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Old 11-11-2009, 07:26 PM
 
Location: Waldo County
1,220 posts, read 3,444,889 times
Reputation: 1393

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Quote:
Originally Posted by Coaster View Post
Exactly. It has nothing to do with the size of the population. North Dakota's demographics are very similar to Maine's, yet its residents pay less for health insurance because of different laws. That's why I don't buy the "smaller population" explanation.



No you can't go anywhere you want to buy health insurance. If you are a Maine resident, you must buy health insurance from an insurance company licensed to do business in Maine.

you can go anywhere to buy insurance but it will not be issued to you if you live in Maine. The state can't stop you from going out of state, but the insurance company will not issue a policy to you if you are a resident in Maine. We are saying the same thing.



Absolutely correct. Such bills have been introduced repeatedly in the legislature, and they've failed repeatedly.
The problem is that an out of state licensed insurance company can't issue a policy that will conform to Maine laws unless it conforms to ALL of them. So a bill brought forth in the legislature to allow people to buy coverage out of state presumes that some insurance company will issue the coverage. That won't happen. The issue is not whether or not a company is located in Maine, but whether an insurance company is willing to underwrite coverage for Maine people, living in Maine, and that such coverage will apply and conform to requirements in Maine.

The issue is not buying coverage out of state. In point of fact most insurance companies that are licensed to underwrite ANYTHING in Maine are not located in Maine at all. The location of the insurance company has nothing to do with the issuance of coverage. The licensing of the insurance company doesn't necessarily require a big office with a hundred employees in Maine, but merely requires that the policies that they issue conform to Maine insurance regulations.
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Old 11-11-2009, 08:47 PM
 
Location: Bernanke's Financial Laboratory
513 posts, read 1,051,364 times
Reputation: 218
Quote:
Originally Posted by GreenGene View Post
There's an article in the New York Times concerning health care in Maine that I found interesting, and perhaps others will as well. It seems to echo some comments I've read on the Maine forum about health care efforts in Maine.

Maine Finds a Health Care Fix Elusive - NY Times, Nov. 10, 2009.
Good job posting. I was just navigating here to post that article when I noticed that you already had.

As someone who's been considering Maine for retirement, I was blown away by some of the things in that article such as:

"health insurance premiums are still among the least affordable in the nation, health care spending per person is among the highest and hospital emergency rooms are among the most crowded."

and

"Maine has the nationís oldest population, its poor are among the sickest, and its median income ranks low."

I was left saying "wow" after reading that piece.
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Old 11-12-2009, 03:47 AM
 
Location: Union, ME
783 posts, read 1,302,562 times
Reputation: 967
Default health care

Quote:
Originally Posted by msina View Post
Good post, 'bout sums it up IMO, woulda "repped" ya but, I need to spread it around first.
Ditto!
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Old 11-12-2009, 03:58 AM
 
1,594 posts, read 3,406,680 times
Reputation: 1092
Quote:
Originally Posted by Acadianlion View Post
The problem is that an out of state licensed insurance company can't issue a policy that will conform to Maine laws unless it conforms to ALL of them. So a bill brought forth in the legislature to allow people to buy coverage out of state presumes that some insurance company will issue the coverage. That won't happen. The issue is not whether or not a company is located in Maine, but whether an insurance company is willing to underwrite coverage for Maine people, living in Maine, and that such coverage will apply and conform to requirements in Maine.

The issue is not buying coverage out of state. In point of fact most insurance companies that are licensed to underwrite ANYTHING in Maine are not located in Maine at all. The location of the insurance company has nothing to do with the issuance of coverage. The licensing of the insurance company doesn't necessarily require a big office with a hundred employees in Maine, but merely requires that the policies that they issue conform to Maine insurance regulations.
I'm sorry, AL, but are you being deliberately obtuse? Are you just not seeing the point? Or are you trying to use a lot of words to obscure the facts I pointed out? My questions are serious, because you usually have a lot more on the ball than you're showing here.
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Old 11-12-2009, 04:36 AM
 
Location: Waldo County
1,220 posts, read 3,444,889 times
Reputation: 1393
Quote:
Originally Posted by Dreamy46 View Post
Good job posting. I was just navigating here to post that article when I noticed that you already had.

As someone who's been considering Maine for retirement, I was blown away by some of the things in that article such as:

"health insurance premiums are still among the least affordable in the nation, health care spending per person is among the highest and hospital emergency rooms are among the most crowded."

and

"Maine has the nationís oldest population, its poor are among the sickest, and its median income ranks low."

