I applaud Elizabeth Rothe for her column about the proposed Republican health care plan (March 19). As a clinical social worker, I have helped many Mainers get insurance through the health care marketplace and wish that I could have helped more. I have seen patients quit gainful employment because of massive medical bills and inadequate insurance putting them in debt.

I am deeply concerned about some of the principles and recent revisions to the American Health Care Act.

• The “shift-shaft” philosophy, which shifts insurance costs from those who can afford it to those who can’t; and shafts the poor, particularly the rural poor.

• Decreasing federal funds to support health insurance, while increasing access to health insurance doesn’t add up. To the Congressional Budget Office, that means inadequate insurance coverage. Everyone needs insurance that is adequate and affordable.

• Moving away from government control and toward a free market insurance exchange. Athul Gawande demonstrated in a 2009 New Yorker article how this free market strategy contributes to a health care system that is heavily weighted in specialty care, with the poorest outcomes at a higher cost than in any developed country.

The revisions recently proposed completely eliminate Maine’s ability to expand Medicaid and places a state cap on federal Medicaid funds, regardless of the number of enrollees.

Maine’s politicians and communities should consider the data, patient and provider stories, and recent history to collaborate and continuously improve, not tear down, the health care system.

Julie Schirmer, Rome