When I started my family practice here in Maine in 1982, caring for people the way I felt best was pretty easy. Of course, the costs were much lower, but at that time insurance companies paid the bills universally. Franchises and exclusions were relatively rare.
We are almost 40 years ahead, and medical practice has been transformed by the supremacy of the insurance industry, which is now needed. Insurance or lack of it often has more to do with our practices than with our training and professional judgment.
While the Affordable Care Act did much to expand coverage to millions of Americans, for many the deductibles and out-of-pocket costs are now prohibitive. According to federal data, insurance deductibles doubled between 2008 and 2017. Faced with this reality, many people cannot or cannot necessarily attend or cannot afford prescribed medications.
Twenty-five percent of the public struggles to pay for their prescriptions. It is well known that Americans pay more for their recipes than anyone else. We are 4% of the world’s population, but we account for 45% of total pharmaceutical revenue.
Governments in other countries negotiate or even regulate the costs of medicines, so these countries basically pay the prices of generic medicines. Our government does not.
To protect their huge profit margins, drug manufacturers delay or prevent generic drugs from playing with delivery systems or smaller ingredients, and then increase those prices year after year. Drug prices in recent years have doubled the rate of inflation, well ahead of anyone’s earnings growth.
We need to do something and we can do it quickly. That’s why, as a doctor, I’m supporting LD 1463: A law to make health coverage more affordable for working families and small businesses. This bill would continue the assessment of federal health insurance at the state level and set out how it would use the potential revenue of $ 30 million to reduce health care costs in Mainers.
This bill would not cost Mainers every day. The health insurance assessment is simply a fee paid by private insurers (which was recently discontinued) that allowed them access to the health insurance market. By returning it to the state level, we can create the Maine Health Care Fund, which could provide financial assistance programs to help reduce out-of-pocket costs and provide coverage to major uninsured and uninsured. That would change the lives of my patients.
“Alex” is a 50-year-old patient of mine who works in construction. He struggles in the workplace because he can’t afford the inhaler he needs for his lung disease.
“Bernice” is a 67-year-old patient with diabetes who has already caused kidney and nerve disease. Insulin treatment has extended the budget to the maximum. One of the new classes of drugs has been specifically designed to prevent the progression of kidney disease to kidney failure and dialysis, but the monthly cost would be like a second mortgage payment for her, even with insurance coverage. .
“Chelsea,” a 32-year-old patient on opiate treatment, could no longer afford addiction treatment when he lost insurance. This led to his relapse, which in turn led to the loss of custody of his children.
The stories are as diverse as my patients, but the common thread is that the lives and livelihoods of my patients depend on having access to comprehensive and affordable health care. These big insurance companies make more money than they need; paying that fee, they would barely lose a drop in the bucket, but my patients could get the care they desperately need.
Dr. Stephen Bien de Jay has been a family physician in Maine since 1982.
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