GOVERNMENT & MEDICINE

Maine's health reform plan is met with cautious optimism

The bold strategy to expand coverage is a risk many are willing to take.

By Joel B. Finkelstein, AMNews staff. April 26, 2004.

Washington -- As Maine prepares to roll out the initial stages of Dirigo Health, a sweeping reform of the state's health care system, anticipation is mixed with apprehension.

The goal of the impending reforms is to ensure access to health insurance for all of the state's residents within five years, while at the same time addressing cost and quality issues. The plan calls for achieving this by expanding Medicaid, creating a new and more affordable insurance product, and offering targeted subsidies to low-income residents.

The strategy relies heavily upon the cooperation of physicians, hospitals, insurers and others in the medical community, all of whom have been asked to subscribe to an austerity plan over the next couple of years.

The medical community has agreed to hold price inflation to 3% and to forgo capital improvements for a year.

The success of Dirigo, named after the state motto meaning "I lead" in Latin, hinges on the notion that health care dollars can be redistributed more evenly and efficiently.

"The lesson is, can we get close to complete coverage at a reasonable cost, and can we do it with a financing mechanism that goes beyond the initial allocation of $53 million," said Robert McAfee, MD, who chairs Dirigo Health's board of directors and is a former AMA president.

The $53 million, set aside last year by Maine's Legislature, will fill the gap in funding caused by the transition to a new way of financing the health care system that aims to save money in the long term by providing universal access to preventive services.

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