I was left saying "wow" after reading that piece.
Don't let it discourage you. If you are retiring, perhaps you will be nearer to the time that you will be able to receive Medicare. If so, you won't be involved in this mess at all.

There may be a larger issue for some though. The health insurance crisis in Maine is a byproduct of a state that has steadfastly attempted to maintain itself in the 19th century. The old industrial model is still alive here, and for some inexplicable reason, the legislature and much of the population still thinks that the old industries will somehow return. Much of Maine's social policy is based on this...ah...ignorance.

Bluntly: Maine has never been able to develop a replacement for the now long departed shoe, textile and fishing industries. Faced with an aging population that is relatively poor, the health insurance industry has become a target of the legislature which in my opinion is too large, and far too dominated by a legislature that is led by union mentality liberals who long ago lost contact with the reality of life in Maine...ANYWHERE in Maine.

Forty years ago it was workers compensation insurance. Did you know that in the 1980's the statistic was that anyone injured in the workplace who lost more than thirty days of work recovering, would NEVER work again? That was the nature of the system then, and the result was workers compensation rates that were among the highest in the country. Add that cost to the already high cost of energy, and you begin to see why there is so little in the way of high paying, blue collar jobs in Maine. The legislature continues to search for a big pocket to lay claims to, and for the most part, that big pocket has always been the insurance industry.

The current health insurance crisis was born out of the governors interest in "solving" the crisis once and for all by creation of a state health insurance program called Dirigo. That begat mandatory issue and the health insurance industry left the state because of this officially mandated adverse selection.

Dirigo has failed. It cannot provide services for the people of the state because it was undercapitalized and because there simply is NOT sufficient policy holder base in Maine's tiny population to support a universal health insurance fund.

In this country we have embraced the free enterprise system of economic development throughout our existence. The proper role of government can vary over time, but being a central player in the competitive environment of commerce should not be one of them. But in the area of health insurance...the mechanism by which HEALTH CARE is delivered...there is a vital role of government, and that is a role that is similar to that of social security: the government should provide a mechanism for providing health insurance and therefore health CARE to the truly poor, and truly sick so that no one in our country is in pain and suffers unduly through their lifetimes where alternatives exist. The healthy and those with sufficient income to do so, should be allowed to buy health insurance in the free market. AND if necessary, there should be a requirement that they do so.

People who refuse to buy health insurance must be required to pay for their own medical treatment and the costs of that should not be pushed off onto the rest of society. I know this is another "hot" button, but it is the same argument that should be made with regard to helmet wearing for motorcycle riders: why should the rest of the social system pay for the injuries sustained when one's helmet-less head is bounced down the pavement, if the injuries so sustained could have been prevented or mitigated by basic safety equipment? (Disclaimer: I am an avid motorcyclist). So, if people in general act responsibly and have insurance for themselves, or can have it through their employer, they must do so. And the chronically ill, and truely poor will be provided with care by the Federal government. such care may well be basic, but we should NOT allow anyone in this country to be in pain and not be able to receive basic medical care for illness and disability, AND the chronically ill, or poor should not be a burden on hospital emergency rooms, where medical care is most expensive and where those costs get passed on to the already insured.

From watching my wife go through her shoulder surgery these past six months, I can well see many, many areas where the medical services industry needs cleaning up, too. My wife's primary care doctor is purely incompetant, and has caused my wife's shoulder issue to be worse than it needed to be; the surgeon did a remarkable job of cutting and sewing, but the after care provided by the practice is purely negligent and disconnected from the patient. The surgeon has NO communication procedure with the physical therapist who is the only health care professional who has tried to deal with the patient, instead of only one portion of her, and I could go on. Having been in the business of insuring medical practices for year, I shudder to think of the points from which malpractice claims could have been brought just on my wife's case alone. I think the medical practice industry needs some serious house cleaning too, because although the docs like to think of themselves as god-like, they are truly full of human frailties.
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Old 11-12-2009, 05:51 AM
 
Location: Central Maine
4,641 posts, read 5,342,682 times
Reputation: 4782
Quote:
Originally Posted by Dreamy46 View Post
As someone who's been considering Maine for retirement, I was blown away by some of the things in that article such as:

"health insurance premiums are still among the least affordable in the nation, health care spending per person is among the highest and hospital emergency rooms are among the most crowded."
.....
Quote:
Originally Posted by Acadianlion View Post
Don't let it discourage you. If you are retiring, perhaps you will be nearer to the time that you will be able to receive Medicare. If so, you won't be involved in this mess at all.
My wife and I are seriously considering Maine for our retirement. The health care insurance situation in Maine would not directly affect us - we are both federal retirees covered by the Federal Employees Health Benefits Program until we die or lose our minds & drop the coverage ... unless the national health care reform screws that up for us.

