Staff Writer Joe Lawlor did a wonderful job depicting the pain and dysfunction of our American system of health care (“Hidden charges, denied claims,” Aug. 21, Page A1). The stories he tells are compelling and leave little question but that the system is badly broken. But while Lawlor hints at the roots of the problem (citing, for example, powerful vested interests that oppose reform), I think he missed an opportunity to make a more definitive diagnosis.

What separates the American medical landscape from the rest of the developed world, aside from the staggering gulf in money spent, is the powerful dominance of the corporate model, and the increasingly absurd argument that the free market will fix things.

I’ve been lucky to practice medicine during a golden age, in which scientific and technological gains have been stunning. But at the same time, there has been an insidious growth in corporate influence. It may have begun with for-profit hospitals and insurance plans, but it has metastasized to dominate even the not-for-profit world of academic medical centers and community hospitals – the world that we in Maine are familiar with and that now works poorly for too many of us.

Care has become larded up with executives extracting seven-figure salaries while they deliver no patient care. These salaries are rationalized as being “market-driven,” but it’s noteworthy that they are unparalleled in the rest of the industrialized world. The free market trope falls apart when we examine its appropriateness in the equitable delivery of health care.

George McNeil, M.D.
Steep Falls