Single-Payer Health Care Reform: Cost Considerations in Maine

This commentary addresses the issue of costs in the case of a state-based single-payer model for the state of Maine. The model proposed covers the commercially, self-, and un-insured populations by a publicly funded, privately and publicly provided state plan supplemented with vision, hearing, and dental benefits. The model continues current funding of Medicare, Veterans Affairs, and Indian Health Service programs, incorporates the Medicaid (MaineCare) program into the state plan, and eliminates all but token cost sharing. Additionally the proposed model achieves provider and payer savings, reimburses providers at rates above Medicare’s because of provider savings, reimbursement negotiation, and hospital global budgets, and continues coverage of long-term care through MaineCare and private arrangements.