Problems with MaineCare expansion

Dear Editor:

In November, voters will be asked whether to increase the number of Maine people covered under the MaineCare program.

I would like to talk about MaineCare from a provider’s prospective. I have been providing care to MaineCare patients for 22 years and I have found that there are several problems to address.

  1. First and foremost, MaineCare does not reimburse providers enough to even cover the cost of providing that care. Expanding MaineCare would shift the financial burden to providers and hospitals that are already struggling financially.
  2. In my previous practice, when MaineCare was expanded, I was not paid at all by MaineCare for nearly two years.
  3. Giving free care to patients devalues the care they receive. If it costs nothing, it means nothing.
  4. Frequently, we schedule a MaineCare patient and that patient does not show for the appointment. We started scheduling two MaineCare appointments for one slot hoping one would show up. We then realized that two patients per slot still left us with an empty appointment.
  5. Patients who have no accountability expect all services to be provided by someone else. Patients with commercial insurance who need an MRI are screened for the need for an MRI. MaineCare patients have no such screening. It is an open credit card with someone else paying the balance.
  6. MaineCare pays most providers less than what it costs to take care of MaineCare patients. At some point all of us private providers will decide to stop accepting MaineCare in order to stay in business. I, for one, have already done so. I would rather provide the care for free and declare it as such.
  7. Politicians who propose expansion of MaineCare do not realize that most private physicians cannot afford to provide care when reimbursements do not even cover the cost of running a practice. Physicians employed by hospitals will continue to provide care to MaineCare patients, but at some point someone has to pay for that care and that burden then falls on rural Maine hospitals that are already struggling to stay afloat and have no option to decline MaineCare patients.
  8. I don’t declare to know how to change the health care system, but expanding MaineCare is not an answer.

Sterling Craige Williamson, MD


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