enlarge 2007 Press Herald file

A patient awaits treatment in the emergency room at Maine Medical Center in Portland. A state lawmaker says it’s a struggle to ensure that insurance company profits come second to affordable health care.

ABOUT THE AUTHOR

Rick Burns is a Democratic state representative from Berwick.

Two reports brought to my attention recently were absolutely striking. One was a February press release from an insurance industry-friendly think tank criticizing the governor's nomination of the new superintendent of insurance, saying she has been "a strong advocate of many policies that would continue Maine's recent history of high insurance premiums."

In the other hand was a report from the Bureau of Insurance, declaring that Anthem Health Plans of Maine made more than $75 million in profits from Maine customers alone in 2007.

At the same time that Mainers are watching rates skyrocket, Anthem, which covers the majority of customers in Maine, is reaping record profits. Insurance industry promoters are working day and night to push for changes in law that would boost those profits at the expense of all Mainers.

Where is all that money going? According to the Maine Bureau of Insurance, Anthem's treasurer earns more than $1.4 million. Anthem's president makes more than $643,000. The assistant secretary earns more than $400,000.

Keep that in mind the next time you receive a letter saying your rates are going up again.

In September 2006, Anthem requested the state's approval to increase rates for Maine customers by an average of 20 percent, even though they had earned more than $40 million in profits that year. That rate request came on top of an average rate increase of 14 percent in 2005, when the company made more than $35 million in profits off of Maine rate payers.

Maine has been working for years to reduce these costs and ensure that profits come second to affordable health care.

Since Dirigo Health was established, it has saved the health-care industry in Maine more than $100 million, largely by covering people who were previously uninsured and working with hospitals to reduce expenses. Instead of letting the industry keep those windfall profits, we capture the savings and use them to continue in our mission to expand access and reduce costs.

But the Legislature struggles daily to ensure that costs are fair and transparent amid heavy lobbying by this highly profitable industry to preserve the status quo.

The bottom line is Anthem is a for-profit company. The right to earn a profit is derived from the taking of risk. Rather than take risk and earn a profit, Anthem lobbies legislators to create high-risk pools that shift the risk away from them and onto us, the Maine people.

Sony can charge what it wants for a television, and we can decide whether we want to buy it or go without. An insurance company should not be able to drag every last penny out of its customers for the health care they need.

Government must play an active role in regulating the market and requiring that providers control costs.

Maine is a national leader in the rate of people with insurance, and in monitoring health-care expenses to keep costs down.

Still, Anthem is able to make $75 million in profits from Maine people while the rates we pay for coverage are soaring – and they still push for destructive reforms like high-risk pools, which would push their profit margins even higher while shifting the risk to consumers.

The insurance industry seeks "market reforms" from legislatures across the country and in Washington D.C.

It is important to remember that health insurance works exactly the opposite of typical products and services delivered in the marketplace. While prices of other goods and services are determined by "quality" and "delivery" at ever lower prices, health-care prices are determined by the denial of services.

They seek to insure only the healthy among us, at least until they reach an age when health-care needs increase, and then the industry seeks to push them into high-risk pools created with the support of their friends in legislatures.

We'll continue to fight in the Maine Legislature for low rates, while the insurance...