May 26, 2013

Bill Nemitz: Hospitals need to show leadership

Mission statements are not something most organizations take lightly. Each word is carefully chosen, each phrase honed and polished to capture the essence of who you are, what you do and why it's so important.

Take the Maine Hospital Association, for example.

Its mission: "To provide leadership through advocacy, information and education, to support its members in fulfilling their mission to improve the health of their patients and communities they serve."

Did someone say "leadership"?

And might this be the perfect moment for Maine's hospitals to step up and, as they promise in their 27-word raison d'etre, "improve the health of their patients and the communities they serve"?

We wish.

"Our members are now trapped in the middle of a partisan war up here," said Jeff Austin, the Maine Hospital Association's vice president of government affairs and communications, in an interview last week from the State House. "We're not going to participate in it."

Instead, they sit and watch while Gov. Paul LePage and the Legislature's Democratic majority battle each other to a stalemate over a piece of legislation that could well be titled "An Act to Make Maine Hospitals' Dreams Come True."

It's one of those "we wish we could do more, but ..." kind of things.

On the one hand, the association's 39 member hospitals are 100 percent behind LePage's crusade to pay them the $186 million the state owes them for services rendered to Maine's Medicaid (also known as MaineCare) recipients.

Considering that federal matching funds will bump that payment up to $484 million, what's not to support if you're a hospital CEO looking to fortify your balance sheet?

On the other hand, the hospitals remain strangely silent over the Democrats' insistence that the debt repayment be tied to expansion of MaineCare under the federal Affordable Care Act.

Considering the latter will insure some 60,000 needy Mainers at no cost to the state through 2016 (and no more than 10 percent of the cost after that), why aren't the hospital honchos crowding the steps in the State House Hall of Flags and lending this entire package their full-throated endorsement?

Because LePage has them in his back pocket, that's why. And for that, the leaders of Maine's hospitals should be ashamed of themselves.

"The Maine Hospital Association supports both the Medicaid expansion and the hospital payment," Austin insisted. "Our issue is with the tactic of linkage -- and not with the goal of passing them both."

Translation: The hospitals have for months been held hostage by LePage, who loves the idea of paying the hospital debt (see: 2014 re-election campaign) but hates the idea of expanding Maine's "welfare Medicaid" program (see: tea party talking points).

And now that LePage has vetoed the bill that accomplishes both, the hospital execs have a choice: They can remain on the sidelines and wring their hands over all the partisan wrangling, or they can loudly and publicly call for Republicans in the Legislature to do the right thing this week and override LePage's veto.

So, as LePage is fond of saying, "What's the holdup?"

"It's not that we don't want Medicaid expansion," Austin said. Rather, it's "the condition being put on these overdue bills being paid. It's, 'Go solve this Indiana Jones mission and then we'll pay you.' "

Actually, the Dems' attachment of Medicaid expansion to the hospital payment is no Indiana Jones mission at all. Lest we forget, advocating for the health of Maine citizens -- including those who currently lack insurance coverage -- is the stated mission of the Maine Hospital Association.

In an interview just after LePage hastily signed his veto message Thursday, House Speaker Mark Eves, D-North Berwick, and Senate President Justin Alfond, D-Portland, agreed that the hospitals, like it or not, are on the hot seat this holiday weekend.

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