Maine Hospital Association,

The following opinion editorial appeared in the Feb. 20, 2005, edition of the Maine Sunday Telegram

Hospital Report Makes Wrong Diagnosis

by Steven R. Michaud, President, Maine Hospital Association

The Portland Press Herald's editorial, (Hospital Study Commission Has Right Diagnosis, Feb. 12), like the report it agrees with, offers unproven, untested and unsupported treatments to problems that don't exist.

The Press Herald and the Hospital Study Commission Report continue to support hospital regionalization and consolidation without any evidence that such drastic measures will lower health care costs one penny. Nor has anyone investigated what unintended side effects would result from such measures.

The editorial criticizes the Maine Hospital Association for being "harsh" in our defense of community hospitals. When it comes to protecting access to health care throughout the state, we will be harsh, though we prefer the term "vocal." Unlike the Portland Press Herald, we must have a statewide perspective of health care that is focused on ensuring access throughout the state. We explained hospitals' primary care role and that they serve to ensure access to physician services, home health services, public health and mental health services-stories that the paper has written series on, but apparently connecting the dots is not their strong suit. We can't afford to be so narrow-minded in our efforts to preserve health care for the people of Maine.

The Press Herald admits, that "New technologies and their ever-widening application, expensive prescription drugs, outdated Medicare and Medicaid policies and the unhealthy lifestyles of Maine people are significant contributors" to the problem of health care affordability. Wouldn't it be wiser to address these drivers-the true reasons that health insurance costs so much in Maine-instead of attacking what works-a state hospital system that has been ranked third in the nation twice for the quality of care they give Medicare patients?

No one is arguing that all hospitals should offer all specialty care. We agree that complex surgeries and procedures should be channeled to larger hospitals, exactly as they are now. But when we ask the Press Herald and the Hospital Study Commission which services should be regionalized that aren't already, neither can name a single procedure.

Hospitals work together in a variety of collaborative relationships throughout Maine and these relationships include efforts to capitalize on group purchasing, clinical collaboration, development of shared information systems and quality improvement initiatives among peers.

We oppose the creation of any kind of state-overseen consortium as unnecessary because it would be an additional unneeded costly bureaucracy given the existing and growing collaborative efforts. State involvement is duplicative and could prove to be an inhibitor to continued creative collaboration among hospitals. The majority report's recommendation in this regard is dominated by the view that there is a need for greater centralization of hospital care arguing that "Family doctors and local hospitals were primary sources of health care." We take issue with that statement. Family doctors and local hospitals are primary sources of health care and must remain so. As it happens, the reason many communities have family doctors is that they are subsidized by the local hospital.

Like the Hospital Study Commission Report, the Press Herald claims that Maine hospitals aren't running efficiently. But that contention simply isn't so. Average hospital costs per patient in Maine are well below the New England average and only slightly above the national average. The Study Commission and the Press Herald may not like those facts, but they are in fact just that.

The Press Herald implies that patients can't seek treatment at a hospital other than their local one if they want. That simply isn't so. Patients can and do seek treatment at hospitals other than their local one. But it is unacceptable for insurance companies to force patients to skip their local hospital in favor of cheaper care, which is what the Hospital Study Commission advocates.

Maine hospitals are dedicated to healing and preserving the health of the people in our communities. We are dedicated to ensuring that our patients receive the right care at the right time in the right setting. We cannot support health care policies that undermine those efforts. The costs-the human costs--are simply too high.

Steven R. Michaud lives in Topsham.

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Hospital Report Makes Wrong Diagnosis