Health Insurance/Health Care/Privatization
    There is so much to this question.
    How do we get to affordable, high quality effective care with access to for all?
    Employer based health insurance has been the basis for paying for health services since 1940, but this system is breaking down under the rapidly rising cost of care. Currently, 27% of our population receives government insurance including Medicaid, Medicare, military, and VA. About 60% of our population has employer based insurance, but these individuals and families are being asked to shoulder a higher and higher proportion of the cost of care. Spending on health care has been rising faster than spending in the rest of the economy since the 1960's, by 2015, healthcare spending will reach $4 trillion, about 20% of the GDP. Currently, our government pays 46% of all health care costs through public programs.
    The major costs in health care spending are Hospitals (30%), Providers and clinical services like lab and x-ray studies(20%), medications (10%), administrative (7%), nursing home (6%) and other including technology, over the counter meds, dental, research...(25%). People with chronic disease account for most of the cost of care, but only 55% get the preventive care that they need. The current system does not pay for coordination of care, nor does it cover continuous care for the prevention and management of chronic illness. The other cause of the high cost of care is the cost of technology. The US lacks a central authority to assess effectiveness or cost-effectiveness of new technologies. We have many, many agencies performing the evaluations and insurers and providers are able to reject or use any technology whether it is shown to be effective or not.
    In 2005, The Commonwealth Fund developed a set of criteria for comparing health care systems. The US scored a 66 out of a possible 100. They defined a high performance health care systems mission to be to help everyone lead long, healthy and productive lives. Quality care would be provided when necessary and appropriate and with evidence supporting its effectiveness. The care should be accessible to everyone in the population with a low rate of overuse or of high administrative cost. Health information technology should be used to improve care coordination and communication among providers. There should be no difference in access to care based on ones age, sex, race or ethnicity. There should also be avenues for innovation and improvement. The Commonwealth Commission estimated that improvements in the system would save 50 to 100 billion dollars a year and prevent 100,000 deaths per year.
    We have, for the first time in my lifetime, the national will to create a quality system of care. We must have Universal Access to affordable coverage for benefits that constitute quality. One challenge will be to decide what to cover now and what criteria will determine what gets covered in the future. We already have a sysstem that is mixed public and private. The real problem is in the way it is organized. Universal coverage does not have to mean a single payer. Some single payer systems (Ireland) have decided not to cover effective therapies (dialysis) for elderly patients because they are not cost effective. There is risk in giving this level of authority to a single agency without adequate oversight. A single payer system will require a higher tax burden on our younger workers; as the population continues to age the younger worker will be required to pay for the retirees health care.
    A mixed system can insure Universal Access (Australia and New Zealand) with the government offering a legal guarantee that everyone has access to coverage for a core package of benefits including preventive services and primary care and coverage for chronic ilness management. There should also be protection from catestrophic health acre expenses. This can be ensured through government subsidies and funded coverage for those that can't afford care. Individuals would be allowed to purchase private, supplemental coverage, allowing them to make their own health care choices.

Campaign Contributions
    Yes, I absolutely support public financing of campaigns. As the true citizen candidate, I entered the race because of my concern over the issues and the belief of my supporters that I have the most skill and expertise of thse running. Wealthy lawyers and benefactors have told me that it is "not my turn" to run, and they have backed other candidates. The need for money has led the other candidates to enter the fundraising race as early as April and May of 2007, for an election to be held in November 2008. I continue to work and see patients 2 days a week, while the others have been paying themselves a salary from their campaign funding. You can pay yourself a salary equal to the salary you earned the year before the race began, up to slightly over $200,000! If public funding is not passed, I would propose that a candidate not be allowed to pay her or himself a salary till 1 year prior to the election, likewise, they could not pay any staff till 8 months before the primary.

