February 3, 2013

Politicians strive to stay in hospitals' good graces

But the partisan tension over who gets credit for paying the state’s debt to medical institutions reveals that industry’s outsized clout.

By Steve Mistler smistler@pressherald.com
State House Bureau

(Continued from page 1)

click image to enlarge

Paul LePage, then the Republican nominee for governor, talks to supporters in front of Central Maine Medical Center on Oct. 14, 2010, at a rally to decry the state’s debt to Maine’s hospitals. As governor, he has delivered on the debt payment that he promoted at the rally, named an industry lobbyist to a Cabinet post and called for another debt payment.

2010 file photo by Scott Monroe/Kennebec Journal

Related headlines

Maine's Top 50 Employers
2nd Q 2012 - by average. monthly employment
Hospitals are listed in red

1  Hannaford Bros Co.
2  Wal Mart / Sam'S Club
3  Maine Medical Center
4  Bath Iron Works Corporation
5  LL Bean Inc.
6  Eastern Maine Medical Center
7  T D Banknorth N A
8  Unum Provident
9  Central Maine Healthcare Corp
10 Mainegeneral Medical Ctr.

11 Shaws Supermarkets Inc.
12 Mercy Hospital
13 Verso Paper Corp.
14 Home Depot Usa Inc.
15 Lowes Home Centers Inc.
16 Pratt & Whitney Aircraft Group
17 S D Warren
18 St Mary's Regional Medical Ctr.
19 Southern Maine Medical Center

20 Rite Aid Of Maine Inc.
21 Jackson Laboratory
22 Goodwill Industries Of Northern N E
23 Bowdoin College
24 Circle K
25 York Hospital
26 University Of New England
27 Mid Coast Hospital
28 Penobscot Bay Medical Center
29 Aroostook Medical Center

30 FIA Card Services NA
31 Idexx Laboratories Inc.
32 Spurwink Services Incorporated
33 Cianbro
34 Central Maine Power Co.
35 Rumford Paper Company
36 Henrietta D Goodall Hospital Inc.
37 New Balance Athletic Shoe Inc.
38 Attendant Services Inc.
39 North Country Assoc Inc.
40 Bates College
41 United Parcel Service Inc.
42 Mardens Inc.
43 Dead River Company
44 Anthem Health Systems Inc.
45 Colby College
46 Franklin Memorial Hospital
47 C N Brown Co.
48 St Joseph Hospital Inc.
49 Martins Point Health Care Inc.

50 Nestlé Waters North America NA
Source: Maine Department of Labor

In the Brunswick area, some residents have chosen sides in a long-standing turf war between Mid Coast Hospital and Parkview Adventist Medical Center. The battle for market share has prompted some to put "Take me to Parkview" bumper stickers on their vehicles.

Lisa Miller, a Democratic former state representative who works as a program officer for The Bingham Program, a nonprofit organization that promotes improved rural health care, said hospitals are keenly aware of their community connections.

"The hospitals recognize the power of constituents, the will of communities," Miller said.

The built-in constituencies enable hospitals to wield influence through their boards of directors and in Augusta through the Maine Hospital Association, she said.

Thirty-four Maine hospitals are nonprofit corporations, overseen by self-governing boards populated by prominent, well-respected and well-connected members of the communities they serve.

The boards' members, like many of the hospitals' executives, are people of diverse political and professional backgrounds who are willing to lobby policymakers.

"It's tough to get a bunch of phone calls from respected community leaders on any issue," Miller said. "You get six, eight or 10 from some hospital board members and that's like a tidal wave to a legislator."

EXTENT OF INFLUENCE DEBATED

Gordon Smith, spokesman for the Maine Medical Association, which represents the state's physicians, echoed Miller's view. "What legislator hasn't been invited to a breakfast by their hospital and not heard about the need to pay the (hospital debt)?" he asked.

The hospital association spent close to $326,000 lobbying state lawmakers between 2002 and 2012, according to filings with the Maine Ethics Commission. Individual hospitals have spent another $547,000 on lobbying.

Other ethics commission records show that the hospital association's political action committee, Friends of Maine Hospitals, has spent more than $307,110 on legislative and gubernatorial elections since 2002. The contributions have been mostly split between Democrats and Republicans, a distribution strategy that often signals that a group is taking the long view to ensure that it doesn't fall out of favor with either party.

The hospital PAC has donated $2,000 to LePage's re-election committee. Until recently, LePage was the only prospective gubernatorial candidate with a campaign apparatus in place.

The American Hospital Association, the parent organization for the Maine Hospital Association, has also split its campaign spending between Democrats and Republicans, favoring one party during some elections.

Michaud, the hospital association president, questions the political power of hospitals.

"I'm not sure how strong our voice is because I can't see anyone else running around begging to be paid four years late," Michaud said. "That's what we have to do. I don't see any other group having to do that. I question whether there is much influence."

He said Mayhew, the DHHS commissioner and former association lobbyist, has proposed an agency budget that cuts hospital reimbursements by $45 million a year.

"The budgets, completely separate from the old debt, are very problematic for us," Michaud said.

But David Farmer, who was communications director for Baldacci when the Democrat was governor, disputes Michaud's characterization of hospital influence.

"They are very effective and they are first in line," Farmer said. "Whether or not that is the right policy, that is the political truth."

Baldacci witnessed the power of hospitals firsthand in 2004, when he created the Commission to Study Maine's Hospitals to improve the state's health care delivery. Baldacci tapped William Haggett, former CEO of Bath Iron Works, to head the commission.

Under Haggett's leadership, the commission delivered a report that pointed to inefficiencies. It called for developing a three-region hospital network, closing underutilized community hospitals and merging others to reduce the duplication of services.

(Continued on page 3)

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