We must take time to study the current health care system and plan for our future.

Several days ago I wrote my first letter to my senators and representatives here in Maine, not only on behalf of myself but also on behalf of the majority of the emergency physicians in Maine. I did so because of the concern that I have regarding the Dirigo Health plan currently being considered by the Legislature.

I oppose the health care reform plan introduced by Gov. Baldacci. Although I applaud the efforts of the governor regarding this well-intentioned proposal, I think that it is unrealistic and will severely impact the medical infrastructure of Maine.

I came to Maine in 1996 and did my emergency medicine residency at Maine Medical Center. For the past four years, I have been practicing as an emergency medicine physician at Central Maine Medical Center as well as Maine Medical Center, Rumford, Bridgton and Parkview hospitals. I am also the president-elect of the Maine Chapter of the American College of Emergency Physicians.

Emergency departments are America’s safety net, providing care for our state’s uninsured citizens. Emergency departments practice under a federal mandate requiring us to provide health care to anyone who comes through our doors regardless of the hour or their ability to pay. We willingly provide this care and have never deviated from our high quality standards nor based it on the economic or insurance status of our patients.

We practice this way because not only is it the law, but it is also the right thing to do.

The governor’s plan stipulates a severe reduction on hospital expenditures. This rationing of health care will severely weaken and probably destroy the hospitals where we practice.

Many of my fellow colleagues have already begun the difficult process of looking for jobs and opportunities in other states. Financially weakened hospitals will not have the resources to maintain emergency rooms. Citizens of most rural Maine communities will suffer needlessly since they will need to travel far distances to a surviving regional emergency room when lifesaving treatment is needed.

Tragically, some of these Maine citizens will die due to the closure of rural ERs, which we believe will happen under the governor’s current proposal.

The irony is that Maine people will have health care coverage, but no local hospitals or emergency rooms in which to receive routine and lifesaving care.

As a leader of the state’s emergency physicians, I can adamantly state that we are deeply committed to the notion that the people of Maine should have access to quality, state of the art, comprehensive and affordable health care. Unfortunately, although this plan sounds wonderful to some, it is unrealistic and misses the mark.

By instituting a global spending budget for hospital care, the governor’s plan rations health care services in Maine. Decisions about what services are available for patients and where those services are provided will be taken away from local communities, doctors and patients and, instead, will be given to state health-planning bureaucrats.

I hope that as our senators and representatives consider this legislation that they remember that Maine hospitals are community oriented charities, providing valuable services to the communities they serve; and especially in regard to the golden hour associated with trauma and cardiac care.

Health care can be reformed without unnecessarily destroying Maine’s nonprofit hospitals. The current plan has been hastily created with minimal input from those who actually provide the majority of health care in the state; the most egregious fact though is that it is being rushed through the Legislature with the hope of minimal opposition.

To accomplish a health care plan that will benefit everyone in Maine, from the richest to the poorest, we must take the time to study the current system, to learn from past mistakes and carefully and thoughtfully plan for the future long-term health care of Maine.

Kevin M. Kendall, M.D., is president-elect of the Maine Chapter American College of Emergency Physicians, assistant medical director of emergency medicine/EMS at Central Maine Medical Center, and regional medical officer of emergency preparedness for western Maine at CMMC.


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