As members of the United States Senate debate both the merits and potential flaws of the 2,000-page bill before them, consumers are generally concerned with three aspects of health care: quality, affordability and access. At St. Mary’s Regional Medical Center, we believe the final version of any health care reform legislation should take the following form:

Health care would be available and accessible to everyone, paying special attention to the poor and vulnerable. We have an unwavering commitment to provide services, no matter the state of the economy. We are responsible and accountable to provide health care to the people in our community who are unable to pay because they are poor, out of work, uninsured or underinsured. From the emergency room, to the operating room, preventative care to primary care, no one is ever turned away due to financial circumstance. We’ve always done it and we are privileged to continue to do it. By year’s end we will have provided approximately $10 million of care to people who can’t pay for it.

Health care would be oriented towards prevention, with the goal of enhancing the health status of the entire community. We’ve deployed resources responding to community health threats. This year we’ve held numerous seasonal flu shot clinics in partnership with CMMC, created campaigns about containing the spread of illnesses such as H1N1, and offered nutrition programming to prevent and help treat conditions such as diabetes, obesity and high blood pressure. We have programs in place to screen employees and community members for health risks. By identifying these risks, we are able to work with individuals to take corrective action to prevent illness.

Our health system has also invested in the use of electronic medical records for our primary care and family physicians. These record systems are a powerful tool for physicians practicing preventative care.

Health care would be patient- and family-centered, providing preventive and restorative services for people at all stages of life. St Mary’s has spent the last several years incorporating the most current evidence-based clinical practices in every setting.

We believe patients and their families are our partners — integral members of the care team. They collaborate with providers in making clinical decisions. They are responsible for important aspects of self-care while we provide the tools and support they need to carry out that responsibility.

We’ve also enlisted the help of former patients to act as advisers for the design of care. Their input proved invaluable in the construction of our Center for Joint Replacement, Rehab Center and Emergency Center. We’ve also changed protocols and processes based on the advice of our advisory boards to better meet the needs of our patients.

Health care would be sufficiently and fairly financed, with all stakeholders (individuals, government, employees, charitable organizations and health care providers) taking some fiscal responsibility. Recognizing elders are our most vulnerable population, the government instituted Medicare in the mid-1960s, with a goal of providing health services for those 65 and older. Their well-being and quality of care need to be considered in any meaningful health care reform. This will be a challenge when the current payment system and reimbursement rates are well below what it costs to provide services. Maine has the second lowest Medicare payment-to-cost ratio of all states. For $1 of care we provide to a Medicare patient, the government reimburses us $0.79. This is simply not sustainable. Therefore, health care reform that extends Medicare payments to a broader population without payment restructuring will have a devastating effect on providers and will ultimately lead to reduced access.

Health care would require hospitals to scrutinize spending and look for responsible ways to use their resources. Hospitals must do their part to keep finances in check. We are near completion of a two-year analysis of our entire health system. Everything was scrutinized for efficiency, from purchasing contracts to staffing, and how we deliver care. The result … we reduced our annual costs by $10 million and these changes are already showing improvement in both the quality and cost of care we provide.

Health care would stress quality and transparency. Quality and transparency have been, and will always be, areas of focus for St. Mary’s. Our quality scores are listed on our Web site so consumers can make informed decisions when choosing health care and so we can publicly hold ourselves accountable.

In the end, it is quality services that matter and why health care reform is so important to all. There are many things that can be improved in the current system and we see indication that they will be addressed. But, there are also things that work well and we can all agree that those need to be preserved.

Lee Myles is CEO of St. Mary’s Health System. Sharon Millett is chairwoman of the St. Mary’s board of directors.