Maine: Martin targets smokers who get Medicaid

bangordailynews.com ^ | December 14, 2006 | Mal Leary

[SheLion]

AUGUSTA - Mainers on Medicaid who smoke would be offered incentives to stop smoking and could face sanctions for not quitting under a measure being introduced by Sen. John Martin, D-Eagle Lake.

"There is a connection between the health of individuals and the fact that they are still smoking," Martin said. "One of the questions that came out of discussions I had with physicians is why we are as a state, and the federal government, paying the health care cost of people that are smoking two and three packs a day."

The Medicaid program serves about 262,000 Mainers at an estimated cost of $2.2 billion a year, with the state paying about $872 million of that total.

Martin said the state should consider both incentives and penalties to get Mainers on the state Medicaid program, called Mainecare, who are smoking to stop. He said Mainecare currently offers smoking cessation programs at no charge to recipients, so the state needs to consider additional steps to encourage Medicaid recipients to quit smoking.

"You could put a sliding fee on those who [continue to smoke] so that they will have to pay a portion of the bill when they go see a medical professional, a doctor or whoever," he said. "I am not sure which way to go on this. I want to go with what is the most successful way to get people to stop" smoking.

Martin said there are some co-pays already assessed to some Medicaid recipients. He said an option would be to waive those payments for nonsmokers.

Ed Miller, the CEO of the American Lung Association of Maine, said Martin’s proposal deserves consideration. He said statistics indicate smoking among Medicaid recipients is higher than among all Mainers.

"Senator Martin is raising the right issue," Miller said. "I think we need to talk about this and what can be done to move this situation even faster. We have seen some positive results, but not as fast as any of us would like."

Miller said his group has long advocated for increased efforts targeting smokers for intensive programs to educate them to the dangers of smoking and to help them quit.

Miller said the smoking problem is far more serious among the low-income population served by the Medicaid program than among all Mainers.

As an example he pointed out that "somewhere around 35 percent of pregnant women on Mainecare are still smoking. That compares to less than 10 percent among all women that are pregnant."

Miller agreed with Martin that smoking contributes to too many of the health problems found in poor Mainers and that the state needs to address the disparity between poor Mainers and the rest of the state’s population.

While acknowledging there is a problem, Chris Hastedt, an advocate with Maine Equal Justice Partners, said Martin’s approach would not be the most effective.

Hastedt said that even though her organization advocates for Maine’s poor, it supported increases in the tax on cigarettes in part because the higher price is a smoking deterrent to poor Mainers. "That kind of approach — that is, increasing the cost of a product that is wreaking havoc with the health of the people of Maine — is the right approach," Hastedt said.

She said Martin’s proposed penalties would make a bad situation worse by making it more difficult for the poor to get needed health care.

"The goal is to improve health, and I don’t see how sanctions would help do that," she said.

Shenna Bellows, executive director of the Maine Civil Liberties Union, said the state should not turn Medicaid workers into "smoking police." She said punishing smokers amounts to "lifestyle discrimination" by the state.

"If the state wants to address the challenge of smoking, there are alternative ways that may not infringe on people’s individual liberties or private lives," she said. "The state could raise taxes on cigarettes without unduly interfering with people’s lives or engaging in lifestyle discrimination."

Martin said he expects his proposal will be controversial, but said the issue is too important to go unaddressed.

"I want to find a solution," he said. "We need to address this and we can’t continue to not do anything about it."

[SheLion]

"You could put a sliding fee on those who [continue to smoke] so that they will have to pay a portion of the bill when they go see a medical professional, a doctor or whoever," he said. "I am not sure which way to go on this. I want to go with what is the most successful way to get people to stop" smoking.

Then just say you quit two months ago.  If you are caught smoking by a health care person, just say "Oh gosh, I had a relapse!  I am going to quit again post haste!!  (They can not prove that you are lying).

"The state could raise taxes on cigarettes without unduly interfering with people’s lives or engaging in lifestyle discrimination."

RAISE TAXES???????????????  Maine just RAISED taxes! $2.00 a pack and $20 dollars on a carton.  Are they NUTS?  Who do they think they are kidding.

What a bunch of idiots.

Hastedt said that even though her organization advocates for Maine’s poor, it supported increases in the tax on cigarettes in part because the higher price is a smoking deterrent to poor Mainers. "That kind of approach — that is, increasing the cost of a product that is wreaking havoc with the health of the people of Maine — is the right approach," Hastedt said.

