Maine Medical Association says American healthcare system needs an overhaul

By Emily Bader
The Maine Monitor, September 11, 2023

Members of the Maine Medical Association over the weekend strongly endorsed a policy statement calling for universal healthcare insurance coverage, becoming only the fifth state medical association to do so, according to advocacy groups.

“I don’t think it’s credible for physicians to stand on the sidelines of this issue of universal access to care … while millions of patients and thousands in Maine don’t have ongoing primary care, access to specialist care, access to hospital care treatment for severe illness without taking on the risk of bankruptcy or not being — simply not being able to afford it,” Dr. Erik Steele, immediate past president of the MMA, said Monday.

“And many of our members, including me, felt we could not stand on the sidelines of that issue without tackling our position on health system reform,” he said.

Founded in 1853, the MMA is a professional and lobbying organization representing approximately 4,000 medical doctors, osteopathic doctors, medical students and retired physicians across the state.

In June, the MMA board approved the statement and members who attended the association’s annual session in Portland voted to endorse it on Saturday, Steele, a Yarmouth family practitioner, said.

The statement calls for immediate action to “create a system that provides access to healthcare for all (as a public good), contains costs, eliminates health disparities, and ensures a robust public health system.”

“A new system must be a full reconfiguration of health care delivery and financing, designed by evaluating the failures and successes of our present models and the systems of other countries,” the statement read.

Universal insurance coverage should be provided either through an “adequately funded single-payer system or a combination of private and public financing where the federal government has, at minimum, regulatory powers over health care delivery to protect consumers and providers from private profit-driven motives.”

An ad hoc committee formed in 2021 surveyed MMA membership and held four listening sessions across the state before finalizing the statement this spring, committee chair and Augusta ophthalmologist Dr. Maroulla Gleaton said.

The way the current system works, where insurance and costs of drugs stand in the way of patient-provider relationships, Gleaton said, is contributing to physician burnout.

Medical students are not taught about handling finances or running a practice, she said.

“You’re not taught that part because you’re supposed to follow what’s best for each individual patient. So that leads to a whole bunch of decisions when you’re out in the real world that really make a lot of unhappiness between the patients and the institution and the goal of trying to get the best care for the patient.”

“It’s getting to be slowly but surely increasingly difficult, I think, for everybody in the healthcare system,” she said.

While the administrative burden on physicians is heavy, “sometimes we don’t even get to see the patients that we would like to take care of but they can’t get access to the office because they just don’t have insurance,” Dr. Paul Cain, an Auburn orthopedist and MMA president said.

A year ago, Gov. Janet Mills’ office said that Maine’s uninsured rate dropped from 8% in 2019 to 5.7% in 2021 through a combination of employer-based coverage and MaineCare. Mills said the drop represented “the largest percentage decline among all states in the nation.”

As of May, 360,187 Mainers were enrolled in MaineCare, the state’s Medicaid program, according to data from the U.S. Centers for Medicare and Medicaid. About a third were able to enroll through MaineCare expansion, according to the Maine Department of Health and Human Services.

Still, complaints about uneven access, long wait times for appointments, and high out of pocket costs are still common.

Only four other states’ medical associations — Hawaii, New Hampshire, Vermont and Washington — have passed similar resolutions, according to Physicians for a National Health Program and Maine AllCare, which call for publicly funded healthcare coverage.

The American Medical Association has not passed a resolution or adopted a statement similar to Maine’s or the other states. Its House of Delegates — made up of representatives of all fifty states’ medical associations — came within 30 votes of endorsing Medicare for all in 2020, Steele said.

“While we are among a small number of medical associations to do this, we think our actions represent a growing consensus of physicians, both in Maine and nationally, that it’s time for every American to have healthcare insurance and to figure out how to do that in a way that’s affordable and equitable,” he said.