Source: County Health Rankings 2016
“It’s the Economics!” – A clear call for universal health care from a Maine small business
Editor’s note: The following letter appeared November 18, 2016 in the Bangor Daily News, The Ellsworth American and The Weekly Packet detailing the financial plight of a Blue Hill small business, Lucy’s Granola due to sky high health insurance costs. It is a clear cry to make health care accessible and affordable by everyone in Maine. Please join our work – Subscribe and Support Maine AllCare – in helping Maine businesses owners and their employees become more healthy and successful. You may request a health policy expert to speak before your business group by writing to us.
Fix our health care system
Our family of five should be part of the effort to ensure the success of Maine’s economy. We run a small business with six employees, all paid above the minimum wage. We hire Maine-based consultants and suppliers to help us continue and grow our business.
Despite this, we are now looking for full-time jobs that come with health insurance benefits as we can no longer afford private health insurance. In 2016, we have paid Anthem Blue Cross and Blue Shield $24,257.28 for insurance. Our family deductible is $10,000. By the end of this year, we will have paid more than $34,000 for health insurance for our healthy family. Had we enrolled under the Affordable Health Act our costs would have been more as we do not qualify for the subsidy.
In 2017, Anthem has quoted $33,229.68 for our insurance, not including the $14,300 deductible. That comes to over $47,000 for 2017. Under the Affordable Care Act Bronze Plan, we might be able to bring our costs down to between $36,000 and $40,000. That’s hardly “affordable.”
Today’s health insurance costs are the greatest threat to our economy’s growth and success. Clearly, neither private health insurance nor the Affordable Care Act is affordable for our family. With the result of the election, there is an assumption that the Affordable Care Act will be overturned. We need our elected officials to recognize that their failure to develop a truly affordable health insurance system is preventing the success and growth of our state and national economies. It is long past time that the state and federal governments resolve this crisis.
East Blue Hill
Struggling to Serve at the Nation’s Richest University
By Rosa Ines Rivera
October 24, 2016 in The New York Times
Editor’s note: This letter exemplifies why Maine AllCare is fighting for universal, publicly funded health care here in Maine, and nationally. Please join our work by contacting a Chapter near you.
Cambridge, Mass. — I’ve been at Harvard University for 17 years, but I’ve never been in a classroom here. I’m a cook in the dining halls. I work in the cafeteria at the T.H. Chan School of Public Health, where every day I serve amazing students studying medicine, nutrition and child welfare, as well as the doctors and researchers who train them.
While I’ve earned no college credits here, I’ve had a lesson in hypocrisy.
On my way to work each morning, I pass a building with the inscription: “The highest attainable standard of health is one of the fundamental rights of every human being.” If Harvard believes this, why is the administration asking dining hall workers to pay even more for our health care even though some of us pay as much as $4,000 a year in premiums alone?
I serve the people who created Obamacare, people who treat epidemics and devise ways to make the world healthier and more humane. But I can’t afford the health care plan Harvard wants us to accept.
That’s why I have been on strike with 750 co-workers for more than two weeks. That’s why the other day, co-workers and I were arrested after we sat down in Harvard Square, blocking traffic, in an act of civil disobedience. And that’s why the medical school students, in their white coats, have been walking the picket line with us in solidarity.
The co-pays alone can be a problem. When a doctor told me my daughter had failed a hearing test and might need surgery, I thought about what care I could do without. I recently skipped an appointment to have a spot on my lung checked for cancer to save on the co-pays.
Medical students analyzed Harvard’s proposal and found that the cost of premiums alone could eat up almost 10 percent of my income. And Harvard wants to increase our co-pays for every single doctor visit to $25, from $15, for primary care and to $100, from zero, for outpatient hospital care and some tests. Some costs would be reimbursed for lower-income workers, but out-of-pocket expenses would still be hard to meet.
The students say that Harvard’s proposal is unaffordable for nearly all of us according to state government guidelines. If it goes through, I will keep avoiding the doctor to save that money for my kids’ co-pays. Any increase puts me at the breaking point.
Harvard is the richest university in the nation, with a $35 billion endowment. But I can’t live on what Harvard pays me. I take home between $430 and $480 a week, and this August, I fell behind on my $1,150 rent and lost my apartment. Now my two kids and I are staying with my mother in public housing, with all four of us sharing a single bedroom. I grew up in the projects and on welfare. I want my 8-year-old daughter and 2-year-old son to climb out of the cycle of poverty. But for most of my time at Harvard it’s been hard.
The average dining hall worker makes $31,193 a year, higher than other cafeterias in the area, but it still doesn’t go far around Boston. That’s why we’re asking for an annual salary of $35,000 for some financial stability, particularly since most dining halls are open only during the school year. Right now I’m lucky to work in one of the few cafeterias that’s open all year.