But the overall health care situation in Maine is a big concern. All the insurance in the world won't help if the care you need isn't there when you need it.

I was heartened to find that, in 2006, Maine ranked 13th (http://www.census.gov/compendia/statab/ranks/rank18.html - broken link) in the country in doctors per 100,000 resident population at 270 doctors. To give you an idea of how that compares, Massachusetts was first at 462, and Idaho was last at 169. In fact, the Northeast had the highest number of doctors in the country, from Maryland and Pennsylvania on up.

But regardless of health insurance and the number of doctors, the crowded emergency rooms mentioned in the article and the trend noted that "doctors are closing solo practices and joining hospitals" are troubling.

It's not like my wife and I can move to Maine tomorrow. It will be another year, perhaps two, at the earliest. We should have national health care reform in place for some time before the move, and we will watch carefully to see how it impacts health care in Maine.
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Old 11-12-2009, 06:41 AM
 
Location: WV and Eastport, ME
10,285 posts, read 10,388,952 times
Reputation: 6941
Quote:
Originally Posted by Coaster View Post
..... Absolutely correct. Such bills have been introduced repeatedly in the legislature, and they've failed repeatedly.
You could eliminate the arguing about legislative bills by posting links to a few of the bills that have been introduced.
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Old 11-12-2009, 07:04 AM
 
Location: On a Slow-Sinking Granite Rock Up North
3,637 posts, read 5,265,453 times
Reputation: 2650
Quote:
Originally Posted by GreenGene View Post
But regardless of health insurance and the number of doctors, the crowded emergency rooms mentioned in the article and the trend noted that "doctors are closing solo practices and joining hospitals" are troubling.
Yes. I attribute the closing of many solo practices -to some extent - to what I will term (and I'll probably get flamed for, but bear with me here) the "Wal-Martization" of healthcare. Healthcare, IMHO, is becoming the last "industry" -if-you-will of decent-paying jobs. Many entities see this as a capitalistic opportunity; however, IMO, there should be absolutely nothing for-profit when it comes to healthcare.

Sorry, but I just simply see too much room for fraud and abuse; and furthermore, there aren't many avenues by which this is being monitored (with the exception of Medicare which I will give some "props" to for clamping down on fraud and abuse, but they still have a ways to go IMO). And yes, I will also concede that ego-boosting, feel-good legislation that's completely devoid of one ounce of common sense also plays a part in it.

I use Wal-Mart in my discussion because they offer services for not only housewares, but pharmacy, groceries, cosmetology, auto repair and parts, home renovation items, banking, and now introducing healthcare! I need to dust off my dictionary and look up the word "Monopoly" I guess.

The area surrounding the Bangor Mall tells the tale of the waste laid in the wake of the anticipated expansion - not very many can compete with WM buying power. In their newly-opened clinic, people can go for inexpensive treatment for colds, flu, etc. The last I knew (and correct me if I'm wrong) some patients are given a beeper and allowed to go through the store until they are beeped - much like when you have to wait for a table at a restaurant. Please pardon me if I think that sending a "Typhoid Mary or Marvin" out into the general public to shop for their Ring Dings while the await an opening begs for the spread of disease. I suspect they'll rethink that ideology fairly soon. Here's hoping for a little common sense there. What surprised me most about that was that it is a partnership with EMMC (and let me clarify because I actually spoke to someone last night who was worried that it was an employee of Wal-Mart who would be taking care of him - OY) with qualified EMMC employees. I'm sure EMMC is in full "virtual disaster mode" due to the declaration of pandemic, so I would question whether or not people are actually allowed to wander the store ???

Yet, here we have a classic example of what by all appearances seems to be a good "capitalistic" idea, when in fact, it's not true capitalism as it should be - rather, it's "consumerism."

