A public insurance option would introduce some compassion, fairness and efficiency back into our nation’s health care system. I have been a family physician for 25 years and I am aghast at the way my profession has been crippled by our nation’s progressively more expensive and less efficient health policies.

Our American health care system is overly influenced, and at times controlled, by private health insurers that have failed to manage health costs or protect patients from skyrocketing premiums. Up to 70 percent of Americans believe health reform should include a public health insurance option. Almost three-quarters of physicians agree, including our own Maine Medical Association. Yet the health insurance industry is working furiously via advertisements, lobbyists and paid or misled “newscasters” and “demonstrators,” to undermine meaningful health reform.

Although we in Maine are somewhat protected by strong state laws, insurance companies in many other states engage in a variety of practices that are harmful and unfair to patients. They rescind policies when people get sick or need costly care and delay or deny treatment. They are not forthcoming about what their policies don’t cover until a claim is made. They even stretch the notion of pre-existing conditions. Now “family violence” is considered a pre-existing condition — how long before being overweight will be one? They have even started to pay for medical tourists to get expensive treatments more cheaply in other countries, instead of keeping our dollars at home!

Doctors and other health care providers have also suffered as health insurers have forced them to waste time and money fighting payment denials. Health insurance companies have been “rapaciously, greedily and unstoppably making money by underpaying the patient, by underpaying the provider and by overpaying themselves,” said Sen. Jay Rockefeller of West Virginia. We find it hard to put our patients’ health first when we are buried under a mountain of inefficient and time-consuming insurance paperwork.

In fact, a major reason for the current shortage of primary care physicians is burn-out due to such busy-work. It has caused many of my colleagues to retire early or change careers. It leads medical students to head instead for the lucrative, procedure-oriented specialties.

The sad truth is that reform without a public option isn’t reform at all.

Even worse, the recent proposal for reform with no public option, put forward by Senate Finance Committee Chairman Sen. Max Baucus, would force Americans into plans that would cover less and enable even bigger insurance company profits. Under his plan, employers would not be required to provide sufficient benefits, could offer stripped-down high-deductible plans and would not have to contribute any money toward the mandatory premiums paid by the employee.

Additionally, under the Baucus proposal, more Americans without employer-sponsored coverage would essentially be forced to buy costly insurance policies with high out-of-pocket expenses that many simply cannot afford.

With 46 million Americans uninsured and another 25 million underinsured, we can’t afford to enact health care reform without a public option. We are all in this together. Our total health care costs soar when we do not help all patients get preventive and timely care, as this promotes last-minute expensive emergency room visits and emergency surgery. We finally have the opportunity to change the health insurance system for good; to ensure that future generations will feel secure that their health is in good hands.

To those who claim that government is inefficient let me point out the very good and efficient care that veterans receive, the fact that Medicare has been hampered by starting out as an insurance policy for acute treatment only (preventive coverage gets tacked on from time to time by the Legislature), and by the fact that the newer Medicare Part D works poorly due to the compromise made to not allow our government to negotiate prices with the drug companies. MaineCare actually works quite well for our patients except that it is not fully funded.

Baucus’s plan is not the right prescription for our failing system. Health insurers will have no incentive to control administrative costs so patients, doctors and taxpayers will continue to pay the price for their greed. We must have a public option.

Alice C. Haines, M.D., lives in Auburn.