For the past six years, I and a handful of Maine volunteers have been donating our time, efforts and treasure to Maine AllCare, a non-profit organization, that is unique in Maine in its commitment to bringing real structural healthcare reform to Maine and the rest of the United States.
During the past 15 years, we have witnessed the coming – and going – of “Dirigo”, an unsuccessful effort to “reform” the Maine healthcare system by tinkering around the edges of our existing insurance-based for profit system of health insurance. We have also witnessed the coming – and now going – of the Affordable Care Act, a national system based on propping up and augmenting the commercial insurance system and the for-profit system of health care delivery. Even most of the non-profit co-ops established by the ACA, have gone belly-up. Maine’s co-op’s future is tenuous.
The most obvious beneficiaries of the ACA have been health insurance, pharmaceutical and medical device corporations, (whose market caps have risen sharply since the laws’s enactment), and corporate hospital systems. The losers have been the public, with steadily rising insurance premiums and out-of-pocket costs coupled with shrinking coverage despite a rise in the number of people covered – by lousy and unstable insurance – and doctors and other caregivers, who are being crushed by the new administrative burdens created by the ACA.
With the election of Donald Trump and a Congress dominated by a Republican party committed to repealing the ACA (to be replaced by we know not what), the ACA is likely to be changed beyond recognition. Most of the ideas now being floated by Republican health policy wonks have failed in the past. Even Medicare, one of the most successful and popular federal programs ever created, is now under threat despite its 50 year track record of bi-partisan support.
Given the gridlock and dysfunction of the Congress, many (I’m one of them) believe that real reform is most likely to begin at the state level, before spreading to the entire country. That is how Canadians got their publicly funded system. That’s where Maine AllCare comes in.
Although real constraints on what we can do at a state level are imposed by federal law, there is much we can do at a state level given adequate support by the public. If the legislature continues to fail to act on real reform, in Maine we can always go directly to the people through the initiative process.
The fight for healthcare equality has been ongoing in the US for about 100 years. We have made significant progress with the passage of Medicare, Medicaid and the ACA. But we’re still not where we need to be. Winston Churchill is reputed to have once said “Americans will always do the right thing, once they’ve exhausted all alternatives”. I think we’re almost there.
Maine AllCare is the only organization in Maine to advocate for real reform, not simply fine-tuning a fundamentally flawed system. By replacing our current fragmented profit-driven health insurance system with a not-for-profit publicly funded system that includes everybody in Maine, and working to replace the profit-driven culture of health care delivery with an ethic of service to the public and the Hippocratic imperative of “putting the patient first”, we could create a healthcare system that not only covers all Mainers, but does so for less than we are now spending.
We hope to help achieve this goal through public education. Maine AllCare has sponsored hundreds of public meetings and other communications throughout the state during the past six years of our existence. These have included newspaper columns, op-eds and letters to the editor, blogs, the showing of educational videos in churches, rotary clubs and town meetings throughout the state. and media interviews. We currently have five chapters in various parts of the state.
Our goal is to increase the public’s understanding of the benefits of the universally inclusive, publicly funded and much more efficient system we advocate, including real cost savings and effective constraints on future increases in health care costs, and great simplification of our overly-complicated system of healthcare finance and delivery.
In a 2014 survey, 64% of Maine physicians responding to a Maine Medical Association survey supported this goal, rising from 51% in 2008. I like to think that Maine AllCare’s efforts at pubic education were at least partially responsible for this result.
So far, Maine AllCare has carried out our work entirely through the volunteer efforts of our Board and a few energetic and committed activists. But we have grown to the point where that is no longer enough. We need to hire staff, and professionalize our operations.
We are currently conducting a fund-raising campaign to help us evolve to the next stage in our campaign. I am asking you directly for your help, by contributing to our efforts through cash contributions.
Maine has been a leader in reform. Despite the current regressive leadership in our state, we have enacted marriage equality, the legalization of marijuana and ranked-choice voting during the past few years.
Go to the “DONATE” button and contribute whatever you can. Sign up to receive ongoing information about our campaign to fix our healthcare system in Maine once and for all. Or, send a check to Maine AllCare at PO Box 5015, Portland, Maine 04101.
We can’t do this alone. Be generous. Join the fight. You’ll be glad you did.
Philip Caper, M.D.
Founding Board Member, Maine AllCare
Editor’s note: Maine AllCare is entirely funded by contributions from individuals who support universal healthcare. Please send your tax-deductible gift today. Your donation will help us continue our educational and outreach efforts. You can click here to make an on-line donation, or send your check to Maine AllCare, PO Box 5015, Portland, ME 04101.