In laying out options for health care reform in the United States. I would like to build on this point and discuss a state-based strategy for health care reform. In fact, Canada began its health reform in one province-Saskatchewan and did so incrementally. The plan first covered hospitals for everyone and grew to broader coverage. In Canada they have taken a different approach in this country. Today only the elderly have universal access to coverage through Medicare, we will discuss the broader population of Americans without any health insurance. Indeed, there are more uninsured in the United States than Canada has citizens. About 140,000 of us in Maine below the age of 65 lack coverage. The biggest groups of uninsured are those between 18 and 24, often identified as the invincible individuals who think health coverage is not essential because they won't get sick and t hose between 60 and 64. This latter group often includes older Americans who were forced by illness or disability to leave the work force, have exhausted their COBRA extensions, and are left uninsured until Medicare becomes available.
While the notion of a national response and a national solution to this growing an absence of health insurance is appealing, Americans tend to be raging incrementalists. In fact, states can and must lead, particularly now that the U.S. Medicaid program is, in fact, larger than the American Medicare program in both dollars spent and numbers served. Indeed, states have a proud tradition of leadership and Congress has only acted in health reform after the states have served as laboratories for innovation. The Health Insurance Portability Accountability Act (HIPAA) provided protection, assuring that those who once had insurance will never lose that coverage even if changing jobs or becoming unemployed................