Global Warming/Alternative Energy
    I independantly paid for my college education by working summers and winters as a Boilermaker and a laborer. I worked on construction and repair of fossil fuel, nuclear and refuse recycling power stations and I helped construct a precipitator device on a conventional power station that reduces acid rain. Pollution control devices like precipitators and improvements in generator efficiency made a great difference in the amount of acid rain produced from conventional power plants. Refuse recycling was touted as the big pollution solution in the 1970's and 80's, but they didn't produce enough electricity to replace conventional plants and they produced a significant amount of pollution. If refuse has to be burned, cogeneration will at least reclaim some of the heat generated in its combustion. A national cap and trade program may induce some development of renewables but it puts any real carbon savings well into the future.
    The key is to begin conserving now. American's currently consume 25% of the oil produced on the planet, but we produce only 3%. Dylan Voorhees of the Natural Resopurces Council of Maine and Bill Hastings of Nova Atlantic LLC spoke at the Camden Energy Symposium on Feb 9 in Belfast about the importance of conservation to carbon savings now. Wind power will only account for 5% of our current energy demand. Corn alcohol will only return a 25% gain on the energy input, and at a great increase in the cost of food worldwide. Switchgrass and cane are potential resources, but there are barriers to implementation.
    The consumer is in many ways in control. But the government can do a lot to stimulate good choices. I recently wrote a piece for an energy stimulus package:
    The President and the Congress are afraid that our economy is heading into a recession. In the last two months, the subprime mortgage crisis has led our leaders to propose and enact one ineffective stimulus after another. This week, Mr. Bernanke, our Federal Reserve chairman, presided over the steepest one-day interest rate cut in the central bank’s history and President Bush called for nearly $150 billion dollars in tax relief for business and individuals.

    How did this happen? NY Times reporter David Leonhardt blames it on a huge speculative bubble, first in stocks and then real estate. He said that “everyone from first-time home buyers to Wall Street chief executives made bets they did not fully understand, and then spent money as if those bets couldn’t go bad. For the past 16 years, American consumers have increased their overall spending every single quarter, which is almost twice as long as any previous streak.”

    At the same time that we have an economic crisis, The Wall Street Journal said that “home construction had plunged to its lowest level in 16 years.” Lenders have “grown wary” from exposure to delinquent construction loans and new home starts were down 14% in December. This will result in a loss of jobs in the building and construction industry and make more Americans dependant on unemployment insurance and Medicaid. A short term fix is not likely to alter this decline in the housing market, but strategic investment by our federal government could make a real difference.

    In the face of the economic crisis, we have a housing crisis in Maine. The crisis is two fold: First, without affordable housing within reach of Maine families, we face sprawling development as people move away from their workplace in search of affordable homes. Second, too many families are struggling to pay their heating bills and the financial support for low income families isn’t keeping pace. Maine and many of America’s towns and city’s have old homes and unused or abandoned buildings in need of rehabilitation. These older buildings are energy inefficient with poor insulation in their walls, windows and roofs. They also hold toxic chemicals like lead in their paint and pipes.

    There is an opportunity here. If the President and Congress really want to promote a plan, “big enough to make a difference,” they should offer financial incentives for property owners to make their building’s more energy efficient with credits for putting in new furnaces, windows and insulation. Credits should also be available for homes and businesses to be fit with solar panels and utilize other alternative energy sources. We should promote an economic stimulus package that encourages communities to reclaim vacant and blighted properties and rewards innovation leading to energy efficient and healthy buildings, free from lead and other toxic chemicals. In addition the funds available for families struggling with their heating costs must be increased now and assistance provided to help these families make their homes energy efficient as well.

    The process of renovation to create energy efficient homes will keep our building trade workers employed. The buildings will burn less fuel, decreasing our dependence on foreign oil and lowering emissions of greenhouse gases. Tax credits for “green” industry, like research, production and installation of alternative energy sources will also add to the job base and offer young entrepreneurs an opportunity to start a business. Our leaders should not react to the current economic situation out of fear.

    An economic stimulus package should not offer short term relief and it is no substitute for thoughtful, forward thinking leadership and an investment in tomorrow’s industries. We have an opportunity to make a difference right now to support middle and lower income families, to strengthen our building and construction industry and provide the jobs that come with an investment in our future.

National Security/Military Spending
    The current Administration uses the argument that to oppose this budget is to oppose adequately funding the troops. We have to remember, this Administration sent our men into harms way with inadequate armor on the HUMVEES and inadequate flak jackets to protect them against explosive devices. The current budget is filled with pork for the military production industry. It does not cost 1/2 billion a day for 150,000 service members to be adequately fed and supplied. We have that many marines on the payroll everyday without adding to our already outrageous deficit. I would like to work with Mike Michaud who is currently on the Armed services Committee to get to the bottom of the budgetary problem.

