The Aug. 21 article by Staff Writer Joe Lawlor (“Hidden charges, denied claims,” Page A1) shines a light on how confusing and frustrating medical billing is in this country, and how it affects Maine people.

From surprise charges such as “facility fees” and denial of claims, to insurance companies not covering medications or procedures that physicians prescribe, the poignant stories of Maine people highlight just how broken our system is.

Many of the fixes enacted so far – from the Affordable Care Act to pricing transparency laws – have made limited improvements. But all leave in place an inherent flaw: the idea that a market-based approach, which allows a few to profit from people needing health care, will work.

In our current, overly complex system, multiple for-profit players seek to maximize their earnings, and one of the ways they do this is by limiting the amount they pay out for care as much as possible. Meanwhile, patients and providers are trapped in a maze of networks, plans, claim denials and billing practices that are murky at best.

We’ve been trying the market-based approach for decades – how’s it working? We pay more for health care than any other developed nation, with worse outcomes. People are spending precious time and energy dealing with the insanity of medical billing; physicians are burning out, and patients and providers alike are losing confidence in a system we all rely on.

lt’s time to take the profit out of health care and choose a simplified, publicly financed system that covers everyone and saves money.

Karen Foster
chair, board of directors, Maine AllCare

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