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Commentary

Command and Control: Maine’s Dirigo Health Care Program
Tarren Bragdon, Heritage Foundation, 9-15-05

Ten years ago, advocates for a single, national health care system funded by the federal government hoped that Tennessee’s expanded Medicaid program (TennCare) would serve as a national model for single-payer health care. Ten years later, the program is a disastrous, budget-busting mess.

This hasn’t stopped the call for a single federal program—or stopped other states from experimenting with a “massive increase in government central planning and control [ of health care].” Bragdon details the lessons to be learned from Maine’s plan, Dirigo Health:

Dirigo Health has three major elements: a massive Medicaid expansion; a state-designed, state-subsidized health insurance plan sold primarily to small employers and the self-employed; and a comprehensive and far-reaching set of new regulations and controls over the private health care and health insurance industries in Maine. The new program is characterized by gov­ernment central planning, government-standard­ized quality, and massive public spending. …
Dirigo Health is based on the premise that government officials can best control and manage the entire health care system. Predict­ably, it is being trumpeted nationally by those who support more government control and more tax­payer funding of health care coverage. In reality, it is proving to be a costly and ineffective expansion of bureaucracy and government control that will drive up costs and further undermine consumer choice and competition in the health care system.

Rather than chasing the utopia of government-managed health care, Americans should follow the genius of their economy and begin restoring power where it really belongs, with “individuals and their doctors.” State policymakers looking for consumer-driven models to emulate should turn their attention to ongoing experiments in South Carolina and Florida.



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