacare," and said he agreed about getting rid of those consumer protection mandates, but also wondered if the governor could make an exception to his free market reforms in order to require insurance companies to cover chiropractic care, like the kind the man was currently receiving.

I think this illustrates an important point about the health care debate: While ideological arguments about reducing regulations on insurance companies, slashing programs and denying care may sound good to some on a political level, it's much more difficult to rally support when those cuts and changes begin to affect real people.

We may soon see this writ large across Maine as LePage attempts to implement his health care plans.

Mike Tipping is a political junkie. He writes the Tipping Point blog on Maine politics at DownEast.com, his own blog at MainePolitics.net and works for the Maine People's Alliance and the Maine People's Resource Center. He's @miketipping on Twitter.

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