Rural hospital concerns dominate forum

BREWER – Despite assurances from Gov. John Baldacci that his health care reform plan would not hurt small rural hospitals, legislators at a forum Saturday learned people’s concerns have not gone away.

About 50 people attended a two-hour forum hosted by the Rural Legislative Caucus at Jeff’s Catering off Interstate 395.

Several people representing small hospitals and municipalities told members of the caucus that the plan could reduce services or even close hospitals in their communities and urged legislators to tread cautiously in assessing the proposal.

Caribou City Manager Steven Buck said the lack of built-in reimbursement rates in Baldacci’s plan could result in even lower reimbursement rates than Maine hospitals get currently.

Without a built-in rate, the effect of the plan on Cary Medical Center in Caribou and other rural hospitals could be devastating, he said.

“The reimbursement level needs to be higher than that currently paid by Medicaid,” Buck said.

After addressing the panel, speaking from the back of the room, Buck said closure of the Caribou hospital could have dire economic consequences for the Aroostook County city and the surrounding area.

“If you close my hospital, Loring Air Force Base will look like a pizza shop,” Buck said.

Michael Duddy, a Portland native who grew up in Calais and represents small hospitals north and east of Bangor, said the proposal is a “very bad plan” for rural hospitals.

“It’s going to create a giant sucking noise out of northern, eastern and western Maine,” Duddy said. “This is a bill that has to work for rural Maine.”

Duddy offered the panel what he admitted was a “tongue-in-cheek” solution.

“Let’s close Eastern Maine [Medical Center]. Let’s close St. Joseph’s,” Duddy said of the two hospitals in Bangor, adding the same could go for larger hospitals in Portland and Lewiston. He acknowledged that larger hospitals in Maine likely will fare better than small hospitals with the governor’s proposal.

Duddy said rural hospitals play important economic and cultural roles in their communities that need to be considered and protected.

“They are not just providers. They are anchors to those communities,” he said.

Robert Dworak, a member of Mount Desert Island Hospital’s board of trustees, said the provision in the plan to levy an assessment fee on insurance companies to fund the proposal could drive insurance companies out of the state.

“It has the potential to cause even more harm to the health insurance environment in this state,” Dworak said. “Once it’s broken, I don’t believe it’s possible to fix it.”

In response to the concerns, Rep. Jeff Kaelin, R-Winterport, said he is inclined to take a methodical, deliberate approach in evaluating the proposal.

“Unfortunately, the plan has caused some real concerns in my towns,” Kaelin said.

At the end of the forum, Sen. Tom Sawyer, R-Bangor, asked for a show of hands from those in attendance on two issues.

Nearly everyone in the room raised their hands once to indicate they would vote against the plan if a vote were held the following day. They then raised them again to indicate they would prefer the Legislature make its vote on the proposal next February rather than in June.