Illusion of progress

Politics and other mistakes
By AL DIAMON  |  October 9, 2008

As the world teetered on the brink of another Great Depression (“I dunno, Doc, I just can’t get excited about being a planet, anymore. This whole orbiting-the-sun thing is so, like, 16th century”), I was comforted by the knowledge that if civilization collapsed, I’d still have quality health care.

I wouldn’t have a job, a house, a retirement account, or access to cable sports programming. But thanks to Governor John Baldacci’s Dirigo Health program, I wouldn’t have to worry about my medical expenses (“You’re suffering from malnutrition, exposure, anxiety, rickets, and a severe lack of National Football League games. Your co-pay is 15 bucks, plus a dollar for the office football pool”).

Oh, wait, there seems to be a problem with my plan. Even though the imploding of the international banking system might render me unemployed, homeless, destitute, and devoid of information on late playoff games from the West Coast, I still can’t sign up for Dirigo.

One reason is that the program isn’t accepting new applicants because it’s broke. Another is that even if I could get in, I’m broke, too, and I wouldn’t be able to pay the bill.

As of late September, Dirigo was running a $20-million deficit and being kept afloat by loans from the state’s general fund. Unless a stable funding source is found, the health plan’s only hope of survival may be making risky investments on Wall Street or winning my doctor’s office football pool.

Given the propensity of Dirigo administrators to make bad choices (“Washington Mutual stock looks like a safe bet, and Southern Cal is gonna murder Oregon State”), I don’t see that working out.

As for the cost of an individual Dirigo policy, it runs about $400 a month. With a $2500 deductible. Try scraping that together when your primary source of income is collecting returnable bottles. (“That treatment for rickets is gonna run you a couple grand, but you’ve got insurance, right?”)

There’s no doubt Dirigo helps a few people get medical care. Emphasis on the word “few.” While a recent Baldacci press release claims the program “has been responsible for 29,000 Mainers having access to affordable insurance since its inception,” that’s a little misleading.

OK, a lot misleading.

There have never been 29,000 enrollees in Dirigo at any one time. That many people may have passed through, but a lot of them left in a hurry, because they couldn’t afford the premiums. Right now, Dirigo is covering about 18,000 folks, but more than a third of them are Medicaid recipients, who are eligible for government-funded health care, anyway. That leaves 11,500 real participants, somewhat short of the 139,000 Baldacci promised would be covered in 2009, when he initiated Dirigo five years ago. Of course, the governor also picked Dallas to cream Washington and has his personal fortune invested in Freddie Mac.

This brings us to the question of who’s picking up the tab for this feeble effort. The answer is: you. It used to be you and me, but I’m not declaring what I make panhandling, so I don’t pay state income tax (although I’ll probably have to ante up after backing Kansas City to upset Denver and selling Lehman Brothers short).

Next year, Dirigo is going to cost you either $49 million or $75 million. The fun thing is, you get to choose which amount you’ll pay.

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