Transportation
    As I don't live in Portland, I am less well acquainted with these projects than others might be. I would put a passenger rail in to Brunswick as it would decrease the traffic and decrease enrgy consumption by people driving alone in their cars.
    I would also invest in buses, ferries and paratransit vehicles for the same reasons.
International Relations
    1- The Middle East affects us all in so many ways. We must work with Sahib Erekat and others in the Palestinian community to develop a 2 nation solution for Palestine and Israel.
    2- Global warming is an issue in China as well as the USA and we need to co-develop technologies that help us both get to energy efficiency and independence without harming the environment.

Mortgage crisis in ME/Banking and lending
    The current problem with subprime mortgages is that many owners felt that they could sell before their rate was ready to adjust. Many of these loans will now adjust to a ballon rate that is not manageable. It is not in the banking industries interest to foreclose on these homes, they have no one to sell to. The Federal Housing Authority must step in and broker an arrangement that enables the homeowner to receive a fair and reasonable payment rate. This will protect the banks as well as the homeowners.

Gay Marriage
    Same Sex Marriage: There are a number of important points to clarify. First, I believe that people live better when they have a stable relationship with someone who cares for them. Promiscuity and infidelity can cause great harm to all involved, and a great society should promote stability in monogamous relationships. Second, the state should be interested in promoting formal contracts between individuals interested in creating a partnership. Civil Unions allow partners to enjoy the legal benefits of their bond, clarify personal responsibility, and clarify the law regarding property transfer, and emergency responsibility. Third, I feel the ceremony of marriage is a cultural, religious and family institution that has nothing to do with the state. The state should not be involved in regulating our personal religious beliefs. In summary, I support civil unions to promote stability and clarify personal responsibilities whether a partnership is heterosexual or same sex. Marriage is a spiritual celebration and I feel the state should not interfere with this personal practice.

Living Wages/Jobs in ME/poverty/homelessness
    A healthy middle class is fueled by education, training and jobs. Trickle down economics did not trickle down, and our gains in productivity came because so many women moved into the workforce and out of their homes. This movement to work changed the fabric of our culture so children are no longer supervised by their parents and when they turn 11, many are latch key. This is when they can get into trouble. We need flexible work schedules so that mothers and fathers can spend time with their children. Maine has a traditional economy dependant on paper and textile mills, farming and natural resources from the forests and the sea. Globalization has changed much of that, moving our manufacturing jobs to other countries. We have a strong job base in defense, natural resources and tourism. We have enormous potential to draw on the traditional industry and craftsmanship of Maine natives who work in the creative economy. The Naval Shipyard in Kittery must be kept open and operational. There are 4,300 civilians and over 100 Navy staffers and each of these jobs is supported by 5 service related jobs in the community. Maine’s ship building industry has historical roots and natural resources which will continue to support this industry including deep water ports, nuclear licensure and experienced workers, We need to protect the jobs at Bath Iron Works. In 2005, Congress approved a “dual yard arrangement” with Bath Iron Works and a shipyard in Mississippi to build the next Navy Class of Destroyers. Recently it was announced that BIW has been awarded an additional 140 million for this contract, with 25% of the work to be performed in Bath. Despite this, the work force in Bath has dropped from a peak of 12,000 jobs in 1991 to less than 6000 today. The Brookings Report on the state of the Maine economy cites Maine’s strengths in our small towns, sense of community and unspoiled land and seascapes. Investing in biotech and high tech allows the Maine economy to use innovation as another natural resource. We are competing in a global economy which is increasingly led by ideas rather than raw materials, and Maine’s future economic investments must be in education, using technological advances to compete. Our state is moving forward with a consortium of non-profit labs called the Maine Biomedical Research Coalition. UNE is developing a new biomedical research center that will attract new faculty and federal grant money. Every dollar of investment in biomedical research brings a 7 fold economic return to the Maine economy. Maine won a Federal Department of Labor grant for 15 million dollars, surpassing 80 competing proposals to help create 2000 jobs in boat building and composite materials use. Maine boats and composite material moorings are now being marketed to Chinese marinas as a result. Maine’s creative economy consisting of entrepreneurial business development particularly emphasizing the arts has recently received attention as a source of community vitality and economic strength. Artisans, craftsmen, and performing artists play a vital role in making Maine a national treasure. In Washington, the National Endowment for the Arts has been neglected and its funding has been weakened. As your congressman, I would support reinvigorating this and other funds supporting artists and entrepreneurs of the creative economy. We need a multidimensional approach to job creation through the development of infrastructure, a trained and educated workforce and R&D, supported by a public-private alliance.
    Finally, we need to control health care costs to help jobs stay in America.

