Maine State Senator Peter Mills

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Peter Mills: Deliver health care, not insurance
By Andy Kekacs
Copy Editor: The Village Soup

AUGUSTA (Dec 23): The DirigoChoice state-subsidized health insurance plan has become a "nightmare of cost" that threatens to drive people currently on private insurance out of the system, according to Sen. Peter Mills, R-Cornville.

Mills, one of several people vying for the Republican gubernatorial nomination, said Dirigo "has the soundness of a chain letter."

If not overturned by the courts, a $43.7 million "savings offset payment" that the state wants to levy on private insurers to fund Dirigo will likely be passed on to Maine workers and businesses through higher insurance premiums.

"To cover just 2,300 previously uninsured people [through DirigoChoice] is costing us a 2-3 percent tax on the other 700,000 people who are paying into the system," said Mills. "[That] tax is enough to drive out some people who would otherwise continue buying their own insurance. I am concerned that we will lose as many people from the market as we presently protect through Dirigo."

Mills, who has served five terms in the Maine Senate and one in the House, is known for his outspoken and independent views on state finances. While he is a fiscal conservative, Mills has reached across party lines to explore pragmatic solutions to the state's continuing budget woes.

The senator is no longer a supporter of DirigoChoice. He said the health insurance program has changed substantially since it was first proposed to the legislature, in particular the mechanism for funding the program.

"The original model, upon which two-thirds of the legislature voted, was primarily funded by employer premiums and matching federal funds," said Mills. "It was almost going to be a money machine."

That model proved to be unrealistic, however, and Mills said a new initiative is needed.

"One trouble with Dirigo is that so much of the money is kept by Anthem [Blue Cross, which administers the plan under a contract with the state] as profit and cost of administration. Presently enrolled clients are not necessarily receiving much health care. They are receiving 'insurance,' the purpose of which is to protect their assets and not necessarily their health."

Mills favors a different approach.

"I am tempted to bypass the insurance industry [altogether] to offer direct preventative and clinical services to the poor, with sliding-scale cost participation by patients," he said.

The senator proposes to extend the reach of public health services through, for example, more school-based health clinics, low-cost or free dental clinics, expanded rural health centers and other medical facilities with sliding-scale fees, and greater use of regional hospitals to improve the health of the state's largely rural population.

"Many of these services could be covered by Medicaid," he said.

Mills is offering a "12-step plan" to wean Maine from a perceived addiction to unsustainable tax and budget practices. The plan can be seen at Among his other thoughts for addressing Maine's health-care needs:

  • Create a high-risk insurance pool with disease management features to replace Dirigo and revive the competitive insurance market.

  • Impose taxes or fees to discourage unhealthy behavior that costs the state money to repair.

  • Create a statewide, secure, electronic medical information system for patients and providers.