I commend the Press Herald’s Joe Lawlor for trying to understand our complicated and often confusing medical system in his Aug. 21 report. I think he did a laudable job outlining some major issues that trouble patients.

There are many patients who do not understand their bills for medical care. Patients experience great difficulty obtaining answers to their questions and are understandably frustrated and angry. As a result, many people avoid obtaining medical care until they are desperate.

We patients are financially punished for our ignorance about a medical system that is complicated, inconsistent  and, often, not understandable. Some suggestions from providers and insurers stated that we should research the lowest cost for care before presenting ourselves to providers. I would agree that such an expectation can be unreasonable when we are sick and scared. Another was that we patients needed to follow a program of – expensive, and often not covered by insurance – preventive care.

Several interviewed patients said they felt the care system was structured in a way that maximizes profit as opposed to good and accessible patient care. Generally, health insurance companies want to avoid paying for care and providers want more profit. How can we expect payers and providers to work together to solve problems in a way that is in the best interests of the patient?

The Press Herald series was a good start to a very overdue and needed debate concerning the overall structure of our medical care system.

Where are the physicians and nurses in this discussion? They are avoided in many articles such as these. They make up the segment of the system that is most likely to understand the problems patients have. Unfortunately, they are also part of the segment with the least power.

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With the Press Herald’s reporting as an exception, I have failed to understand the resistance our media has had to discussions concerning this important subject.

Medicare is, financially, the highest performing part of our health care system. Patient satisfaction with Medicare is quite high. Why is this so, and why were its successes not described in this feature? Why did the largest provider of primary care in Portland decide to cease accepting new Medicare patients?

What is the future of increasing efforts of hedge fund managers to purchase sources of care? If the Affordable Care Act has significantly lowered the uninsured U.S. population, why have so many politicians worked so hard to abolish it? If the answer is, as is so often true, a plunge into socialism, should we not more closely examine other examples of socialism in our government and the reasons for our blind fear of it?

The answers to questions about single-payer health care were evasive, unsupported, and poorly structured. They were also unchallenged. Andy Mueller, the new CEO of Maine Health, raised the risk of the government not putting enough money into the system. Why did Mueller make such an obvious, fear-producing and unsupported statement? It is more likely that voters would not allow that to happen.

Perhaps his reasoning is revealed by his other statement: that if Medicare becomes underfunded such a shortcoming could be made up by increasing charges to “private insurers.” Such a move is not likely to be received well by Anthem, a private insurer, given its recent conflict with Maine Health over high charges. It would be easier to negotiate with private insurers than the federal government.

In general, I think that the Press Herald series suggests that the nation is approaching a breaking point in health care that, if not addressed, will lead to its collapse. Let’s move on to a deeper and potentially more embarrassing discussion of our failing health care system through the involvement of providers, insurance companies and patients.


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