It was of great concern to all of us to read recently of the financial distress facing Franklin Memorial Hospital. It was disappointing to me, however, that in the very week of the disclosure of deficits and layoffs, there was no evidence that our hospital’s leadership was asking some important questions of the Governor, during his recent visit, and of concerned elected officials who were hearing the news directly from Rebecca Ryder, hospital CEO.
As she expressed the hospital’s concerns over declining revenues, increasing costs and “charity” (uncompensated) care, here are some points I didn’t hear mentioned:
1.On his own, the Governor is refusing to allow Maine to participate in the Medicaid expansion that is part of the Affordable Care Act (ACA). According to Maine Equal Justice Partners, a low-income advocacy group, “The ACA …increases the amount of money Maine receives from the federal government to pay for Medicaid. The federal government will pay 100 percent of the costs of covering ‘newly eligible’ individuals in Maine from January 1, 2014 through December 31, 2016.” By his refusal, the Governor is leaving $100 million per year “on the table” where it will be redistributed to other states, many of which, by the way, have Republican governors – New Jersey, Florida, Arizona and Ohio for instance. In the 28 states that have agreed to expansion, the most convincing cases have often been made by hospitals who will directly benefit from having more patients covered by insurance.
Has the CEO of Franklin Memorial projected what the dramatic increase in “charity” care she cited last week will be during 2014-2016? Has she presented this statistic to the Governor and elected officials? Have she and other health care leaders spoken of the favorable impact on uncompensated care that having an additional 69,000 Maine residents covered by MaineCare will have? Is there a plan among those we have elected to address this deteriorating financial picture?
There is one simple answer that I can provide for them: With an expansion of Medicaid (fully funded by the feds for 3 years and 90 percent funded after that) charity care will decrease and people with insurance will see rate relief. Providing insurance for people living in or near poverty will reduce emergency room use and dramatically reduce charity care. It’s as simple as that.
2. In addition to impacts on medical care for those who don’t have insurance, there are additional concerns for Franklin Memorial and all health care providers in Maine (to say nothing of our low-income elderly and disabled residents) in the governor’s proposed budget. The program that provides low cost drugs for the elderly will be eliminated. Some 80,000 low-income elders and those with disabilities will lose coverage for prescription drugs. The Medicare Savings Program will be cut and those same elders and disabled will lose help paying for Medicare premiums, co-payments and deductibles and prescription drug costs. Unless these residents go without healthcare (which, sadly, many will do), this is another hit to “charity” care for hospitals, nursing homes, pharmacies and physicians. To say nothing of its impact on quality of life.
I think that Maine is better than that.
I work every day as a health care provider, and I witness every day the anguish of disease, dementia, loneliness, depression and mental illness in those we serve and the pain which all of this creates in their families. I fully understand, as well, the deteriorating financial conditions under which we work.
But, that’s precisely my point. In the face of this struggle, it is not enough to tell our citizens, “Good luck. You’re on your own” while, at the same time, telling the health care system that we are going to stop paying for the essential work you do.
We’re all in this together. It’s time for leadership, tough decisions, new revenues and full use of the resources being made available to us. Nothing less will do.
Irving Faunce
Wilton
The Gov is doing the right thing. We do not need to expand on ANYTHING in this state, until we get our fiscal house in order, and limit borrowing until we have the ability to pay our bills.Anything else is just plain wrong.
if medicare is going to be cut, then ALL should know now (or should have known before you supported Pelosi “we have to pass before we find out”) that it’s Obama to blame – not LePage or any other governor. Maybe we’ll have a real uprising.
Every dollar Augusta takes from DC comes with a Gordian Knot’s worth of strings attached. We would all be better off with a new federal tax structure that doesn’t remove money from Maine in the first place, that doesn’t force governors to kneel at the federal trough. This advice covers not only health care, but also every other program which dispenses “free” money to the states.
Maine receives $1.41 from the federal government for every $1 paid in taxes. Refusal to expand Medicaid for those making up to 133% wages above the poverty line effectively shifts the costs back to the hospital charity system, not a cheaper insurance pool. Without the expansion, employers with more than 50 employees will be required to pay for health insurance for those employees making between 100 percent and 133 percent of the poverty level, – employees who would have been covered by the expansion – or face stiff penalties. The Governor’s refusal to expand Medicaid is a political posture that results in economic harm to hospitals and small businesses.
Hurray! for
Gov..Lepage for standing up for the citizens of Maine against Big Government in Washington.
time to stand up and be counted against all the government is try to thrust upon the people.
seamus, the other $0.41 has to come from somewhere. Most likely it was extracted from other states, who receive back much less for punishment, and redistributed to Maine for being reliably blue at the Federal level, including in the Senate. This is one of those strings I mentioned earlier. It’s a “zero sum” game – if somebody wins, somebody else loses.
