Questions

Yesterday the Portland Press Herald published an Associated Press report on Maine’s Medicaid spending.  In the online version of the story was a “poll” that featured the question:

“Do you support the expansion of Medicaid coverage that has occurred in Maine over the last decade?”

As far as questions go, this one is pretty loaded and doesn’t really reflect the issues at hand.

Alternative questions could have included:

“Do you support eliminating health coverage for tens of thousands of Mainers who won’t be able to afford private health insurance?”

“Do you favor increasing the percentage of Maine’s uninsured population from 10% to almost 15% in order to preserve tax breaks for the state’s wealthiest residents?”

“Do you support policies that actually reduce the cost of providing prescription drugs to seniors and have the potential to result in more cost-effective care for Maine’s highest cost patients- the 5% who account for 55% of all MaineCare spending?”

The point is the questions we ask have a lot to do with our interpretation of the problem and the solutions we seek.  The AP story reads like a LePage Administration press release and the poll question frames the issue exactly the way the Administration has.  The problem is, focusing on Maine’s Medicaid spending relative to other states does little to help us achieve better health outcomes or reduce overall medical spending.

Unfortunately it is much easier to talk about cutting spending than it is to talk about responsible, long-term solutions.  The Administration and the media would do well to ask questions that address the real issues at stake.  Only then can we begin to craft real solutions that move us closer to the outcomes we desire.