
Paul Cain
As Americans head into 2025 and consider the potential for change in our current healthcare system, we must acknowledge an alarming level of dissatisfaction and distrust of our present system among our friends, neighbors and colleagues in the workplace.
This was evidenced by the reaction late last year to the brutal and unwarranted shooting of the CEO of United Healthcare, Brian Thompson.
The dissatisfaction is understandable. The U.S. healthcare system is the most expensive of any developed nation and has inferior comparative results. We rank near the bottom in measures of life expectancy, infant mortality and preventable hospitalizations.
The administrative burden of our system today on the patient and the physician is far greater than at any time in our nation’s history and is greater than most other systems in the developed world. Out-of-pocket health care bills are a major cause of financial stress for many American families and are the leading cause of individual bankruptcy in our country.
If we are to believe that the incoming Trump Administration is going to dramatically cut government spending, what will be the effect on access to care for the average working member of our communities? Chronic, long-term under funding of Medicare payments to the clinicians and health care facilities in our country is already limiting access to care for many seniors.
Many of the 45 million Americans who receive subsidies through the life-saving plans made available through the Affordable Care Act marketplace could lose coverage if the new governing majority in Washington, D.C., cuts social services spending. Will the new governing majority in our capital push for deregulation to permit for-profit health insurance companies to extract more profit from a system that is subsidized by the taxpayers of this country?
The solutions to the dysfunctional healthcare system we have built haphazardly since World War II are elusive and complex, but blaming insurance executives for trying to reduce costs and increasing profits is not a solution. They are doing what is expected of them in the system we have created. If health insurance companies are to remain the intermediary between our health care delivery system and the patients they serve, they should be tightly regulated entities that facilitate, not complicate, the process of delivering the care patients pay for and deserve. We need to develop a system that rewards the provision of quality care, not the withholding of it.
We spend 18% of our GDP on health care, and the cost of health care continues to rise. Physicians and other clinicians need to be the leaders in promoting cost-effective care, and patients must use services responsibly. As a society, we need to improve our health habits and nutrition, and address the other social determinants of health that affect disadvantaged members of our communities.
The Maine Medical Association has recognized the need for reform of our health care system; our Statement on Reform of the U.S. Health Care System can be found on our website, mainephysicians.org. We encourage you to read the statement and other commentaries about our healthcare system and to engage in this important public debate.
Paul R. Cain, M.D., is the immediate past president of the Maine Medical Association. A native of Burlington, Vermont, he spent his entire medical career of 34 years practicing orthopedic surgery in the Lewiston-Auburn community and serving the people of central Maine.
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