Nearly 52 percent, or 6,979 city residents, supported the concept of universal health care. Just over 48 percent, or 6,447, voted against it, according to unofficial tallies.

Also See: Universal Health Care Question for Portland Voters Consumers for Affordable Health Care

The vote is non-binding, meaning that the City Council is not required to approve any of the referendum's proposals, such as approving a city resolution supporting universal health care.

Still, those who initiated a signature drive to put the question on the ballot are treating the results as a major step forward for a grass-roots movement to install a single-payer system in Maine. They contend it is the most cost-efficient way to meet a moral obligation to provide health insurance to all residents.

"(The victory) sends a loud sound of support that we're sick and tired of health care that does not provide quality, that does not provide access and is unaffordable," said Tammy Greaton, an advocate of the referendum and co-director of the Maine People's Alliance.

Supporters said the vote will resound with state lawmakers when they reconvene in January and consider a single-payer system.

Leaders of the referendum's opposition, Citizens for Affordable Health Care, said the result should not be considered a mandate for the Legislature.

"(A close win) in the most liberal city in the state?" said co-chairman Mark Cenci. "No way. This is dead in the water."

Cenci said the group will continue to fight against a health-care system overhaul. A single-payer system would force higher taxes and rationed, lower-quality care, the group says.

Cenci continued to defend Anthem Blue Cross and Blue Shield of Maine, which drew fire for infusing his group with $381,803 at last count. Consumers for Affordable Health Care and the Maine People's Alliance had raised a combined $15,030.

Critics accused the insurance giant of funneling funds into a massive television blitz at a time when some policyholders are seeing double-digit rate increases. Anthem officials said the expenses were necessary to warn people about the referendum and that they would not be reflected in premiums.

The issue has split members of the medical community, with individual doctors and nurses taking varying stances on television commercials and at forums and news conferences.

Medical groups such as the Maine Hospital Association and the Maine Medical Association have tried to stay out of the debate, but spokesmen expressed skepticism about the Canadian-style, single-payer system proposed by the referendum's backers.

Since the mid-1990s, Maine lawmakers have begun to warm to the idea of a government system and this year created a commission to look into the pros and cons of a single-payer system in Maine. The group has started to meet and is expected to make a presentation to the Legislature by the end of March.

Some of the items being investigated by the commission are how the state would negotiate with health-care providers, how much residents would be taxed, and how much administrative staff would be needed.

The Bureau of Insurance has estimated a state health-care system could cost about $3.4 billion a year, but supporters say the amount would be much lower.

In the past several years, other states have taken steps toward universal health care.

In Illinois, similar advisory votes in several counties and townships taken since 1999 showed support for a statewide health-care system. There is now a movement to put a binding referendum on universal health care on the statewide ballot.

Such a question was defeated by a narrow margin last year in Massachusetts, but its advocates are already shoring up support for another try in the coming years.

Beth Murphy, library assistant, contributed research to this story.

Staff Writer Josie Huang can be contacted at 791-6364 or at: jhuang@pressherald.com

Copyright © Blethen Maine Newspapers Inc.

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