House Speaker Talbot Ross’ column of April 12 was a powerful and timely essay (“‘Health care for all’ must not rule out immigrants,” April 12). However, I was struck as much by the readers’ responses to the column online as by the speaker’s eloquent plea for healthcare access regardless of immigration or low-income status.

The eminently understandable and justified frustrations resulting from the breathtaking costs of healthcare and delays in receiving timely medical interventions were comingled and contaminated with the anger and myriad xenophobias that have polarized our country and our state.

As a physician, as a teacher, and as a health care consumer, I want to address both the readers’ frustrations and fears about access to quality care in this era of unprecedented social and public health challenges.

First, let’s revisit the essence of what is arguably Martin Luther King Jr’s most important and overlooked speech, “The World House,” from the Nobel Prize Lecture at the University of Oslo in 1964. King suggested that in the world house, what affects one can affect all indirectly eventually.

COVID-19 certainly demonstrated this prophecy. Under one roof, in the world house, if someone is sick, then you may become ill as well. If someone is poor, they can be hidden away, banished into the basement with little light or access to that which helps sustain life, but they are still there. Our housemates, “essential workers” as they are often called, grow the food, harvest the food, serve the coffee and tend to the sick, often with catastrophic consequences to their own health.

Is this the sort of world we want to live in? Is this the uniquely American way, the Maine way, the Judeo-Christian way? The duty to heal the sick and provide for the poor are deep moral imperatives in the Judeo-Christian tradition. Combined with the biblical command to treat the stranger as yourself because you were once a stranger in a strange land, this duty transforms our obligations beyond the worthy interest in promoting the health and well-being of our own community.

Providing care and support to the needy are at the core of Islamic philosophy and accordingly, the Prophet Muhammad reflected the same through his services to the poor and to patients.

My point here is that every major global religious philosophy has at its core an unconditional commitment to caring for the sick. Despite sociocultural and political differences, we revere this spiritual mandate; it represents a fundamental quality of a decent world.

How do we provide the material and instrumental structure of that decent world? In the most general and modern terms, the path to universal health care is incredibly complex and no single policy solution exists. It involves political will and commitment by governments to meet the health needs of us all (to uphold our right to health); it involves putting the resources in place (financing and health services) to ensure that services are accessible to all; and it involves ensuring that the right steps are in place to protect people from financial ruin.

Again, in the broadest sense, public health interventions for vulnerable populations not only make spiritual sense, they make economic sense by reducing the burden of illness and preventing eventual and inevitable higher costs to the mainstream community.

Care must be based upon a patient’s medical need and not upon medically unrelated and irrelevant factors such as race, creed, color or nationality. Contrary to some views, undocumented immigrants are not the cause of crowding in our emergency departments. Today, most emergency rooms are crowded with patients seeking primary care treatment because they do not have access to an ongoing or real-time source of care.

And yet again, despite claims to the contrary, undocumented workers do pay taxes. They pay sales taxes on purchases, ad valorem taxes through rent or home ownership, and many pay Social Security, Medicare and worker’s compensation via payroll deductions.

Consider also that we can reduce infant mortality and days of neonatal care – all while saving thousands of dollars per child – simply by providing meaningful access to prenatal care.

If we take care to educate our underserved and vulnerable groups, and collaborate with them toward optimizing their health, we will all benefit. It cannot be over-emphasized.

We have made great progress in Maine in terms of pragmatically achieving genuinely adequate and accessible health care. The expansion of Medicaid and Emergency MaineCare are vital elements. L.D. 199, the bill proposed by Talbot Ross, is the next critical piece.

To ultimately and fully operationalize this legislation, we need to closely consider the entire northern half of our state, which is without adequate primary and specialty care, and without a school of medicine or a university hospital focused on educating, training and retaining our own most valuable health care resource: our young people, who will become the physicians, surgeons, and medical scientists of the future.

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