Does anyone in your family lack health insurance? Are you foregoing needed medical care? Have you received a “surprise” medical bill?

How do Maine residents answer these questions?

In autumn 2019, more than 80 volunteers with Maine AllCare interviewed a sample of 3,864 people from every Maine county and 287 towns. The survey, funded by Maine Health Access Foundation, found that while most respondents had health insurance, 78% labeled their health care coverage is “unaffordable.” Forty-two percent reported that they had delayed treatment because of cost while over half received unexpected medical bills that impacted their finances. Most importantly, 81% said they would support “a publicly-funded healthcare system that covered everyone in Maine.”

Also, medical providers complain that they are handcuffed and overburdened by the healthcare system’s complexity and endless administrative paperwork that does not facilitate care. Rural hospitals are threatened with closure. Today’s pandemic underscores the fact that our current system of health care serves both providers and patients poorly, while exorbitant profits flow to insurance corporations, device manufactures and pharmaceutical companies.

Universal healthcare is both equitable and economically viable. Other wealthy countries cover everyone for half to two-thirds of United States costs. Meanwhile, data show that many countries enjoy health outcomes superior to the United States. Advocacy coalitions and legislatures in other states — notably California, Washington, Minnesota and New York — are exploring implementation of universal healthcare. If implemented, these proposals provide more comprehensive benefits than the present ACA plans.

Locally, the Maine Center for Economic Policy examined in 2019 how a hypothetical universal healthcare system would work in Maine. The MECEP study analyst and author James Myall wrote: “I don’t think that it’s impossible for the state to do this, at least from an economic standpoint.” Myall said that Maine residents would save money, despite any new taxes, because care would be virtually free. Moreover, without the need to pay premiums, deductibles or copays, at least 85-90% of families would thus come out ahead and have more cash to spend. Furthermore, businesses would be unburdened from the cost of employee health insurance. Crucially, no person would be uninsured during a pandemic or economic crisis.

Maine Healthcare Action, a nonprofit 501(c)(4) organization started by local Maine physicians and concerned residents, has launched a campaign to put direct pressure on our Legislature in the form of a citizens-initiated resolve. The resolve directs the Legislature “to develop legislation to establish a system of universal healthcare coverage in the State and directs the joint standing committee to report out a bill to the Legislature to implement its proposal by 2024.”

We have begun to collect petition signatures to approve the resolve that will be presented to Maine voters in November 2022. The resolve is simple and straightforward, reflecting the will of the electorate that our Legislature address the inequities and costs of a dysfunctional delivery system and pass comprehensive healthcare reform. Any legislation should be tailored to the needs of Maine residents, and unlike today’s “take it or leave it” insurance-based system, the Legislature could guarantee health care, not just “coverage.”

Universal healthcare — everyone in, no one out — creates unity and solidarity: foundational aspects of American democracy.

William Clark, MD, of Brunswick is a board member with Maine Healthcare Action. Larry Kaplan, MD, MPA, of Cape Elizabeth is the organization’s chairman.

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