Tarren Bragdon- The editorial you have written is by far the best researched editorial that I have read in the BDN. The end opinion is based on facts and data and then reaches a sound logical conclusion. The rest of the BDN editorial staff could certainly learn a lesson from your example.

Bragdon of course has been an outspoken critic of Dirigo from the outset. It is always easier to tear down any well-intended effort than to offer a practical alternatives. He conveniently forgets that Dirigo was meant to serve not only the uninsured but also the under-insured, of which there are many. Sure, Dirigo is far from perfect but If the Maine Heritage Policy Center can find a cost-effective way to provide even minimal health insurance for Mainers with pre-existing health conditions and Maine families living below poverty income levels, working for employers who cannot afford to offer health insurance coverage, let it step forward. Does Bragdon not realize the obvious, that we pay one way or another? We either subsidize care through taxes of some sort or through our currently super-inflated insurance premiums. It's just that the latter method is far more expensive as a direct consequence of delayed reporting of illness, delayed treatment and inappropriate use of emergency medical facilities and other resources.

I think you are correct that the federal government could /should learn a lesson from Maine's Dirigo exercise. I just don't think we are thinking of the same lesson. What Dirigo has shown is that 'baby steps', or working 'within' the current for profit health care system won't work. National health care needs to replace the current broken system.

National health care needs to cover everyone in order to insure that everyone has health care and there is a broad stable base to pay for it. Dirigo didn't.

National health care needs to be accepted by everyone (all hospitals, doctors, pharmacies). It needs to be able to negotiate lower prices for drugs and testing. In order for national health care to work it needs to focus on keeping healthy people healthy and healing sick people. Health care providers should be in the business of helping people not making huge profits on the suffering of ourselves and our neighbors. There should be _no_ private health insurance industry. They are there to siphon our health care dollars into their coffers. They help drive up the cost and reduce the quality of health care. Like any for profit entity, their goal is to maximize their personal profit. If that means denying basic testing, so be it. If the odds are that most people won't need expensive catastrophic coverage or that they'll loose this coverage before they do, it makes economic sense for them to play the odds. The fact that potentially millions of people will end up suffering needlessly isn't their concern. In other states it's fairly common for health insurance carriers to deny coverage for 'preexisting conditions', or to drop coverage should you ever get sick. A more pedantic concern is the fact that insurance companies will use any pretext to deny coverage, something as simple as not filling out a form correctly, or in the right order. Doctors have to incur the needless expense of hiring people just to navigate the myriad private insurance forms. Make a mistake, don't get paid. Needless friction and the extraction of health care dollars that should be spent on the health of our fellow citizens.

Health care needs to focus on providing for healthier people. No child should forgo immunizations because of a lack of coverage, or the byzantine rules of their health care insurance (Ex: If your doctor has shots on hand, they are covered no extra charge. If you have to go to a pharmacy and get the immunization before your doctor can administer it, say you have a smaller family physician, you are charged an additional $40). Monitoring cholesterol or high blood pressure, treating diabetes or asthma, these can be fairly cheap and effective to manage. Unfortunately it isn't in a private insurance company's best financial interest to do so.

I haven't even begun to touch on the secondary costs of our broken system. The needless loss of productivity and the loss of corporate competitiveness as US companies either don't provide any coverage or pay an increasingly higher cost to cover their employees. Something that companies in Japan, or France, or any other first world industrialized nation doesn't have to contend with.

Ironically, I have read that Sen. Snowe is against public sponsored health care as being not _good_enough_. It's ironic in that all of our legislators and even the president himself are covered under a _public_policy.

We need national health care, not a nationalized health insurance policy. If Dirigo taught us anything it should be that public health insurance is doomed to fail. Public health care is what needs to occur, not insurance, assurance. There a three (3) things it will need to succeed. 1) It must cover every man, woman, child in the county. 2) It must be accepted by every health provider in the country, by law. 3) It must be paid for by a broad based tax on all sources of income, similar to income tax. If we can start there we have a chance.

There are powerful people making buckets of money in the current dysfunctional system. Don't expect them to go quietly into the night. If someone's against public health assurance, ask yourself do they stand to make or loose money under a public health care system.

Remember even our seminal documents declare that we have the right to "Life, liberty, and the pursuit of happiness". Access to health care is a right, not a privilege. Until we reform our system we will continue to suffer through a system where how much health care you receive is more a matter of the depth of your bank account as opposed to the extent of your suffering.

Pizanos the $300 million that was WASTED on Dirigo could have insured alot more than 10,000 people if it had been done wisely, they kept on trying to make a broken concept work and then started to tax health insurance claims to make up the rest, it is no wonder this guy opposed Dirigo.......because it was a stupid idea put in place by stupid governor and legislature. Any more questions?

If medicare and maine care paid 100% of the charges, private insurance would reduce 40% and cost shifting would stop..

Started reading Pizano's comment and came to a screeching halt at the words, "well-intended." A well-intended government program, Pizano? Well-intended for some at someone else's expense, you mean. Ergo, you're an income redistributionist, i.e.: socialist.

I on the other hand want government out of everything. Particularly health care, as let's face it---the government has screwed up retirement, education, infrastructure, the dollar, immigration, the drug war, the courts, the jails, the postal service, our roads, and on and on and on... Now we're gonna trust government with health care?

Do me a favor and move to Canada for six months, Pizano. Why not test your love of government run health care where it already exists?

Kudos to Bragdon for a timely opinion piece.

Mr Bragdon's cogent and well researched article will not sit well with those who revel in the false notion that the American health care system is a pool of misery in need of radical undoing.

Thank you Mr Bragdon for your clear minded words.

Ike Morgan

Exeter, Maine

Somebody at the BDN had to of been canned for letting the TRUTH slip through....