By Les Fossel
Portland (Maine) Press-Herald, March 11, 2019
Interesting things are happening in rural Maine:
- People with software jobs elsewhere are moving to Maine – but only where high-speed internet exists.
- Artists, photographers, actors, musicians from away have created a sophisticated cultural economy.
- A bumper crop of young farmers is moving in – the number of farmers, the acres under cultivation and the value of their product are all increasing. Farmers are now growing, processing and marketing specialty products – 30 Acre Farm and Singing Prairie Farm are good examples. This is part of the foodie revolution – note how craft breweries have gone statewide, as is increasingly true of high-quality restaurants.
- Retirees are attracted to our world-class health care, cultural amenities and low living costs. Our economy benefits since they have middle-class incomes and volunteer in the community but do not strain the tax base.
These four legs can be the economic foundation for rural Maine. However, health care is facing daunting challenges:
Maine’s per capita health care costs are among the nation’s highest, but our per capita income is in the middle range. Maine’s per capita wage income is among the lowest and all the other states with the highest health care costs also have the highest incomes. That’s not us. A large portion of our population cannot afford to use our health care system. This is creating a severe financial crisis in health care.
While we like to think that quality is the same among health care providers in Maine, it is not true. The Leapfrog Group is the organization whose annual ratings are the recognized standard for comparing health care quality across America. Only seven hospitals in Maine got the award – all were small rural hospitals with higher costs. Every one of these same rural hospitals also is either in the red, or close to it.
My hospital, LincolnHealth (I’m on the board), has won the Leapfrog Award almost every year. Three years ago Consumer Reports named our hospital the safest in America. This high quality does nothing for our bottom line. Rural hospitals are merging with larger health care groups because we have no alternative. Medicare and Maine-Care reimbursements (which represent most of our revenues) don’t cover costs. We were not bought out – we joined MaineHealth in order to continue to provide world-class care.
Though most Mainers have health insurance, they don’t use it since they can’t pay the deductibles. This is why LincolnHealth’s uncompensated and charity care is so high. Further, the unaffordability crisis in Maine gets worse every year, since health care cost increases always outstrip economic growth – much like a cancer. Health care is now over 20 percent of our economy, but it should be half that. Imagine if Maine could devote those wasted health care dollars to address our real needs.
I served in the Maine Legislature on the Health and Human Services Committee. I authored some good health care legislation, but I could not address our underlying problems. I have been an employer for over 40 years. I have seen solution after solution attempted – but none has worked.
Now I am treasurer of Maine AllCare – our largest universal health care education group – because it is the only way left to control health care costs. Exporting patients to Portland or Boston just treats the symptoms of the crisis, not the underlying problems. To cut health care costs and live longer, we must root our health care in our local communities – the approach that has worked for all other First World countries.
We must pay attention to what works. Universal health care works. It is less costly and more effective. Winston Churchill once said that Americans always do the right thing – but only after they’ve tried everything else.
Well, we have tried everything else – and it doesn’t work. Isn’t it finally time we do the right thing in health care?
Les Fossel is a former member of the Maine Legislature.