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This is Governor John Baldacci and this morning I’m going to be talking about the problems of health care in Maine and what I propose to do about it.

The problems – as you and I both know – are easy to identify in this area. Rising costs, unaffordable insurance make it impossible for an ever growing number of people to get the care they need.

People are forced to go without medicine, tests and attention. Their problems get worse, their health declines, and they are put under physical, emotional and financial stress.

So we know what’s wrong, now the question is what do we do about it?

I am proud that four years ago we enacted the Dirigo Comprehensive Health Reforms, and much has been accomplished. The rate of the people who lack health insurance in our state has been better than the national average. But we must do more. Yes, we have helped small businesses provide insurance to their employees, we’ve given individuals a place to turn when the insurance market failed them, and in some cases we’ve saved lives.

But now is the time to take the next step and learn from these experiences.

Dirigo is going to continue to grow moderately as we move towards universal coverage.

But we also must to more. We must do more in terms of competition amongst the private health care plans.

We must make sure that we have added transparency and held accountable those companies that have gotten a blank check from our health care system.

The work began earlier this week - a bill that was introduced by Representative Jill Conover of Oakland. That bill will create the opportunity for Dirigo’s foundation to expand and give the program the ability to increase competition while lowering costs.

I strongly support that legislation, but health reform can’t stop there.

We’ve built on the state’s MaineCare program to reach out to more individuals, parents and children.

But we must change the way the program does business. We must control the costs, administration, better manage the care.

And as part of my budget, we’ve already proposed bringing the amount we pay for services more in line with other states, and also introduced changes that will create better financial oversight and control.

But more is coming.

No more using the emergency room unless it is an emergency.

And we’re going to put a stop to the MaineCare merry-go-round where patients have too many different doctors. Every member will have a primary care provider who will better manage their care.

And we’re going to add a pharmacy co-payment for those who can afford it without cutting a hole in the social safety net.

To increase the available and affordable choices and maintain protections for those who buy insurance, we’re going to change the regulations in the individual and small group market.

More competition, more choices and more affordable.

I will give regulators the tools they need so there are no more rubber-stamp approvals for rate hikes.

We all know what it means to be uninsured – you don’t have insurance.

But being underinsured is a little tougher to understand.

It means that every month, you pay a premium to an insurance company, sometimes hundreds of dollars. But because the plan has a high deductible – often as high as $5,000 – you can’t really afford to go to the doctor.

As the line goes, the only thing worse than no health insurance is paying for no health insurance.

We’re going to refocus Dirigo on enrolling the uninsured and the underinsured, and reduce costs for businesses to participate in the program.

Dirigo will never become the only insurance plan available, but it can help to increase competition. It can become the public yardstick we use to measure other insurance plans.

We all have a part to play – government, businesses and individuals – in making sure everyone has health care security.

It’s about shared responsibility. First we will work to make insurance more affordable, everyone will be expected to do his or her part.

Since day one, health care reform has had its enemies and challenges. They have spared no expense in attacking our program.

They want it dead because to them it’s just numbers on paper. They think people have too much insurance, too much health care, and the government has no role in protecting people’s health.

They are wrong.

They only need to look at the oldest with the Medicare Program; our sickest, our seniors in nursing homes with Medicaid; our children and families; and our Veterans at our VA Togus facility and Veteran facilities across the country. It’s been the people in the middle who need more help. So far, DirigoChoice has helped more than 24,000 of them.

Health care security is about real people, with real lives and real families. They work hard, they play by the rules yet somehow, before Dirigo, there was no room for many of them in the system.

I’ve talked to the small business owner who was able to have the medical tests she needed because of Dirigo. I’ve talked to the woman whose cancer in her family was detected early enough to treat – and beat -- because of Dirigo.

We cannot turn – and I will not turn my back on them. That’s not how we do things in Maine. Thank you.

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