Friday, December 6, 2013
St. Andrews Hospital's impending closure, outlined July 28 ("Boothbay region 'full of fear' as hospital closing looms"), deserves comment in this state with many small hospitals.
St. Andrews is a special kind of hospital, called a "critical access hospital," one of 1,340 such small rural hospitals in the U.S. These hospitals were intended to meet the needs of places like the Boothbay peninsula, remote from other hospitals.
They get some extra payments from Medicare. They get more than 70 percent of their revenue from their outpatient clinics. They average fewer than four acutely ill patients in the hospital at a time. Practically all lose money on their emergency rooms.
If a hospital and a community don't support each other, the hospital will disappear. If management separates the critical access hospital from the outpatient clinic operation, it's as good as closed. Emergency rooms are like fire departments -- they don't make money. Closing ambulatory surgery suggests a decision to close the place and move that revenue stream elsewhere.
The position that emergency rooms should close that can't maintain at least two physicians is particularly troublesome.
All of the 1,340 critical access hospitals have emergency rooms. That is a major reason they exist. Very few have multiple doctors, nor do many other rural hospitals at $300,000 per doctor per year per shift, with benefits.
Ideal, perhaps. Weigh that against the loss of at least 2,000 single-doctor ERs across the country. It's not gonna happen.
The fact that Miles Memorial Hospital in Damariscotta is concurrently dropping its bed complement to 25 suggests it will apply to "inherit" St. Andrews' critical access designation and beneficial payment status. Miles wouldn't qualify on its own, being too close to other hospitals in Bath.
Bottom line: Boothbay, use it or lose it.
Wayne Myers, M.D.
St. Andrews Hospital does not lose money.
"St. Andrews actually turned a $182,000 profit last fiscal year and $874,000 in fiscal year 2011 but has an overall loss of about $2 million over the past 13 years."
So said the Portland Press Herald/Maine Sunday Telegram, wrongly, in its July 28 front-page story.
Mark Twain said, "It's not what you don't know that hurts you, it's what you know for sure that just ain't so." Of the three numbers quoted above, two of them just ain't so. The only correct one is that St. Andrews reported a bottom-line profit in 2011 of $874,000.
Why does the story cite a long-term loss of $2 million when St. Andrews reported not a loss but a bottom-line profit of more than $5 million for the period?
Why does it understate last year's profit at $182.000?
And why did the annual report published for St. Andrews last year show a profit of about half the $874,000 actually posted?
MaineHealth and Lincoln County Healthcare want you to believe that St. Andrews "loses money," so they misleadingly present other lines as the true bottom line. Two of these misrepresentations are included in this story, as quoted above. In fact, St. Andrews does not lose money. Its own audited financial reports show that it is profitable.
Altogether too many people have been hoodwinked into thinking St. Andrews "loses money" when it does not.
The Press Herald should print a prominent retraction to correct this gross misrepresentation of the facts.
Readers divided over impact of tougher school standards
Referencing the July 21 article "Maine schools' shift to tougher standards will come with costs": Maine's Common Core Standards also benefit the business community by better ensuring a skilled workforce that can compete in our global economy.
The business community was very much involved in developing the standards because they are integral to reversing a looming "skills gap" across our state.
According to a report from the business leaders group America's Edge, Maine needs at least an additional 15,000 high-skilled workers if it is going to be able to fill the jobs of the future. Experts anticipate gaps in business and finance, computer and math, architecture, engineering and the skilled trades as well.
Maine's standards are rigorous learning objectives and goals that will help students become college- and career-ready upon high school graduation. These standards were designed to develop skills businesses need and now expect -- communication, collaboration and critical thinking -- as well as a mastery of core academic content.
The standards are coupled with aligned assessments, which will allow educators to determine how students are doing and use that information to better prepare students for success.
The future of Maine's businesses and economy depends upon the caliber of our workforce. Let us make sure we equip our students with the critical skills for these jobs in the future through support for Maine's Common Core Standards and aligned assessments.
president and CEO, Maine Development Foundation
To me, a teacher with 25 years' experience, the Common Core Standards appear to be thorough and effective.
The problem is that the U.S. Education Department continues to believe that by making great standards and testing our students extensively and continually, somehow our student outcomes will improve. (Previously we had Learning Results -- also great standards.) This hasn't worked and it won't work.
If the Common Core Standards are to be used meaningfully, there needs to be intensive, quality training to help teachers understand the foundations and learn the new teaching strategies for these standards. This is a dramatic curriculum shift, and to simply say, "It is in place and now we'll test everyone" is ludicrous.
Funding would be much more effectively spent on teacher training than constant testing. Standards to become a teacher should be made more demanding. Teachers make the most critical difference in each child's education, no matter what the standards or the curriculum are.
If our education system first committed itself to democratizing public education, learning would improve dramatically and rather quickly.
The difference in the learning experiences of students between rich and poor towns is stark. Funding needs to be changed from property taxes to state taxes so that children in every part of the state have access to equivalent educational opportunities.
Improving education by improving teacher education and democratizing schools would not make anyone profits, so we will continue to spend billions on expensive tests that educational corporations are happy to create. Then these same companies will develop and sell expensive curricula that will teach to the tests for us.
Spending our time and resources on testing is only benefiting corporations. Business as usual.
Bleak coverage overlooks all that seniors do for state
Your special report July 21 describing Maine's oldest-state status as a "predicament" ("A special report: The challenge of our age") was depressing, demeaning and absorbed with aging issues common in every state.
You missed an opportunity to present encouraging news about our older population. Over the past couple of decades, Maine has enjoyed a steady in-migration of senior adults who recognize that Maine is a great place to spend the rest of one's life.
These folks sold their homes in metropolitan areas and moved to less expensive homes in Maine's cities and villages. They have lowered their overhead and also, in most cases, their blood pressure.
Once here, they have become our most enthusiastic volunteers, involved in our churches and libraries, our service clubs and charities, investing their time and money in their new hometowns. The energy and generosity they bring to Maine are warmly appreciated.
Rather than celebrate the fact that so many have chosen to enjoy the rest of their lives in Maine, you focus on the miseries sadly shared equally by older folks living in any of the 50 states, leaving the impression that older folks are a burden, not a joy.
The welcome growth of our senior population should not be denigrated by political claims that the state is not doing enough to meet the needs of its elderly residents.
As for "the onslaught of aging baby boomers yet to come," let's hope more of them end up coming to live in Maine. Our best, most logical economic growth is tied directly to population growth. That, in turn, will generate more job opportunities for us all.
Alan L. Baker