Maine's geographic remoteness means it's more insulated from national trends and fads. And its proximity to Canada means more liberal ideas permeate its border. It's also essentially a poor state where greater necessity makes for more invention.
The Dirigo plan stems from the state's lack of affluence and its fast-rising health-care costs. Between 1991 and 1998, Mainers saw their medical costs jump more than those of any other state, according to federal data. And nearly one-fifth of non-elderly residents - some 180,000 people - spent at least part of last year with no insurance, according to a state-sponsored survey.
The popular new Democratic governor, John Baldacci, recently signed the Dirigo plan into law. It will levy a surcharge on health insurance that will help pay for insurance for the poor. The plan also encourages hospitals to prevent fees from rising more than 3.5 percent per year. It's a dramatic approach - with plenty of free-market critics. But given the great need for affordable health insurance, it's being widely watched as a national test case.
Maine's health care policies also landed on the nation's radar screen in May, when it won a high profile battle in the US Supreme Court to implement its Maine Rx plan. It combines the buying power of the state's 1.2 million residents to strong-arm drug manufacturers into lowering prescription drug prices. Gray-haired Mainers' frequent trips to Canada - where drugs are subject to price controls - gave rise to the plan. Canada also figures into Maine's new climate-change law, which grew out of meetings in 2001 between Canadian and New England leaders. Maine plans to reduce greenhouse-gas emissions to 1990 levels by 2010 - and eventually by as much as 80 percent - by encouraging state companies to pollute less. It's reminiscent of the Kyoto Protocol, which the Bush administration pulled out of in 2001.