I know that health care costs are going up everywhere, and I don’t have all the answers. But there must be some way not to shift costs onto Harvard’s poorest workers.
If good health is truly “one of the fundamental rights of every human being,” then shouldn’t that also apply to the human beings working in Harvard’s cafeterias?
Rosa Ines Rivera, a member of Unite Here Local 26, is a dining hall worker at Harvard University.
Our new bumper stickers are here and ready to be mailed to you!
Please show your support for universal health care by making an online contribution of $4 or more and we’ll mail to you one of these bright, colorful 10x3 inch bumper stickers. HEALTH CARE FOR EVERYONE IN MAINE is a clear message to your community. It affirms that you support a transition to a publicly funded system of comprehensive care accessible to every person in our state – one that will improve both individual health and business productivity, and will costs less overall than what we are paying today.
We welcome contributions in any amount – they are tax deductible – but our main goal is to increase visible support in each community throughout our state.
'Maine' reasons for universal health care
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What Can Maine Doctors Do?
Return medicine to its healing roots — help educate and advocate for universal, single-payer health care that covers every Maine resident
- Join Maine AllCare mailing list, and volunteer to help, including supporting financially
- Join PNHP — www.pnhp.org
- Visit our websites regularly — www.maineallcare.org & www.philcaper.net for more information
- Organize and make your voices heard through the Maine Medical Association
- Doctors have lost influence during the past 30 years or so, but we are far from powerless – they don’t have much of a business without us!
- Doctors are still influential – make your views known
- Write op-eds and letters to the Editor of your local paper
- Testify in person and in writing before the relevant legislative committees when legislation affecting health care is being considered. MAC can help organize these efforts
- Organize speaking events directed at professions and lay audiences for Maine AllCare speakers
- Grand rounds
- Local and specialty medical societies
- Community forums, church groups, Rotary Clubs, Lions Clubs, Chambers of Commerce
If you have ideas about how else we might advance the cause of universal health care here in Maine, please write to us at firstname.lastname@example.org and and put "Idea" in the Subject line. Thank you.
Maine Voices: The problem isn’t Obamacare; it’s the insurance companies
Patients and primary care physicians are getting the raw end of the deal for the sake of corporate profits.
By Cathleen London, MD
November 28, 2016, The Portland Press Herald
Editor’s note: The following Portland Press Herald article by Dr. Cathleen London, a primary care physician in one of the underserved areas of Maine, shares her real life personal challenges with insurance companies. The examples she cites are very persuasive reasons for transforming our current, wasteful health care financing system into a publicly funded system – one that covers everyone and is paid for by each of us.
MILBRIDGE — With the recent news about increases in premiums for health plans sold through the Affordable Care Act marketplace, everyone wants to vilify the ACA. The ACA is but a symptom of the issue. Where are our policy dollars going?
As a primary care physician, I am on the front lines. Milbridge is remote. In good weather, we are 30 to 40 minutes from the nearest emergency room, so my office operates as an urgent care facility as well as a family medical practice.
It can take 20 minutes for an ambulance to get here (as it did one time when I had a patient in ventricular tachycardia — a fatal rhythm). I have to be stocked to stabilize and treat.
We are also about two hours from specialist care. Fortunately, I am trained to handle about 90 percent of medical problems, as my patients often do not want or do not have the resources to travel. I have to be prepared for much more than I did in Boston or New York City, where I had colleagues and other materials down the hall or nearby. No longer do I have a hospital blocks away.
One evening I was almost home after a full day’s work. Around 7:30, I got a call on the emergency line regarding an 82-year-old man who had fallen and split his head open. His wife wanted to know if I could see him, even though he was not a patient of mine.
Instead of sending them to the ER, I went back to the office. I spent 90 minutes evaluating him, suturing his wound and making sure that nothing more sinister had occurred than a loss of footing by a man who has mild dementia. When I was sure that the man would be safe, I let them go.
I billed a total of $789 for the visit, repair, after-hours and emergency care costs. Stating that the after-hours and emergency services had been billed incorrectly, Martin’s Point Health Care threw out the claims and reimbursed me $105, which does not even cover the suture and other materials I used.
I called them about their decision, said that it was not right and let them know they’d lose me if they reimbursed this as a routine patient visit. They replied, “Go ahead and send your termination letter” – which I did.
The same day, Anthem Blue Cross kept me on the phone for 45 minutes regarding a breast MRI recommended by radiologists on a woman whose mother and sister had died of breast cancer. She’d had five months of breast discharge that wasn’t traceable to anything benign (and it turns out the MRI is highly suspicious for cancer).
