Last weekend, I researched health care — the question dividing the country, including Maine. It will come as no surprise to you that I found lots of questions, but no easy answers.

• Is health care an entitlement to be given all Americans? Is it a basic right?

• Should we have a universal government-run health care system?

• When is health care welfare?

• Are we morally obligated to “help those who cannot help themselves?”

• Are we truly our brother’s keeper?

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Try those questions on with your morning coffee. As I study the debate and form opinions, I have reached some conclusions:

First, I don’t believe health care is a basic “right.” Universal free health care would indeed bankrupt the country. And there is no evidence that government would be good at running a health care system.

Health care should be a collaboration, a partnership between government and a network of health care providers. Health care is a service to be provided, not a right.

Those of us who can afford to pay for health care should pay our fair share. Those who cannot pay should be helped, lest they fall through the cracks and spiral downward into catastrophic illnesses. It is less expensive for us to help those who cannot help themselves than for that to happen.

The introduction of the Affordable Care Act (Obamacare), although well-intentioned, has been an early disaster. When seeking changes through the legislative process, however, it is neither politically possible nor logical to try to kill a program that is now law. Republicans, led by the tea partyers, are only making matters worse by treating the Affordable Care Act as a weapon to use against Democrats in this year’s elections. The only sensible approach is to work toward meaningful adjustments to the law while dealing civilly with their opponents.

In the Maine Legislature, the debate is about expanding MaineCare (Medicaid). The House and Senate have passed a compromise measure sponsored by two Republicans, Roger Katz of Augusta and Tom Saviello of Wilton, which captures some of the best of both sides of the argument.

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“Governor Veto” (Paul LePage), however, is about to veto expansion again, the second time in two years. And the Legislature seems to be shy of the votes needed to override his veto.

Thus, with the stoke of his pen, $1 billion the federal government would have given to Maine for health care coverage over the next three years would disappear.

The compromise legislation, favored by a large majority of House and Senate members, has a managed care provision that would make health care providers more responsible for reducing care costs and improved management of those on the program. The bill, among other things, includes a sunset clause ending expansion when federal funding drops below 100 percent and an opt-out if the feds fail to cover the full cost over the next three years.

Enforcement of recipient eligibility rules by the hiring of two new Medicaid fraud investigators helps sell me on the approach. We all suspect some people abuse the system, but let’s go after them without denying help to the really needy, especially those poor with innocent children.

It is anticipated that the Katz-Saviello measure would produce savings in home care services to many mentally disabled Medicaid recipients languishing on waiting lists and would provide coverage to some veterans who do not have coverage.

Another major point that may be missed in this debate is that thousands of new health care jobs would be provided to strengthen our economy, and our hospitals would greatly benefit, as Saviello pointed out.

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Katz, in his testimony, said, “I just don’t think we can turn our back on the remarkable opportunity we have to improve Maine’s economy. Without expanding (health care) we are losing out on $1 billion flowing into our state. That’s a million a day we are turning our backs on.”

Meanwhile, LePage resorts to name-calling again. First he indicates in a news interview that he didn’t know how the House Republicans had voted, that the entire Legislature is wrong, and later attacks the Senate and House leaders as “unsophisticated.” Many would suggest that, based on his antics as governor, LePage should look in the mirror before making that charge.

The governor, for political purposes, is about to reject the will of the people represented by the majority in the Legislature, as well as the wishes of Maine’s hospitals. And, in spite of his previous job as a “businessman,” LePage will refuse to accept a 100 percent federally guaranteed, critical billion dollars in capital toward funding health care in Maine.

I don’t think that’s too smart, but I’m sure that it is all red meat for the governor’s 35 percent core base.

Don Roberts is a former city councilor and vice chairman of the Charter Commission in Augusta. He is a trustee of the Greater Augusta Utility District, and a representative to the Legislative Policy Committee of Maine Municipal Association.


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