College Affordability
    When I went to college, tuition was supplemented by a state and federal capitation payment for state schools or just a federal payment for Private. Ronald Reagan decided that it wasn't in our nations interest to supplement post High School education so he cut the supplement. Tuition leapt upward. He then removed our ability to write college loan interest off on our taxes. We now tax scholarships if they are won through a contest and tax scholarship money as income if it is used to pay for food or lodging.
    When you graduate from college, your employer or the State of Maine may offer you loan abatement as an inducement to stay in the State. This, too is taxed as income. This strategy doesn't make sense. We should reinstate the capitation payments to induce young people to enter needed areas of training and education and we should not tax loan abatements if the money is used to pay down the loan. We should never tax scholarships no matter if the money is used for tuition, room and board or books and supplies.

AIDS Awareness
    As a 4th year medical student, in 1984, I cared for one of the first AIDs patients seen at the New England Medical Center in Boston. In my residency at Columbia Presbyterian Medical Center in NYC from 1984 to 1987, I personally diagnosed over 20 children and teens with HIV/AIDs. Nearly all of these children died, we didn't have any effective medications. Cases are rising from the use of heroin and contaminated needles. Needle exchange programs work and should be implemented. Young men who have sex with other men must be educated on safe sex! It worked before, it will work again! And young men and women should be aware of risk factors and prevention methods here and throughout the world.
Fair Trade/Unions Rights
    It is clear that the current President has usurped much of Congress authority, this is always a risk when one party controls the House, Senate and Executive branches. But, The Trade Act of 1974 was passed during Jimmy carter's Administration to help industry become more competitive. It created fast track authority for the President to negotiate trade agreements that Congress can approve or disapprove but cannot amend or filibuster. The fast track authority created under the Act extended to 1994 and was restored in 2002. I would have to study this rule a lot more before I could comment. The concerns or our workers must come first whenever we move into a trade agreement.

Iraq War/Torture
    The war in Iraq is a humanitarian and economic disaster. Saddam Hussein was a threat in the region, but there are many threats that we manage through diplomatic and economic means. President Bush's vision that Iraq will become a flourishing Democracy was seriously flawed. These are a people who were arbitrarily aligned after World war I and they were held together by a strong dictator. Currently, the warring factions do not seem to have great incentive to work together to develop a lasting peace. One of the current positives in Iraq is that the military is providing humanitarian care to Iraqi children. A recent paper in the journal Pediatrics showed that 25% of the American Army hospital bed days are for Iraqi children. these children have meningitis, dehydration from infectious diseases and other medical and surgical problems. The community goodwill is always ehnaced when we provide humanitarian care.
    We do not have the authority to make decisions for Arab and other Middle Eastern leaders, but we need to have our reputation restored as an honest broker. We have to have an agenda that is supported by our allies and agreed to by other nations in the region. there will be no decisive military solution, we need a coherent diplomatic approach to Iraq and to the Middle east as a whole. There are no good options in Iraq, but we need to limit the damage. Madeleine Albright describes 3 potential nightmares.
    1- Iraq becomes a training and recruiting ground for Al Qaeda
    2- Iraq becomes subservient to Iran and threatens Israel
    3- Iraq becomes fractured and ignites a region wide war.
    Iraq's neighbors and our allies have a stake in ending this conflict, they should be engaged in the process now, just as we engaged outside forces to a diplomatic effort in resolving the conflict in the Balkans.
    We should not invade Iran, and create another Iraq scenario.

