Daniel Bryant’s March 8 letter to the editor describes problems stemming from linkage of health insurance with jobs, and wonders, in the words of the Press Herald-written headline, whether “employment-based health insurance needs rethinking.”

West Virginia teachers confirmed that insurance-job linkage needs rethinking. One striking teacher’s sign read, “Will teach for insurance,” and she told The New York Times that “a 5 percent raise isn’t going to feel like much when we have so much coming out for insurance.”

Additionally, major insurance issues “need rethinking.” Presently, 70 years after linking insurance with jobs, millions remain uninsured. Others discover policies’ dollar limits, opaque language concealing coverage gaps and that insurers refuse payment for relevant, effective treatments.

“Insurance” provides less protection because insurers spend heavily on administration, marketing, profits and lobbying lawmakers. Insurers persuade lawmakers to prioritize markets above patient care. Recent efforts to improve Affordable Care Act markets left more people uninsured. Competition and profits before medical care! Why?

Thirty-three of the 34 other Organization for Economic Cooperation and Development countries provide comprehensive care to everyone, pay less than we pay and generally have better health care outcomes. Most use a tax-based (“single-payer”) system. Those using market mechanisms heavily regulate profits and coverage rules.

America could achieve comprehensive benefits and universal coverage. Proposed House (H.R. 676) and Senate (S. 1804) legislation would bypass “market adjustments.” These thoughtfully crafted proposals unlink jobs from health insurance, lower families’ costs, encourage service delivery in rural areas, create health care jobs and support entrepreneurship – according to analyses by experts in health policy and by comparison with OECD countries. Monies saved could fund education and infrastructure improvements.

Many states, including Maine, are rethinking state-based universal coverage, notwithstanding an uncertain path to success.

An unregulated health care marketplace will never serve the common good of providing universal, comprehensive coverage.

Citizens, advocate for the common good, and demand that lawmakers prioritize patient care.

William D. Clark, M.D.

Brunswick

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