Doctors have never operated under a "consumerism" type of model - they've simply wanted to practice medicine; however, between medical malpractice insurance, and patients who march in demanding them to fix whatever ails them (or their money back!) and lawsuits that are obscene, many opt for the protection of the Healthcare Foundation umbrella, and frankly, I don't blame them one bit. They want to practice medicine not fight with an insurance company over how many sutures they use on their patient so that the company can keep a comfortable profit margin, and I'm sure they don't want to wade through a 10 lb 3 - ring binder of regulations and rules governing their business.

Last edited by cebdark; 11-12-2009 at 07:27 AM.. Reason: moved sentence/added something
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Old 11-12-2009, 08:53 AM
 
Location: Bernanke's Financial Laboratory
513 posts, read 1,051,364 times
Reputation: 218
Quote:
Originally Posted by GreenGene View Post
My wife and I are seriously considering Maine for our retirement. The health care insurance situation in Maine would not directly affect us - we are both federal retirees covered by the Federal Employees Health Benefits Program until we die or lose our minds & drop the coverage ... unless the national health care reform screws that up for us.

But the overall health care situation in Maine is a big concern. All the insurance in the world won't help if the care you need isn't there when you need it.

I was heartened to find that, in 2006, Maine ranked 13th (http://www.census.gov/compendia/statab/ranks/rank18.html - broken link) in the country in doctors per 100,000 resident population at 270 doctors. To give you an idea of how that compares, Massachusetts was first at 462, and Idaho was last at 169. In fact, the Northeast had the highest number of doctors in the country, from Maryland and Pennsylvania on up.

But regardless of health insurance and the number of doctors, the crowded emergency rooms mentioned in the article and the trend noted that "doctors are closing solo practices and joining hospitals" are troubling.

It's not like my wife and I can move to Maine tomorrow. It will be another year, perhaps two, at the earliest. We should have national health care reform in place for some time before the move, and we will watch carefully to see how it impacts health care in Maine.
You reinforced my point exactly. I could care less about the medical bills, insurance etc., but showing up and not being able to get timely care because the emergency room is crowded with people that shouldn't even be in an emergency room, well, that's a whole other issue.
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Old 11-12-2009, 09:06 AM
 
Location: Bernanke's Financial Laboratory
513 posts, read 1,051,364 times
Reputation: 218
Quote:
Originally Posted by Acadianlion View Post
In this country we have embraced the free enterprise system of economic development throughout our existence. The proper role of government can vary over time, but being a central player in the competitive environment of commerce should not be one of them. But in the area of health insurance...the mechanism by which HEALTH CARE is delivered...there is a vital role of government, and that is a role that is similar to that of social security: the government should provide a mechanism for providing health insurance and therefore health CARE to the truly poor, and truly sick so that no one in our country is in pain and suffers unduly through their lifetimes where alternatives exist. The healthy and those with sufficient income to do so, should be allowed to buy health insurance in the free market. AND if necessary, there should be a requirement that they do so.

People who refuse to buy health insurance must be required to pay for their own medical treatment and the costs of that should not be pushed off onto the rest of society. I know this is another "hot" button, but it is the same argument that should be made with regard to helmet wearing for motorcycle riders: why should the rest of the social system pay for the injuries sustained when one's helmet-less head is bounced down the pavement, if the injuries so sustained could have been prevented or mitigated by basic safety equipment? (Disclaimer: I am an avid motorcyclist). So, if people in general act responsibly and have insurance for themselves, or can have it through their employer, they must do so. And the chronically ill, and truely poor will be provided with care by the Federal government. such care may well be basic, but we should NOT allow anyone in this country to be in pain and not be able to receive basic medical care for illness and disability, AND the chronically ill, or poor should not be a burden on hospital emergency rooms, where medical care is most expensive and where those costs get passed on to the already insured.
You bring up up a lot of valid points. I recently ran into an old coworker in his late 40's, who's unemployed. He's not broke, far from it, but living largely off the radar. He's not counted in the unemployment numbers, buys used vehicles with cash etc.

We were discussing our lives nowadays and I asked him how he handles his health care needs and health insurance issues just bumming around. He confided that he's on the "$20 plan." Shocked that he was paying far less than me, I asked "what the heck is that?"

He goes on to tell me that the $20 plan is where if you need health care that you go to the emergency room to get it as needed. As you're leaving, he says, you tell the billing department that you don't have a job, or any money, and give them $20. Then as they send you bills in the coming months and years, you just keep sending them $20, which he said kept them from taking any meaningful legal action against you.

Let's just say I don't have any problem whatsoever with the government taking action against people like this that refuse to have health insurance...
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