The United States spends 16 percent of our Gross Domestic Product on healthcare every year, which breaks down to $2 trillion (or $6700 per person per year). This is expected to rise to 20 percent in the next few years. In 2006 employer healthcare premiums increased by 7.7 percent and the annual average cost to cover one person was $4200. More than 47 million Americans are uninsured, though we’re spending more on healthcare than any other nation in the world. In France, where everyone has healthcare, healthcare spending accounted for 9.5 percent of the GDP and 10.9 percent in Switzerland (considered by many to have the best healthcare in the world). Politicians make life-or-death decisions daily, when they vote on bills affecting healthcare, particularly for those on Medicaid, Medicare, or other publicly funded programs. And they are often beleaguered by lobbyists, industry insiders, and interest groups with limitless budgets and powerful connections.Hannah Pingree, Maine House majority leader and former House chair of the Health and Human Services Committee, has some answers about what goes on in lawmakers’ minds when casting those life-changing votes that affect not only quality of life, but in some cases, life or death for Maine people and their loved ones.
What are some of the biggest challenges facing healthcare in Maine and the nation?
I think you could easily say that a country that spends more for healthcare than any other country in the world while many of its citizens live without insurance has a serious problem. When my sister, brother, and boyfriend all “risk it” and live without insurance because they can’t find affordable insurance, I know we have a problem. The cost of insurance, and the overall cost of healthcare, is out of sight and getting worse. This system isn’t making us healthier, and it is not sustainable. Anyone who has dealt with a rejection from his or her insurance company, spent a few hours in the emergency room, or tried to navigate the system for a chronically ill family member knows what I mean.
If I told you about how hard it was when I was sick in New York, and still is, to navigate the system and get fair treatment, would you be surprised?
Our current healthcare system is broken, fragmented, and is a challenge for many, many people to navigate — whether they have MaineCare, Medicare, private insurance, or no insurance. Recently I have watched my dad dealing with cancer. Seeing the complexities he is dealing with — from figuring out his treatment, to dealing with cancer — blows me away. But this is the struggle of many families: on top of a major illness, the unaffordable costs, high deductibles, and dealing with insurance companies is a cruel and unnecessary burden.
We have tried in the state of Maine to increase payments, especially to physicians, to encourage them to take MaineCare patients, but there are clearly still issues for many providers, especially non-hospital-based doctors, who are often struggling and make a financial decision not to take MaineCare patients. Obviously, to significantly increase state payments would be a huge cost to the state and as lawmakers we weigh that against whether the state can afford that and if not, whether we’d be willing to take the increased reimbursement costs from overall MaineCare services, which could threaten to cause fewer people to be served.
