It has been both heartening and frustrating to follow news accounts of the LePage administration’s proposed MaineCare cuts that would, among other things, end MaineCare coverage for 65,000 Mainers.

Heartening to read that as protesters held signs stating “Budgets are Moral Documents,” Bishop Richard Malone of the Roman Catholic Diocese of Portland told legislators on Dec. 14 that, “Health care is a basic human right … no less essential than food, shelter and clothing,” and that, “Eliminating health care coverage … is a tremendously risky enterprise that will result in worsening health, and for some, given the complexity of their condition, lead to premature death.”

I agree wholeheartedly that health care is a basic human right and that access to health care is a moral issue.

A 2009 study published by the American Journal of Public Health bears out Bishop Malone’s concerns with its finding that every 12 minutes an American dies from lack of health insurance as the uninsured are more likely to go without needed care.

It is moral bankruptcy that the richest country in the history of the world fails to provide all of its people with comprehensive, equitable coverage as does every other developed nation (and at significantly lower per capita cost than what we spend here in Maine and nationally).

Unspeakably frustrating is the fact that it goes almost wholly unremarked that 10 percent of Maine people are uninsured now, before any MaineCare cuts.

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This represents twice the number of people whose proposed coverage loss has sent hundreds in outraged opposition to Augusta. Do these impassioned advocates not know about the existing uninsured? Do they think the uninsured are all healthy and don’t need health care? Do they think the uninsured choose to be uninsured?

MaineCare recipients rely on the program for health insurance they could not otherwise afford, a problem shared by the majority of Maine’s 130,000 uninsured.

Any number of government-sponsored studies, apparently now collecting dust on State House shelves, have shown that the uninsured are largely taxpaying, moderate income, working people without employer-provided coverage. They are ineligible for MaineCare but cannot remotely afford comprehensive coverage such as that provided under MaineCare or the state employee health plan (the state’s largest and largely taxpayer-funded group plan), which legislators on both sides of the aisle have seen fit to provide for themselves.

(Sidebar to Democrats: Why can’t the state employee plan be Maine’s public option? To Republicans: You want those of us in the individual market to have more options, how about giving us the option you have?)

Gov. Paul LePage is right to look at the rising costs under the state’s Medicaid program and deem those costs unsustainable. He lacks the broader vision, however, to recognize that unsustainably rising health care costs represent a systemwide crisis whose cure can lie only with a systemwide, re-engineering of our wildly expensive, absurdly fragmented, grossly inefficient and unconscionably inequitable health care system.

Current State House moralists need to similarly broaden their vision to encompass all Maine people.

A harmonic convergence of cost-conscious rationalism with love and concern for all our fellow citizens could lead us to a truly universal health care system, thereby freeing our economy from wasted health care spending and our civic lives from the ugly politics of narrow, selfish self-interest.

Alice Knapp, of Richmond, is a former health insurance regulator. She was the first director of the Consumer Health Care Division within the Maine Bureau of Insurance. She has a solo law practice in Richmond is a board member of Maine AllCare.


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