If Maine Medical Center drops out of Anthem’s coverage network because they could not negotiate agreeable terms, as announced last week, it will be patients who suffer. People who have Anthem health insurance and get care at Maine Medical Center, aside from emergency room visits, will pay more or will need to seek care elsewhere.
How do we find ourselves at this moment where the biggest insurer and the biggest hospital in the state have the power to disrupt healthcare for tens, if not hundreds, of thousands of Mainers? Why do we have healthcare networks at all?
Because healthcare networks are one way that insurers can limit the amount of money they pay out, to maximize profits. As for-profit corporations, this is what they are chartered to do.
It is a failure of public policy that permits profit-driven companies to control so much of the healthcare system. The United States is the only developed country in the world to do so. It’s time to rethink our priorities and our values.
Our current system relies on the Affordable Care Act’s market-based model. We have waited over ten years for so-called market forces to kick in and control healthcare spending. But costs continue to rise and the profits of health insurance and pharmaceutical companies continue to surge.
It’s time to declare the experiment with market-driven, for-profit healthcare a failure.
This is why Maine AllCare and our many volunteers urge that we fundamentally change the rules of the game so that patients get high-quality care they can afford, physicians can focus on practicing medicine, and our state is not burdened by uncontrolled healthcare costs.
We advocate a universal program—everybody in, nobody out—for the whole state that would eliminate this kind of negotiation that puts Anthem’s customers at risk. No more tinkering around the edges of a dysfunctional system.
Everyone would be in the program, with no deductibles and no networks. We would all pay fees according to our incomes and receive care when we need it—the way other developed countries do with their humane and popular country-wide healthcare systems.
It would be streamlined, with no need for insurance companies and networks. All providers would be in the program and the state could implement meaningful cost controls.
It would be simple. We would no longer have to comb through confusing annual re-enrollment documents or risk losing coverage when we change jobs or experience a life change.
It would be affordable. Studies done right here in Maine show a program that covers all of us would actually save money by controlling costs and getting rid of waste and excess profits.
This should be a wake-up call for policy makers. They need to hear from all of us: We want a universal healthcare system in Maine and the time is now for fundamental change.
About Maine AllCare
Founded in 2010, Maine AllCare promotes the establishment of publicly funded healthcare coverage for all Maine residents. This system must be efficient, financially sound, politically sustainable and must provide benefits fairly distributed to all. We advocate that healthcare, a basic necessity, be treated as a public good, since it is fundamental to our well-being as individuals and as a democratic nation.