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Grace Lee grew up in Maine and is now a medical student studying health equity and patient-centered reform.
I grew up helping my immigrant parents sort through insurance letters and medical bills long before I could understand the language printed on them. Now, as a medical student, I still hear the same fear in people’s voices: “I’m doing everything right. So why is health care still so expensive?”
Across communities throughout Maine — especially in rural towns — I hear the same worry. In a state with an aging population and long travel distances to care, those costs and gaps can quickly become barriers to staying healthy at all.
A recent AP-NORC poll found that Americans across political lines agree on one thing: health care is becoming harder to afford. Some describe it as a “privilege,” echoing a very human fear that resources are limited and someone else might take advantage of the system. That fear is understandable. Scarcity makes people defensive, not selfish.
But if withholding care truly solved our cost crisis, the United States would already have the least expensive health system in the world. Instead, we spend more per person than any other wealthy nation and still leave millions uninsured or underinsured. People are trying their best, yet the system is failing them.
Even those with “good insurance” run into barriers. One clear example is screening colonoscopies. Under federal law, these are supposed to be fully covered. But if a doctor finds and removes a polyp — something no patient can predict — the procedure may be reclassified as diagnostic, leaving people with unexpected bills. Patients who take preventive steps end up paying more for doing the right thing.
As a medical student, I’ve watched people ration medications, delay check-ups, or turn down tests because they fear the cost more than the diagnosis. I’ve seen families try to figure out which appointments they can afford. These are not failures of personal responsibility; they are failures of policy design.
There are steps states and communities can take right now:
Expand coverage and close remaining gaps. Ensuring more complete insurance coverage would prevent many avoidable medical and financial crises.
Strengthen protections around surprise billing. Closing loopholes that turn preventive care into unexpected expenses would protect people from being blindsided.
Invest in primary and preventive care. Every dollar spent upfront saves multiple dollars in emergency or hospital care later.
But conversations I’ve had with patients, community leaders, and clinicians point to a larger truth: small fixes can only go so far.
The most effective long-term solution, used by every other wealthy country, is universal health insurance. Countries that guarantee coverage through single-payer systems, hybrid models, or tightly regulated private insurers consistently achieve better outcomes at lower cost. More importantly, people don’t lie awake wondering whether a refill or a routine appointment will destabilize their finances.
No one should need luck to stay healthy — not the families I grew up around, not the patients I meet in a clinic, and not anyone in our Maine communities.
Health care shouldn’t depend on the right job, the right ZIP code, or the right timing. It should be a reliable foundation that helps people build stable, productive lives.
We have the knowledge and the tools. What we need now is the commitment to build a system that treats health care not as a gamble, but as a guarantee.
