Voters in Maine’s 2nd Congressional District have important decisions to make in November. The health care we receive in the future will depend on our vote because candidates for the House of Representatives have strikingly different views on how to shape the future of our health care system. A lot is at stake.
Rep. Bruce Poliquin has pushed to ease restrictions on minimum health coverage that insurance companies must provide. In May 2017, Poliquin voted for a bill to repeal the Affordable Care Act that would have permitted states to allow insurers to charge higher premiums to older people and those with pre-existing conditions. Poliquin also voted in favor of last year’s tax bill, providing generous tax cuts for corporations and the wealthiest Americans while eliminating the ACA’s individual mandate, undermining the health care law.
Jared Golden’s vision favors plans that cover more people, not less, with adequate health care coverage and insurance policies that do not allow pre-existing condition exclusions or cherry picking of only healthy policyholders. Golden favors expansion of Medicaid coverage — as did 59 percent of Maine’s voters in 2017 — and lowering Medicare eligibility to age 55. Both of these measures move us toward his goal of decent and affordable health care coverage for all.
Sometimes the health care debate is framed around “health care as a right” or “health care as a privilege,” but I have come to disagree with both terms. My experiences have taught me that in this day and age, health care is a necessity. Poliquin’s and Golden’s differing visions for health care involve both how many people are covered and how people are covered. As a physician, I have experienced countless times the tragedy injury or illness brings to a family, and from my perspective, there is no doubt that people simply need to have decent, affordable health insurance coverage.
Poliquin has pushed for cheaper and so-called more affordable insurance policies that provide reduced coverage benefits with significantly higher deductibles. These low monthly premium and high deductible health insurance policies are often termed “ catastrophic“ insurance policies; it’s an apt descriptor, because I have seen what happens when a Maine family is faced with a $10,000 or $15,000 deductible after becoming sick or injured. Yes, it is catastrophic.
When I began practicing in Maine 30 years ago, things were different and communities were better able to take care of themselves. If my patients who worked in the woods injured themselves and needed care but were without insurance, I might barter treatment for a couple of cords of wood and we called it good. And I still had to stack the wood.
But those days are gone. Health care today has become an industry and spending has skyrocketed. The enormous sum we spend on the health care industry is generated in large part by pharmaceutical companies, device manufacturers, insurance companies and medical care facilities. In this for-profit marketplace, the patient’s interests are often left behind, and we need to develop health care policies that blunt industry demands and place patient care before corporate interests. Golden’s plan to broaden health care coverage does just that.
We are left with an unsustainable system with less people covered due to more people giving up coverage due to rising costs. This is termed “the death spiral,” resulting in more and more uninsured folks. When the uninsured or underinsured become sick or injured, there are catastrophic results, and in the end, local hospitals may not get paid as uncompensated costs simply flow down the system. Costs of caring for the uninsured is compensated by higher charges elsewhere, and we all end up all paying for it anyway.
Meanwhile, too many Mainers lack access to regular and decent primary care, and if our uninsured neighbor is injured, a visit to the emergency department can become a shocker.
I disagree with Poliquin’s short-sighted view that favors industry, and support Golden’s approach. We need more and decent health coverage, not less with more restrictions. Times have evolved, and while it is superficially appealing to tout inexpensive low premium and high deductible health insurance policies, do not let Poliquin roll the dice with your accident or injury — our health is no game. Health care is a necessity, and Golden’s vision of increased access and decent coverage is best.
William Strassberg, M.D., is an orthopedic surgeon and past president of the Maine Medical Association. Retired from surgical practice, he maintains a small volunteer practice at the Ellsworth Free Clinic.
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