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Maroulla Gleaton of Bar Harbor is an ophthalmologist.
I am writing to express my concerns about the need for reform of our health care system. I am an ophthalmologist who practiced in the Augusta area for more than 30 years. During my career, I have noticed very worrisome trends in the financing and delivery of health care services in our country.
Most notably, people are having a harder time finding care. This is partly because physicians are leaving the practice of medicine early, as the administrative challenges are now harder for an independent practice to meet and often outweigh the satisfaction of providing good care. The administrative burdens and barriers, such as prior authorization, often interfere with that critical goal of providing good care to our patients. This problem is especially true in the rural parts of our state
Also, while more patients appear to have insurance cards, which seems like a good thing, I notice that those cards often offer fewer benefits and higher out-of-pocket costs and deductibles for care and prescription drugs. Things like eyeglasses, so needed by my patients, may not be among the covered benefits. I have learned that some practices in the southern part of the state don’t believe they can afford to serve patients with MaineCare or Medicare coverage. Problems with access to specialty services north of Portland have only worsened in the time that I have been practicing.
Tragically, costs of medications are extremely high for some conditions, and people are often asked to shoulder the burden of very expensive medications simply to maintain their eyesight.
In my semi-retirement, I have moved to Bar Harbor and am now more than two hours driving time from my old office. I found that I must continue to drive to Augusta and back at least once a week to help patients who, were it not for me, might have to wait months for the care they need now.
For example, some patients might have to wait six to eight months to see an oculoplastic surgeon to remove even cancerous lesions around the eye. Other patients I serve have a condition that requires special eye injections that must be given as frequently as monthly, or face vision loss. And many of these patients don’t have good enough vision to drive themselves and, therefore, must find a friend or family member to drive them to appointments. Imagine having to make transportation arrangements to travel several hours every month for care or lose your vision!
I am speaking out because I am convinced that the current system does not adequately serve patients or health professionals. Our system is inefficient, often inadequate and relies too much on the profit incentive. More money should be devoted to patient care services and less to the administrative costs of our payment system and the profits of the few large health insurance carriers in our country.
The system needs reform. I direct readers to a 2023 policy statement of the Maine Medical Association, a physician organization that is also speaking out about the need for comprehensive reform of our current system. The new statement is a good summary of the many things wrong with the current U.S. health care system, along with some principles and recommendations for reform.
We need a better system now!