"We must start asking all members of Congress what they have done for us lately to ensure affordable and competent health care for all."
Credit: George Danby / BDN

The BDN Opinion section operates independently and does not set newsroom policies or contribute to reporting or editing articles elsewhere in the newspaper or on bangordailynews.com.

Bob Ziegelaar of Bangor serves as a trustee of Northern Light Health’s Eastern Maine Medical Center. His expressed views above are strictly his own.

Complaints about health care in America have increased. We have long heard about allegedly long waiting periods for patients in Canada or the United Kingdom but waiting times here have recently increased as well, and though some Americans may still enjoy excellent health insurance and affordable premiums, most individual payers have seen costs become unaffordable. Hundreds of thousands of working Americans go bankrupt each year due to medical debt, a phenomenon unheard of in other developed countries.

Commercial television has become saturated with pharmaceutical and insurance ads, fully reflective of the economic trend in U.S. health care, where private sector profits have soared while hospitals and practitioners endured unsustainable cost increases. Pharmaceutical companies have long enjoyed exemptions from basic U.S. competition rules while health insurers have operated in lightly regulated environments, mostly on a state-by-state basis, with limited pricing transparency and poor insurance “portability.”

Notwithstanding superinflated hospital charges, most hospitals are struggling to make ends meet, because they must compensate for losses incurred in treating increasing numbers of Medicare and Medicaid patients, as well as underinsured and uninsured patients.

Our national health care “system” is in effect kept afloat through hospital and provider surcharges. Simply put, patients who pay their insurance and hospital bills are directly subsidizing U.S. health care. Yet, politicians rarely acknowledge or explain the same, assuming they themselves understand it.

Congress has had ample time to put U.S. health care on a sustainable footing but has been reluctant to do so, likely because it would have to admit that the current “system” is dysfunctional. It also would have to recognize that pharmaceutical firms, insurers and medical supply providers tend to be exceedingly well rewarded while the operational core of health care (hospitals, medical practices) faces severe challenges. Some hospital administrators may seem overcompensated, but hospital management has been made needlessly complex and overburdened with paperwork. This has caused a need for multiple layers of financial, legal and administrative expertise, all with requisite support staff.

The COVID pandemic effectively advanced an unavoidable economic reckoning in U.S. health care. Massive injections of federal dollars helped hospitals through the immediate crisis, but many were left financially exhausted. While the operational and mental fatigue of medical personnel has been well documented, the financial strains for hospitals went underreported. U.S. health care should not be a “market” for maximized corporate profits.

Public health is as essential to any nation as a stable economy. America’s hospitals should not have to provide essential medical services under constant financial duress while private entities generate massive profits. Other countries show that the private and public sectors can collaborate in ways by which hospitals function efficiently and patients have affordable medications and insurance through sensibly managed competition.

Partisan ideologies are predictable obstacles in any congressional efforts toward health care overhaul. While former Massachusetts Gov. Mitt Romney and President Barack Obama envisioned similar approaches to reform, it took years of political warfare before Congress developed even a modest compromise. The Affordable Care Act helped millions of patients, but it did not address the financial strain for hospitals, especially in the nation’s vast rural regions.

Voters are not likely to forgive members of Congress on whose watch family members lose access to timely and effective medical care. Members themselves enjoy free access to high quality health care, but it will take a wisely crafted plan to provide all U.S. citizens with even reasonably affordable care. Extensive waiting times, unavailable or repeatedly rescheduled appointments, insufficient numbers of doctors and nurses and deteriorating public health are no way to manage a national health care system and America’s reputation for medical advancements does not make up for systemic failures that directly harm patients.

We must start asking all members of Congress what they have done for us lately to ensure affordable and competent health care for all.