Ben Hagopian, MD, MPH, is a direct primary care physician in South Portland.
The financial unsustainability of our conventional health care system is no longer a slow-motion crisis — it’s an active collapse, felt acutely here in Maine.
The recent announcement of steep health insurance premium increases for 2026 is a shocking confirmation of the failure of the status quo. The average rate increase of 23.9% for individuals and 17.5% for small employers is simply astronomical and economically destructive for Maine families and small businesses.
This financial pressure is already manifesting in the contraction of essential services, especially in rural areas. As a physician who previously practiced at a critical access hospital, I’ve witnessed firsthand how financial stress compromises patient care.
Across Maine, hospitals are cutting services, with nearly half of our 24 rural hospitals considered “at risk” of closure. In 2025 alone, Northern Light Health’s Inland Hospital shuttered its doors, along with multiple other primary care and walk-in clinics, and since 2020, five Maine hospitals have closed their labor and delivery units, forcing expectant mothers to travel much farther for critical care. This pattern of closures and service cuts is the real cost of our broken system.
The problem is deeper than insurance premiums. Americans have been conditioned to confuse expensive commercial health insurance with actual health care access. In reality, escalating cost-sharing mechanisms are erecting massive financial barriers to care.
For the 2026 plan year, the maximum out-of-pocket limit for an individual Marketplace plan is set to rise to a devastating $10,600 and for a family to $21,200, not including the thousands paid in premiums before any health care is consumed.
This structure means that getting seriously ill can be financially catastrophic, even for the insured. It is a system designed to protect insurance company profits, not patient health. I left the corporate health care model after seeing how insurer mandates often dictate care, placing administrative compliance above physician judgment and patient needs.
While the political will for a single-payer universal health care system is not currently viable, we cannot afford to wait for legislative miracles. We must empower the movement toward accessible, high-value alternatives that already exist.
Direct primary care (DPC) offers a model where patients or employers pay a low, flat monthly fee for unrestricted access to their doctor for most of their patient care needs, bypassing the complexity and constraints of insurance. When coupled with transparent pricing models, high-performance health plans and cash-pay discounts for hospital services, this approach fundamentally changes the cost structure of health care for the better.
Instead of continuing to use taxpayer dollars to subsidize a failing, multi-layered bureaucracy that only serves to pad the pockets of insurance companies and private equity firms, we should be advocating for and investing in innovative, patient-centered models.
It is time for our political leaders to support policies that promote true price transparency and remove the regulatory barriers that stifle these common-sense alternatives. Maine deserves a health care system that provides both genuine access and financial security, not just rising premiums and diminishing care options.