Cuts to MaineCare hurt the entire community

Our hospitals provide the core medical services needed for our community.

Central Maine Medical Center and St. Mary’s Regional Medical Center have been serving the residents of Androscoggin County and beyond for well over 100 years. Our quality is strong and continues to rise as we are committed to improving the community’s health while providing high-quality services at a lower cost. Our hospitals provide the core medical services needed for our community and specialized services for people living throughout central and western Maine.

Doing this, we employ more than 525 physicians and associated professional staff in more than 40 medical and surgical specialties. Last year, our local medical practices had some 536,000 patient visits. There were 83,000 visits to our emergency rooms in Lewiston. All of our providers accept MaineCare and Medicare. No one is turned away for inability to pay.

The quality of care and breadth of service in this region is no accident. Our local health systems are the result of thoughtful choices, collaborative efforts, strong leadership and careful investment by the community for more than a century.

Money spent locally on hospital care circulates many times through the local economy. Combined, we employ more than 4,350 people with an annual payroll of $230 million. Our employees pay millions of dollars in state income and property taxes, purchase goods and services from local businesses, and are a bright spot in Maine’s struggling economy.

The problem, and the challenge, is that it is no longer business as usual. Maine’s Legislature is considering proposals eliminating 65,000 people from MaineCare and directly cutting $50 million from hospitals over the next 18 months — even though MaineCare owes all Maine hospitals nearly $400 million for services provided since 2009.

There are rate cuts for inpatient stays and outpatient visits. Caps are placed on the number of hospital stays and outpatient visits per year. These changes represent approximately $20 million in cuts to our two hospitals, which are now owed $75 million by Maine­Care — a debt that grows daily and puts great pressure on our cash flow and ability to pay local vendors.

Regardless of actions by state government, people will continue to get sick and use our services. We expect people losing their MaineCare eligibility will turn to our emergency rooms for care. By federal law, we cannot turn anyone away.

The poor economy has made it difficult for many to pay all or even a portion of their bills. We still provide them care, though combined bad debt at both hospitals was more than $35 million in 2011. Additionally, we cannot shift all of our shortfalls to employers. It hurts their financial viability and affects their competitiveness in the marketplace.

We cannot absorb $20 million in cuts and continue business as usual. If these cuts are approved, we will be forced to make cuts in staffing and services.

The issue calls for real leadership. Fiscal realities need to be addressed, but there cannot be a singular focus on balancing the budget on the backs of those in need. There must be a thoughtful plan ensuring that patients eliminated from Maine­Care continue to get care.

Such a plan could bridge us from today’s budget discussion to the year 2014 when the next stage of national health-care reform goes into effect and all those who would be disenfranchised will again need to be covered.

Right now, no such plan exists.

St. Mary’s and CMMC are proud of our roles in the community. We provide local people with good jobs, buy services from local vendors, and offer quality care to all. We feel it is a privilege to provide services to our fellow citizens. But, we cannot keep doing so with such drastic cuts in MaineCare payments.

Our hospitals have always been here for the public — open and operating 24 hours a day, regardless of good times or bad. But today we need the public’s help and its voice.

Democrats and Republican representatives are concerned with repercussions from the proposed cuts. We urge the public, and their elected representatives, to support the development of better alternatives to dealing with these issues, and that both the safety net and the local health care delivery system we all rely upon will be protected.

Laird Covey is president of Central Maine Medical Center. Lee Myles is president of St. Mary’s Regional Medical Center.

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Comments

Betty Davies's picture

Republicans are short-sighted

First, GW Bush and his cronies drive this country to the brink of Depression-2 by starting two major (unfunded) wars at a cost of trillions of dollars--while actually reducing federal revenues by giving their pals massive tax breaks.

Then, they say, "Guess there's no money left for health, education, or welfare--sorry, peons, better start fighting each other to see what to cut.

Now, Republicans are claiming that the only way to save Maine's economy is massive layoffs of teachers and healthcare workers, as if adding to unemployment will somehow increase spending in our communities. But Maine's own tax breaks for millionaires remain sacrosanct.

They're trying to destroy the country while claiming to want to save it. Their aim? To make us all so desperate that we're willing to work for pennies a day and do without healthcare and education.

 's picture

Thoughts

1. Maine is now the oldest state in the nation. Older, on average, than Florida. Health care needs will continue to escalate. It is inevitable.

2. Maine is one of the poorest states (income-wise) in the nation. I looked at per capita income in Lewiston in the 2000 and 2010 census data. A little under $18,000 in 2000, a little over $18,000 in 2010. Factor in the loss of purchasing power due to inflation over that decade (-31%), we are looking at per capita, adjusted for inflation, per capita income at about $12,500. Average household size in Lewiston is 2.1, so you can see we are very poor as a group.

3. Health care costs continue to rise as technology improves. Residents get older, have less resources to pay for escalating health care services. A true disaster in the making.

4. Federal government is borrowing and printing money. State government is broke and cannot print money like Washington can. High taxes have driven the working young people out of Maine to a great extent (see average age). Option used for many years by Augusta has been to increase taxes and/or borrow. Increasing government revenues has the inevitable effect of depressing private sector investment in Maine and almost assuredly will cost private sector jobs, which, in turn, will result in our young, productive, tax-paying people out of Maine. Downward spiral has been in operation for about 40 years now.

5. 82% of state expenditures are health care and education related.

6. There were no solutions offered by Covey and Myles. Where is the money going to come from to maintain MaineCare? In 2000, there were 200,000 MaineCare recipients. In 2012, there are 361,000 MaineCare recipients. How long can we continue the rate of MaineCare growth? The state of Maine is now delinquent, back to 2009 according to the Covey/Myles piece. The state cannot even pay for care rendered 3 years ago, much less the care being rendered today. What are the solutions?

7. Cut state general purpose aid to education and let the cities and towns fund education at the local level? New Hampshire funds education via the property tax (93%). Test scores are better than Maine and kids are getting educated, most certainly. This would free up over a billion dollars for MaineCare. Education money from the state of Maine is a sacred cow but we have to find the money somewhere, and lots of it.

8. Require local communities to fund their own school building projects? High schools now cost over $60,000,000. Are property owners willing to pay the debt service on $60 million construction projects? To fund MaineCare at 361,000 people, and growing, we might have to. Will people hang around Maine to pay that debt service? Don't be so sure.

9. How about attacking costs at our local hospitals. How about merging the two hospitals? Can we afford two high dollar cost management teams now that the well is dry? It might have worked in the past, can we afford it now?

10. We now live in an America where 49% of households pay no federal income tax. I'd guess that the rate is even higher in Lewiston, given the income numbers above. How long can we ask half to work and pay and allow half to live off the others? ObamaCare is just around the corner, and the load on the payers is going to get that much higher to pay of 32,000,000 people coming in for "free" care. Yipes!

Steve  Dosh's picture

Cuts to MaineCare hurt the entire community

10:30 hst • Saturday night ( Alo'ha Pro Bowl tomorrow :)
Laird and Lee ,
Isn't it the †ruth ? Cuts hurt e v e r y o n e everywhere ? 
Thanks for your letter ? /s, Dr. Dosh , Hawai'i • http://www.pnhp.org/ows/index.php
p . s . i'd like to add that Mike Moore got it right in his movie " Sicko " several years ago . ... How can we remain 37th in the world in health care ? It's a crying shame . ...

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