May 4, 2017

The Honorable Rodney Whittemore, Senate Chair
The Honorable Mark Lawrence, House Chair
Joint Standing Committee on Insurance & Financial Services
Room 220, Cross State Office Building
Augusta, Maine 04330

RE:    L.D. 1274, AN ACT TO PROMOTE UNIVERSAL HEALTH CARE, INCLUDING DENTAL, VISION AND HEARING CARE

Dear Senator Whittemore, Representative Lawrence, and Members of the Joint Standing Committee on Insurance & Financial Services:

I have obligations in several committees this afternoon and you will have many members of the public who will want to speak on L.D. 1274, so I am submitting this letter with attachments to represent the MMA’s “neither for nor against” position on the bill.  The physician community is divided on the “right” approach to health care reform in the United States and the MMA’s recent policy development work in this area reflects that divide.  Despite their differing personal opinions, physicians are interested and engaged in our continuing discussions about health care reform at the local, state, and national levels. 

I would like to thank Representative Brooks, Senator Gratwick, and the other co-sponsors of L.D. 1274 for their willingness to address the difficult topic of health care reform and to pursue the goal of affordable, quality health care for all Maine people.  I also acknowledge the passion and commitment of the physician members of Maine AllCare, many of whom will participate in today’s hearing.

During the Summer and Fall of 2016, the MMA Board of Directors convened an ad hoc committee of about a dozen physicians to review and update the MMA’s policy on health care reform.  The ad hoc committee membership was balanced by gender, age, geography, medical specialty, practice setting, and personal opinions about health care reform.  The ad hoc committee early in its work determined that it lacked consensus to endorse any specific model of health care reform, but decided to focus its efforts on a “preamble” and a series of principles about which the majority of MMA members could agree.  The ad hoc committee produced a Statement on Reform of the U.S. Health Care System which was approved by the MMA Board of Directors on January 18, 2017 (enclosed).  The MMA House of Delegates adopted Resolution #8, Health Insurance Coverage at its Annual Session on September 14, 2002 (enclosed).  These two documents are the MMA’s current, standing policy statements on health care reform.

As further background, I have enclosed one relevant policy statement from the American Medical Association (AMA):  House of Delegates Resolution 165.888, Evaluating Health System Reform Proposals.

MMA members’ views of a single payer, “Medicare for All” approach to health care reform have evolved since the 2002 Resolution with an increasing percentage favoring a single payer approach the more they witness the deficits and frustrations of the current system in their daily work.  We have surveyed MMA members on health care reform three times since 2008 as follows:

• ·       When considering the topic of health care reform, would you prefer:

o   To make improvements to the current public/private system; or

o   A single-payer system such as a “Medicare for all” approach?

• ·       The results are:

o   2008:  current system (47.7%), single-payer system (52.3%)

o   2014:  current system (35.7%), single-payer system (64.3%)

o   2017:  current system (26.83%), single-payer system (63.16%)

• ·       Professional pollsters conducted the 2008 and 2014 polls while the MMA staff conducted the 2017 poll in-house using SurveyMonkey.

Thank you for considering the MMA’s perspective on L.D. 1274 and the topic of health care reform.  I will be available for further discussions about the physician perspective on health care reform at the work session or at your convenience.

Sincerely,

Andrew B. MacLean

Enclosures