A lot of these people on Medicare are elderly.  This state sure must be hard up for money!

Smokers already pay more then their fair share of health care costs.  I am so sick and tired of this state targeting smokers that I can just barf!

Funny, smoking rates have dropped dramatically while health care costs have risen dramatically at the same time. It seems to me that the correlation PROVES that a lack of smokers causes higher health care costs!

  click on image for the truth.  They say "why spend money on cigarettes when you can spend it on the patch and nicorette!!!  Big Pharm needs the money!

Heh!

[SheLion]

Maine Throw Up Ping!!!!!

[trumandogz]

Or perhaps Maine could do away with their socialized medicine program.

[metesky]

The Martins of Eagle Lake have always been statists to the nth degree.

[maineman]

Smoke 'em if you got 'em....oops..unless you're on medicaid.

[Gay State Conservative]

The first set of sanctions should be against those who are more than 33% over their "normal" weight.A proposal like that would cause riots in the streets.

[Prokopton]

Maine collects $216 million each year from tobacco taxes and lawsuit settlements. Why don't they use this money to treat smokers?

[SheLion]

The idiot RAT John Martin.....

[SheLion]

Or perhaps Maine could do away with their socialized medicine program.

The Maine lawmakers suck the big one!  I am so sick of them I can just barf!

Always picking on the smokers.  Always picking on the smokers.

What pleasures in life do our Elderly have?  And he wants to take away their smokes OR TAX them more.

He's a RAT if I ever saw one!

[SheLion]

The Martins of Eagle Lake have always been statists to the nth degree.

NO WONDER!  He is the HEAD!  He's a puke bag!

The Martins of Eagle Lake have always been statists to the nth degree.

NO WONDER!  He is the HEAD!  He's a puke bag!

[absolootezer0]

ouch. hard to say which is worse. letting so many people stay on medicare, or using smoking as a reason to kick them off.

[Little Bill]

I think that the Peoples Republic of Maine could save a lot more money with a fat tax on those spending their welfare money at the Rochester Market Basket,in Rochester, NH, not that we mind them spending it here.

I am far from a health nut but this is ridiculous, I have taken to calling it "Waltz of the Elephants Day", they do move a lot of Basic Cigarettes and rather bad beer though.

[SheLion]

The first set of sanctions should be against those who are more than 33% over their "normal" weight.A proposal like that would cause riots in the streets.

And starting with THIS one...

The first set of sanctions should be against those who are more than 33% over their "normal" weight.A proposal like that would cause riots in the streets.

And starting with THIS one...

[Little Bill]

A 34 D Cup?

[SheLion]

I think that the Peoples Republic of Maine could save a lot more money with a fat tax on those spending their welfare money at the Rochester Market Basket,in Rochester, NH, not that we mind them spending it here.

Well, I hate using this picture, but it WAS in the paper!

The fat boy is a rehab nurse at our hospital!  I couldn't believe it!  And Martin is screaming about the old folks who SMOKE????  Give me a break!!

If this guy is someone's relative, please except my apologies.  I DID blacken out his name.  And you HAVE to admit, this guy is way overweight!!!

[SheLion]

A 34 D Cup?

Sooooooo sickening.  Can you imagine waking up with THAT in the morning!!!!

[Indy Pendance]

Well, knock me over with a feather, I didn't know you couldn't smoke on mars.

[boop]

Ironically, I think that a copay is a GOOD way to help medicaid costs, regardless of the smoking status. Even $5 per visit. It might make some of the freeloaders think twice before rushing to the doctor every time they have the sniffles. They would have to decide whether to go to the doc, or buy that pack of smokes or six-pack.

[Little Bill]

That nurse reminds me of the woman who did the prep on me yesterday at Frisbee Memorial, she did have a nice personality, I am skinny like the old guy, allot younger though.</p>

[redlocks322]

Not to mention the fact that most health care plans DO NOT cover anti-smoking medications or programs. It took 3 months for my insurance co. to approve Wellbutrin for my "depression" - they kept sending my doctor paperwork wanting to know if it was for smoking cessation. I finally gave up on the pills and on quitting... but I am down to 3/4 pack a day now on good days... ;-)