As a physician who has practiced internal medicine in Portland for almost 22 years, I have witnessed the difficulty patients face in managing chronic diseases such as asthma and emphysema when they do not have health insurance.

It is bad enough if people cannot afford medications to manage asymptomatic conditions such as high blood pressure, but not being able to afford the drugs they need to breathe can lead to an immediate health crisis. Effectively managing asthma involves more than access to medication. It takes an ongoing relationship between a patient and physician where trust can be built and education about managing this disease can be delivered effectively.

It has been argued that people can always get care in an emergency room if they don’t have health care coverage. This is the worst way to manage a condition like asthma. Rather than waiting until it is out of control and then hoping to get help and restore breathing after the flare, it is more cost-effective, far more comfortable for the patients, and uses far less resources to have medications and primary care covered up front.

In addition to practicing internal medicine, I am also a member of the American Lung Association’s volunteer Leadership Board in Maine. Speaking from both of these perspectives, I believe that expanding MaineCare to more than 60,000 of our neighbors is the right thing to do. For some people it is a matter of life and breath.

Douglas CouperPortland

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