The Star-Herald

To fix health care, put patients first

All across the state, Mainers are worried about how they are going to get health care for themselves and their family. It’s not just the outrageous insurance premiums and sky-high prescription drug prices, it’s also the hidden fees, surprise medical bills and out-of-network referrals. It shouldn’t be this difficult for Mainers to get help when they are sick or injured. 

 

Families shouldn’t be afraid to go to the doctor because of abusive billing practices. They also shouldn’t be forced into financial ruin for getting the care they need. 

A man from Readfield recently reached out to me about his three-year battle with cancer. For him, the worst part about the whole ordeal wasn’t the pain that comes with the treatment, the fear that comes with a serious diagnosis or the way cancer uprooted his life. The worst part of having cancer was figuring out how to pay for it, dealing with mysterious bills and spending endless hours on the phone fighting about cost and coverage. That is unacceptable, and his story isn’t unique.

Maine patients deserve better than the status quo. They deserve a system that puts their health and well-being first. That’s why my colleagues and I joined patients, health care advocates and doctors to introduce a suite of legislation that will put patients first. It’s clear that we need to shake up this industry to improve quality, lower costs and most importantly, prioritize patients over profits.

The first bill in our health care package is about getting the cost of quality health care under control. My bill – LD 2110, “An Act to Lower Health Care Costs” – establishes the Maine Commission for Affordable Health Care to rein in rising costs and develop a process for effective, data-driven reforms. The commission also serves as an advocate for health care consumers so Mainers have somewhere to turn when they have a billing problem or go up against their insurance company. Patients shouldn’t have to go it alone. With the health care commission, Maine will have your back. 

A number of states already have an affordable health care commission and they’re experiencing impressive results. Our neighbors in Massachusetts have saved patients and businesses $7.2 billion with their Health Policy Commission. Our neighbors in Vermont were able to save rural hospitals $7.3 million and stabilize their finances in the long run. Now, Maine isn’t Massachusetts or Vermont. That’s why the Maine Commission for Affordable Health Care was designed to meet the specific needs of our state. Mainers deserve to experience the same savings and security when it comes to their health care. 

Another bill – LD 2111, “An Act to Establish Patient Protections in Billing for Health Care” – would clamp down on abusive billing practices in our health care system. My colleague Sen. Ned Claxton, D-Auburn, introduced this legislation after hearing from his former patients and current constituents. Before serving in the Legislature, he spent almost four decades as a family physician in Auburn doing everything he could to get his patients the care they need. Sometimes, that meant accepting a sack of potatoes or a cord of wood as payment. His bill requires health care organizations to bill patients within six months after a procedure and be upfront about costs. 

Just one unexpected bill can push a family into debt and undermine their credit score. We’ve heard over and over again from patients who received inaccurate or unexplained medical bills and saw their credit destroyed while they fought them – even if they didn’t end up having to pay the bill. 

The final two bills are from Speaker Sara Gideon. The first bill would cap the out-of-pocket cost of insulin at $100 for patients in the individual and small group markets. The second bill protects patients from high bills from out-of-network providers when they never had an opportunity to choose a cheaper option. 

When it comes to health care, Mainers are at their wits’ end. As one woman from Alfred put it, “Every medical bill is a surprise. I don’t know anywhere you can go without getting an estimate for service except medical.” They’re tired of feeling at the mercy of the insurance company or provider.

Last year, my colleagues and I banded together to take on “Big Pharma.” Against all odds, we won. Now it’s time to take on the health care system. It’s time to put patients first.

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