In a guest column published on Feb. 24, the president of Franklin Memorial Hospital spared little wrath for state government and its policies regarding MaineCare reimbursements.

Rick Batt, in short, compared the state’s accounting of MaineCare to Enron, the malevolent corporate titan whose fiscal tricks and obfuscations caused its empire to crumble, emptied employees’ retirement accounts and created, in American corporate lexicon, a whole new synonym for fraud.

Not a rosy analogy, by any stretch.

Batt, among hospital administrators, is the lone, thundering voice against the state’s MaineCare payment system. In late 2006, most hospitals and Gov. John Baldacci struck a deal to repay millions in owed payments, but the tab has been running since then. Batt is demanding his hospital’s payments for past services.

His published assessment – and the arguments contained within the hospital’s lawsuits against the Department of Health and Human Services and its commissioner, Brenda Harvey – of Maine’s outrageous MaineCare funding should infuriate taxpayers by its allegations of mismanagement.

Batt has railed against a system that apparently benefits the least efficient hospitals, as reimbursements scale upward along with the cost of services. Higher costs trigger higher reimbursements, he wrote, the antithesis of what’s really needed: strong incentives for hospitals to control their costs.

The result of higher MaineCare costs for hospitals is undeniable. The growing reimbursement gap, plus the unrecoverable cost of charity care, gets shifted onto patients with private insurance. Health care costs then increase for the “paying customers,” especially their insurance providers.

Insurance becomes unaffordable for businesses and individuals, who either pay more, cut back their coverage into near-catastrophic policies, or drop their policies altogether. When these folks then require care, they add to the cost burden on patients with private insurance, and the spiral continues unabated.

It’s little wonder, then, why this year’s presidential candidates are pivoting on their health care platforms. And programs worthwhile in concept, like Dirigo, just cannot find a funding mechanism that works.

Batt blames the system, and has put hospital lawyers to work proving it. His case against the state is worth watching. Although Batt is standing alone among hospital administrators, he may speak for a sizable silent majority.

Or does he?

If the system is as busted as Batt claims, it’s a real wonder why other Maine hospitals haven’t joined his crusade to bring equity and expediency to the reimbursements. Either there are other interests to consider, or Batt’s frustration is simply the fierce venting of somebody fed up with the cost of health care.

Batt may not speak for all hospitals, but in this regard, he certainly speaks for patients.