Unless, of course, they just print the extra money out of thin air. In which case, everybody loses.
Here’s a map showing where federal monies were collected and dispensed between 1990 and 2009. Apparently, it’s more complicated a question than who’s blue. (If anything, the trend seems to be in the other direction.)
http://www.economist.com/blogs/dailychart/2011/08/americas-fiscal-union
How astonishing – an issue that can’t be explained away through stereotyping and black/white (or red/blue) thinking.
frostproof:
A more likely cause of the disparity is that Maine has an older and poorer population in comparison with other states. The governor’s failure to use a fully funded Medicaid program does mean that “somebody wins and somebody else loses”. The losers in his scenario are hospitals, businesses, and the poor. The winners are states that avoid ideological pigheadedness in the face of the huge financial problems. Florida and New Jersey’s Republican Governors are examples. Also, don’t look too closely at the spending patterns in red states. It may upset your votes-for-payment theory.
Let me get this straight…You are upset that the State of Maine is not expanding Medicaid? One of the reasons that the hospitals are in a bad situation is because the state has not paid for Medicaid services already rendered. Where does that make sense?
So sad, our communities were founded on the willingness to help others. We are all so busy worrying about what everyone else has, that they don’t deserve we pick each other apart. Once again how sad.
Hospitals don’t stop treating the uninsured just because the governor refuses federal funds. That’s how it makes sense to accept the Medicaid expansion. These expenses occur no matter what the governor says. The only difference is that by accepting the funds, hospitals will receive payment. The fact that LePage has tried to monkey Mainecare into oblivion in the past should not be taken as proof that federally funded expanded Medicaid in the future is a bad idea.
The article below has some good info on why it’s not such a great idea to accept this money. I know many of you may severely dislike the person saying it but when you read what he says instead of listening to it, it actually makes a lot of sense. I was a hater at first too but after reading many of his transcipts I began to realize that it was one of the only places to get real, truthful information instead of all the proganda and lies that Obama spews out daily.
http://www.rushlimbaugh.com/daily/2013/03/04/obamacare_and_the_gop_govs
Just a couple questions:
Do people need medical care?
Don’t more services of the same type reduce the overall cost per unit of service rendered? Doesn’t medicare/medicade get the best prices around?
If services for one group need to be given, morally and ethically, but are not paid for, do not all of the other receivers of that service that can pay, pay more to cover the difference??
Expand and reduce the overall cost, don’t expect the able rate payers to cover for those that can not…expand the pool.
I used to listen to Rush too, more than 15 years ago. I ranked him right up there with Saturday night live as fun to listen to. Now he preaches too much HATE. Its what he does best, so nothing else he says matters.
Sorry a well paid turkey is just that….a well paid turkey
People have different views of things which is a great thing. In my view I don’t see or hear any hate from Rush at all. I see a man that actually loves his country and wants it to be the best it can be for everyone. It took me a little while to realize that because I, like many others, only heard what others were saying about him and not what he himself was saying. To me, it’s a great place to get real information on our country’s issues and you can still learn a lot no matter which way you lean politically. Hearing our president rattle off nonsense from a teleprompter is getting old.
Thank you H-m-m-m-m-m!!!
What I know of Rush is what I have heard him say….15 or so years ago it was great entertainment and satire aimed mostly at both political parties. Now he attacks those whose opinions differ from his.
He attacks individual citizens expressing their opinions, the more he attacks the more he gets paid, because people enjoy blood sport. His version of Blood sport gets lots of listeners.
We are a great country with real, serious problems to work out. Incendiary, highly paid speakers are not going to solve problems.
We need to support peoples healthcare needs, and we need to pay for it if they can’t themselves. Medicare/Medicaid are more efficient than most plans, so why not fund them appropriately and get it done, instead of just passing off extensive emergency care as write offs?
Hi short term,
Here is an excerpt from the transcript you cite,
“There’s nothing constitutional about Obamacare anyway. The whole bill is unconstitutional. But it’s amazing how quickly that’s been forgotten, and I guess it makes sense. There’s nothing anybody can do about it, anyway, apparently. But you simply can’t force people to buy anything. The federal government doesn’t have that power, although they do now, thanks to John Roberts, chief justice, Supreme Court”
But in fact in 1792Congress, (including several signers of the U.S. Constitution), enacted a law mandating that all able-bodied citizens obtain a firearm, and amazingly relevant to the current debate, in1798, Congress required seamen to buy hospital insurance for themselves.
So Limbaugh once again is simply wrong in his facts. He of course has every right to his opinion on Obamacare but when he consistently defends those opinions with false information he loses any credibility he might have had.