Anthem did not want to approve the MRI unless it was to localize a lesion for biopsy, even though the mammogram had been inconclusive! This should have been a slam-dunk fast track to approval; instead, dealing with Anthem wasted a good part of my day.
Then Aetna told me there is no way to negotiate fees in Maine. I was somewhat flabbergasted. I do more here than I did in either Brookline, Massachusetts, or New York. The rates should be higher given the level of care I am providing. I have chosen not to participate with them. This only hurts patients; however, I cannot keep losing money on visits.
I do lose money on MaineCare – their reimbursement is below what it costs me to see a patient. For now, that is a decision that I am living with.
I had thought those losses would be offset by private insurance companies, but their cost shifting to patients is obscene. I pay half of my employees’ health insurance, though I’m not required to by law – I just think it is the right thing to do.
My personal policy costs close to $900 a month for me and my sons (all healthy), and each of us has a $6,000 deductible. This means I am paying rack rate for a policy that provides only bare-bones coverage.
Something is wrong with the system. In one day, I encountered everything wrong with insurance. I am not trying to scam the system. I am literally trying to survive. I am trying to give care in an underserved area.
This is not the fault of Obamacare, which stopped the most egregious problems with insurance companies. Remember lifetime caps? Remember denials for pre-existing conditions? Remember the retroactive cancellation of insurance policies? Returning to that is not an option.
One answer is direct primary care: contracting straight with patients to provide their care, instead of going through insurance companies to get paid. I offer it (though I still accept Medicare, MaineCare and some private insurers). Many of my colleagues have also opted for direct primary care – they’ve experienced the same frustrations I have.
Something has to change if we are to attract up-and-coming medical students to primary care and retain practicing physicians. When both patients and physicians are frustrated, we know that only greed is winning, and the blame for that lies with corporations.
“Now is the time: Healthcare for everybody”
A new film by the producers of The HEALTHCARE Movie
Brunswick ME – A small crowd of supporters attracted by Maine AllCare, Peaceworks, and Brunswick Greens engaged with the issues presented in “Now is the time: Healthcare for everybody,” a film shown at Brunswick's Curtis Memorial Library on November 9.
Customizable movie flyer for your local publicity will include date and time, location and sponsor(s).
The powerful movie shows core problems with the US healthcare “system” and the obstacles to change. Interviews with key players and archival video from Senate ACA hearings and Vermont single-payer efforts are gripping, the graphics are helpful, and the filmmakers’ first person healthcare disaster stories ground the film in 2016 realities.
One viewer said, “It underscored the disgraceful posture and behavior of Obama and the Democrats surrounding the enactment of the ACA, a law that leaves many uninsured or grossly underinsured, nicely demonstrating the moral bankruptcy at the law's core inasmuch as the law was largely shaped by the health insurance industry, which continues to game the system to avoid paying for needed care.’”
Another commented, “Now I get it- costs skyrocket because our system is profit-driven, so mega-merging institutions (like Mass General Hospital) raise prices, big Pharma is unrestrained, and insurance companies keep profits up through government collusion with network-narrowing, lemon-dropping and cherry-picking!”
Arrange for a local showing for your group! Maine AllCare will lend the DVD and send poster copy for your use. If you would like a moderator to lead the discussion following your film screening, please email Dr. Bill Clark, Leader of the Midcoast Chapter with the details of your event.
—Submitted by Bill Clark, MD & Alice Knapp, Esq.
FIX IT – Healthcare at the Tipping Point a must see documentary for all Americans
This documentary takes an in-depth look into how our dysfunctional health care system is damaging our economy, suffocating our businesses, discouraging physicians and negatively impacting on the nation's health, while remaining un-affordable for a third of our citizens. Produced by Richard Master, owner and CEO of MCS Industries, an Easton PA company.
My company now has to pay $1.5 million a year to provide access to health care for our workers and their dependents. When I investigated where all that money goes, I was shocked. I found that the first three cents of every premium dollar goes to the insurance agent who helps MCS select an insurance plan and negotiate rates with our insurer. The next 20 cents goes to the insurance company to help pay for its sales and marketing and other administrative functions, which includes the work of a huge staff that does nothing more than approve or deny care. Another 10 cents (at least) goes to cover what it costs doctors and hospitals to handle the massive amount of paper work and phone time made necessary by my insurance company’s pre-approval demands, denials and other payment issues. That’s 33 cents of every premium dollar, 33 cents that has nothing to do with the delivery of health care.
Excerpt from a introductory letter by Richard Master
For arranging a FREE screening of this one hour documentary please email us.