Iraq War/Torture
    As a physician who provided direct care to Iraqi prisoners during the first Gulf war, I cannot abide by torture of any kind. War wounds are torture enough. We treated the Iraqi men with respect and care. I am embarrassed and humiliated by the idea that we have allowed this to happen. I would, of course, support legislation that clearly defines torture and prohibits its use.
Presidential Power
    The Constitution sets the Power to make laws in the hands of the Congress, and the power to implement laws in the hands of the President. The President is also the commander and chief of the military and is expected to use that power effectively in the time of war. There have been wide interpretations of the expansion of the Presidents Powers during a time of war. In 1942, FDR demanded that Congress repeal certain provisions of the Emergency Price Control Act. President Roosevelt formulated his conception of his powers as ''Commander in Chief in wartime'' as follows: ''I ask the Congress to take this action by the first of October. Inaction on your part by that date will leave me with an inescap able responsibility to the people of this country to see to it that the war effort is no longer imperiled by threat of economic chaos. In the event that the Congress should fail to act, and act adequately, I shall accept the responsibility, and I will act. At the same time that farm prices are stabilized, wages can and will be stabilized also. This I will do. The President has the powers, under the Constitution and under Congressional acts, to take measures necessary to avert a disaster which would interfere with the winning of the war."
    My primary concern with the current administration is their assertion that they have the right to interpret the constitution and can therfore ignore rule of law laid out by Congress. The interpretation of the Constitution is currently taking place in the Office of Legal Council in the Attorney General's Office. The proper role of this organization to interpret the constitution is the key iussue of the moment and this needs to be clearly defined.
    We need strong leadership from the President, someone we trust and whose values we share. If we have a rogue, we should vote him or her out as soon as possible. One of the great strengths of our system is its inherent instability.
Experience that relates to youth
    As a pediatrician I work closely with Teens and young families. My life has been spent in service to help our youth grow, develop, gain independence and succeed. In my town, I helped to create a mentor program, so every student could have a caring and competent adult in his or her life. I worked with the school to get grant funds for an after school program so that kids wouldn't be latch key and helped the school get another grant to support a service learning program that would help kids to see the connection between class work and a career.
Top 3 priorities
    Promote advanced education and research so that new technologies can be developed in Maine and that will lead to job growth, especially in entry level positions.

    Improve access to affordable medical and mental health care, especially in rural areas. A quality health system will help control costs and will attract young people and young families to Maine.

    Improve energy efficiency in homes and businesses so they will use less energy and produce fewer emissions of greenhouse gasses.

Maine’s commercial fishing industry
    There are a number of conservation groups that are working with environmental organizations to preserve Maine's fishing industry. Stripped bass Unlimited is an organization of guides and boatmen who make their living from fishing, they understand the complex nature of the aquatic lifecycle and are working with other conservation groups along the coast to protect the habitat and thus ensure the survivability of these fish. Also, Land for Maine Trust is buying land along the coast to ensure that fishermen will have continued access to fishing regions.
    We need strong international laws to protect our fish from overfishing by foreign organizations. the coast guard must be empowered to prevent overfishing in our national waters. Fishing is an important part of our traditional economy and maine's way of life.

Reproductive Rights
    In 1987, I was in charge of a pediatric emergency room in Northern Manhattan, NYC. A 17 year old girl was brought in to see me by her mother. She had a fever of 105 and was critically ill. The girl had had an illegal abortion 5 days earlier (she couldn't afford the $150 for a legal one and medicaid wouldn't cover it) and now she had puerpal sepsis. She had a stroke and then arrested, and we managed to save her life, but not without a 3 month hospital stay. Abortion was first legalized in NYC in the early 1970's because over a thousand girls a year were dying after their illegal abortions. Hilary Clinton is right when she says that abortion should be available, affordable and rare. As a pediatrician, I regularly counsel teens and young adults on birth control and I respect the rights of individuals to control what happens to their body. The rate of Teen pregnancy in Maine is one of the lowest in the nation, so is the rate of abortion.
    We are our government. We need to be certain that we do not elect state or federal officials who use their religious preferences to determine the rights of the rest of America or the World.

Tax and Budget
    Deficit reduction is a high priority. A recent article in the Atlantic Monthly, "The 1.4 Trillion Question" shows the danger of our current dependance on China and other nations to keep us afloat. This spending approach to helping the economy will only drive us further into debt.
    Solutions:
    We must get our health care costs under control. The expense is driving our businesses over seas and will only drive the deficit higher if we have a single payer health system.
    We need to seriously alter the current budget so that money is not wasted on the current military spending.
    The alternative minimum tax was intended for the top 150 families in America to pay at east some tax. it has made our current tax system even more obtuse and adds significantly to administrative government costs. It needs to be eliminated.
    We could benefit from a progressive Capital Gains Tax, the longer an investment is held, the lower the tax paid. This would limit the wild speculation and sell off of stocks and properties that has plagued our economy this year. Any stock or property held for 5 years when sold would pay the current 15%. 4years, 17.5%, 3 years 20%, 2 years 25%, 1 year 30% and less than 1 year would be 35%. This would still promote investment.
    The estate tax should remain, propertied families have significant power in other countries and it leads to an untenable separation between the propertied owners and those that work for a living.
    The tax cuts will need to be allowed to expire as we focus on reducing the deficit as a national priority. At least in the short term, paying taxes should be viewed as our patriotic duty to help reclaim our nation from foreign debtors.
Comments
    Thanks you!