The Working Waterfront

Fishermen at risk without health insurance

‘Maine AllCare’ is a way to extend coverage

Daniel C. Bryant
Posted 2022-07-25
Last Modified 2022-07-25

On July 1, 1966, I arrived “from away” to begin my medical residency at the Maine Medical Center in Portland. One of the first patients I was called down to see in the ER was a fisherman complaining of depression. This didn’t jibe well with the idyllic view of Maine I had at the time, but I counseled him the best I could, gave him a prescription for an antidepressant, and advised him to contact his physician within the next 24 hours.

When he said he had no physician, I gave him several names and sent him on his way. I’ve thought of that fisherman periodically ever since, especially when I’ve stopped into Harbor Fish down at Portland’s Custom House Wharf for some haddock.

Thanks to the health care system I worked in, I knew I could easily afford the haddock, not to mention lobster as well if I wanted; thanks to that same system, I knew the fisherman who caught my haddock might have been unable to afford a visit to my office.

President John Adams signed An Act for the Relief of Sick and Disabled Seamen.

Partly because of this and similar experiences in my practice, since retirement I’ve become a supporter of Maine AllCare (, a nonprofit organization that advocates for publicly funded, privately and publicly provided universal health care at the national and state level.

In my work with MAC, I’ve learned, among other things, that in 2014 34.6% of farming, fishing, and forestry workers had no health insurance (CDC), and that in 2018 38.3% of fishing and hunting workers had none (Zippia).

This is not right. It should be noted, though, that government has tried to make it right ever since 1798 when President John Adams signed An Act for the Relief of Sick and Disabled Seamen.

In 1870 the federally funded marine hospital system created by the act became the Marine Hospital Service, which in 1912 became the Public Health Service. However, as described in the March, 2008 issue of Fisherman’s News, in 1981 President Reagan eliminated fishermen’s eligibility for care by the USPHS hospitals and contract physicians. Sen. Ted Kennedy tried to make up for that loss with the Commercial Fishing Industry Health Care Coverage Act of 2008, but that failed to pass.

Fishermen, never covered by workers’ compensation, were thus still on their own to pay for their health insurance, try to get on a spouse’s plan, or go without. The Affordable Care Act of 2010 threw a lifeline, but it perpetuates the cost and waste of the commercial health insurance system, eligibility is dependent on fluctuations in income, and, up until now, at least, family coverage has been questionable (“family glitch”).

MaineCare expansion in 2017 gave another option for coverage, but a limited number of physicians participate because of low remuneration, eligibility is again restricted, and there is the stigma of “being on the dole,” something no one, especially a hardworking fisherman, should have to deal with.

If readers would like more information about publicly funded universal health care or would like to get involved in the movement to bring health care to all Mainers, including fishermen, they should contact Maine AllCare.

That will make me feel a lot better when I stop in for my haddock.

After his residency at Maine Medical Center in Portland and serving as ward medical officer at Naval Hospital Jacksonville for two years, Dr. Bryant practiced office and hospital medicine with a five-doctor medical practice and then with the large independent medical group Intermed in Portland. He lives in Cape Elizabeth.