As a psychiatrist, I sit across from Mainers every day: retired electricians, young mothers, business leaders. Some come to me sick or scared. Others come to think out loud. But lately, one thread ties their stories together: fear that Maine is slipping away, either from rising taxes or from a fraying safety net. Let me tell you about three patients. Their names have been changed, but their stories are real.

Walter is 82. He’s a retired electrician with diabetes, arthritis and early signs of dementia. He lives alone in subsidized housing and relies on MaineCare for his medications. “Doc,” he once told me, “If I lose my nurse, I lose everything.” That nurse checks his blood sugar and keeps his fridge stocked. Her salary comes from taxpayer dollars.

Claire is 29. She fled an abusive relationship and lived in a shelter with her two children. She’s been clean for six months, sees a therapist weekly, and is working part time. Her child care is covered by a state voucher program that’s barely holding on.

Then there’s David, a wealthy entrepreneur from southern Maine. He built his company from nothing and gives generously to his community. But recently, he looked at me and said, “Doctor Jeff, if they raise taxes much more, I’ll move to New Hampshire. I love Maine, but I can’t be the only one writing the check.” And a financial planner in the Portland area shared with me that high-earning taxpayers are, in fact, leaving Maine for New Hampshire: “We lost five wealthy families just last year.”

Here’s the hard truth: all of these people are existentially connected. The safety net that keeps Walter alive and helps Claire rebuild her life? It exists, in part, because of taxes paid by people like David.

That’s why this isn’t a simple case of “tax the rich” versus “protect the poor.” Not some catchy three-word phrase attempting to solve one of the most important and complicated issues. It’s about balance. About keeping Maine whole. We are already one of the highest-taxed states in the country. Top earners here pay over 7% in state income tax compared to zero just over the border in neighboring New Hampshire.

According to Maine Revenue Services, the top 1% of earners contribute nearly a quarter of all income taxes collected statewide. And when they leave, they don’t just take their dollars. They take jobs, charitable giving and civic leadership with them. Again, wealthy high-taxed people do leave Maine. And when they do, it weakens our ability to help those who remain.

But that doesn’t mean we abandon the safety net. Quite the opposite. Right now, rural hospitals and birth centers are closing. Foster families are overwhelmed. Nursing homes are shuttering their doors. If we don’t invest in these services, we’ll all pay, not just in dollars, but in lives.

So, how do we move forward?

First, we need to stop framing this as a war between the wealthy and the vulnerable. Most Mainers, whether they own a business or rely on public services, want the same things: a state where people can live safely, raise families and grow old with dignity.

Second, we need better data. How many people are truly leaving due to taxes? What do we lose when they do? Let’s answer those questions honestly before writing new laws and budgets.

Third, let’s think creatively. What if we offered tax incentives for high earners to donate directly to Maine-based services such as rural health clinics, food pantries, legal aid, job training, and infrastructure? What if we made giving as rewarding as leaving?

And finally, let’s not forget who we are. Maine is a small state with a big heart. We dig each other out after snowstorms. We show up with casseroles. We wave at strangers on back roads. But we can’t do any of that if we drive away the people who help power our economy or if we look away from those sinking beneath its weight.

As a psychiatrist, I’ve seen what happens when the safety net fails. Patients end up in jail instead of treatment. Children go hungry and don’t graduate. Elders die alone. These aren’t abstract budget items. These are people. With names, fears and dreams. And as a Mainer, I see the value in keeping our most successful neighbors here, not out of guilt or fear, but out of both necessity and pride. Pride in a state that works for everyone.

So, let’s hold both truths close: that we need our wealthiest neighbors, and that we must never abandon our most vulnerable ones. Because in the end, Walter, Claire and David aren’t just stories. They are us. And if we lose even one of them, something in Maine is lost for good.