Sen. Susan Collins could not have picked a better moment to announce her decision to forgo a race for governor and continue serving in the United States Senate.

Just as she was walking the members of the Penobscot Bay Regional Chamber of Commerce in Rockport through her analysis of the problems in our health care system, President DOnald Trump was in Washington trying to make that system fail.

Sen. Susan Collins speaks Friday morning at the Penobscot Bay Regional Chamber of Commerce event where she announced she will not run for governor. Staff photo by Shawn Patrick Ouellette

The contrast was stark. Collins was talking about ways to make the system better while Trump was looking for leverage, no matter who gets hurt along the way. It should be obvious to everyone why Maine and the nation need an independent-minded Republican like Collins in Washington to block the administration’s dangerous excesses and, when possible, forge pragmatic deals that keep the country moving forward.

SHOCKING DISREGARD

Trump’s moves on health care last week expose his approach to policy-making and a shocking disregard for the millions of people who stand to lose health coverage because of his desire to put pressure on his opponents.

In an executive order signed Thursday, Trump opened the door to insurance companies to sell low-cost plans across state lines. While that might sound good, it’s not. The premiums are less expensive because the plans don’t cover much. A young, healthy person who doesn’t expect to get sick or injured might be willing to take the risk, but these are exactly the people needed in the insurance pool to spread costs. If the only people who buy state-regulated health insurance are the ones who are most likely to make a claim, the premiums will go sky high, and many people will be forced to drop coverage. And to make sure that happens sooner, rather than later, Trump announced with a tweet that he that he would unilaterally end subsidies to insurance companies designed to cover people with the most expensive conditions. That will also drive premiums up, and force people to drop coverage.

CREATING CHAOS

Creating chaos in the health insurance markets might deliver some short-term political advantage for Trump, but it won’t get more people covered by decent comprehensive health insurance.

And it will not address the basic underlying problem with health care in this country, and that, as Collins rightly pointed out Friday, is its cost. We pay twice as much for our care as people in other developed countries, and often with worse outcomes. Health insurance can’t be affordable if care costs so much.

But for the last decade, health care reform has been focused on who pays the bills — insured versus uninsured, government insurance versus private insurance — and not enough on why the bills are so high. The Affordable Care Act aimed to expand coverage, and it achieved its goals in that regard, but it did not end medical inflation.

It’s the high cost of health care, not the regulatory mandates of Obamacare, that have been driving insurance premiums up, and the chaos of Trumpcare will just make things worse.

FOCUS ON COSTS

Collins said her focus would be on cost control, after the existing insurance markets are stabilized (“First, do no harm,” she said, quoting the Hippocratic Oath).

She identified competition among providers and regulation of the prescription drug industry as good places to start. She should also advance work on payment reform, to encourage preventive care and chronic disease management, which save money by keeping people healthy.

Mainers have been encouraging Collins to run for governor since the 2014 election, and Collins seemed legitimately interested in the prospect of coming home and administering programs that affect people’s lives, instead of arguing policy points in Washington.

WHAT’S BEST FOR MAINE

But she has also consistently said that she would base her decision on what would be best for Maine, and she made the right one. Very few Republicans are willing to stand up against Trump, as Collins did with her votes against irresponsible health care overhauls and some of his worst appointments.

Other pragmatic Republicans have been afraid to speak out because they don’t want to face an extreme opponent in a primary. Collins is in a secure position, with three years left on her current term and the high regard of Maine voters, and has made her presence known.

It was good to hear that Collins plans to continue to serve in her current role. As long as Trump is in office, the people of Maine — and the rest of the nation — need her in the Senate.

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