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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