HOULTON — Local doctors and others told Sen. Susan Collins on Monday that the Balanced Budget Act of 1997 threatens the future of health care in Maine.
Collins agreed.
The legislation, she said, which was intended to bring some control over rising Medicare costs, “created such chaos that we are seriously jeopardizing the survival of our rural hospitals … and health care agencies.”
Collins was in Houlton not to speak, but rather to listen to the concerns of doctors and directors at Houlton Regional Hospital about what the future of rural medical care will be like in Maine, and especially Aroostook County.
“It’s something I feel so strongly about because it’s so closely related to our quality of life, and the economic health of the region,” said Collins during the luncheon meeting. “The survival and financial health of our hospitals … is critical.”
The problem is reimbursements.
Maine medical-service providers like hospitals, nursing homes and home-health care services are reimbursed only 80 cents for every dollar they spend on Medicare patients. It is the lowest rate in the country.
On the other hand, as many as 20 states get 110 percent of their Medicare costs back from the government, allowing them to make a profit.
“All we want from Medicare is, if it costs us a buck, give us a buck,” said Thomas Moakler, the hospital’s chief executive officer.
The problem, he told Collins, is that the system is set up to reward more costly medical-care providers. Maine typically has one of the more cost-efficient health-care systems in the country. Because of that, Medicare returns less money to the state.
Moakler said that if the reimbursement system to Maine is not changed, within five years, his hospital, and others like it, will have to seriously consider cutting services.
About 55 percent of the Houlton hospital’s patients are on Medicare, Moakler said. Revenues for 1999 are expected to fall short by an estimated $560,000 this year.
Dr. Ted Sussman said the problem is compounded by demands from health-maintenance organizations that doctors offer greater and greater discounts, so that the HMOs can hold down their costs.
“If Medicare cuts back more, or doesn’t increase much more, doctors will be required to provide more discounts,” said Sussman. “That puts us in an unwinnable situation.”
Another problem, he said, is that Medicare doesn’t cover prescription costs. Rising costs for medications can cause serious financial problems for senior citizens on fixed incomes.
Sussman said the cost for medication for heart disease, high blood pressure and high cholesterol for a patient “is pretty much going to take most of your Social Security check.”
Collins said she favored revision of the Medicare laws that would allow medications to be covered, at least for low- and middle-income people.
“I don’t think when Bill Gates retires, that he should be getting his prescriptions with Medicare,” she said.
Collins added that she expects the issue will be addressed by Congress during its next session.
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