Thursday, December 5, 2013
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"?
"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.
"They are a key element," Eves said. "If they want both (the debt repayment and expanded Medicaid coverage), this is their opportunity. And if they don't, they made a poor choice."
Added Alfond: "They have a huge role to play in the next three to five days."
That could mean a rapid response force of hospital CEOs calling Republican lawmakers between now and Tuesday, when the Senate will vote on the veto override, and reminding them that what's good for LePage in 2014 might not be so good for them.
It could also mean descending on the State House on Tuesday morning and, once and for all, getting out from under the thumb of a governor whose behavior grows more erratic by the day.
(Moving out of his office? Prohibiting his commissioners from speaking to the Legislature? Rather than enabling LePage, the hospital execs should be figuring out a way to involuntarily admit him.)
Even Austin, the association's political point man, concedes that LePage's obsession with paying off the hospital debt has a lot more to do with politics -- as in, "I'm the guy who pays the bills" -- than with the fiscal health of Maine's medical facilities.
"He's not in love with us," Austin said, noting that LePage's budget proposal includes $50 million in lost state and federal revenue for the hospitals over each of the next two years. "He doesn't hate us, but he doesn't love us. He likes this issue."
Put more simply, LePage is using the hospitals to feather his own political nest -- and they know it.
At the same time, he's using his veto to once again demonize people who have the gall to need health care without having the means to pay for it -- and the hospitals know that, too. (What's worse, they end up absorbing those costs in the form of charity care.)
Yet there the Maine Hospital Association sits as a win-win disintegrates into a lose-lose, timidly claiming there's nothing it can do to resolve this standoff.
"This thing's broken," Austin said. "And it's going to take leadership to pick it up and put it back together."
Hear that, hospital CEOs? That's not just your guy in Augusta talking.
It's your mission statement calling.
Columnist Bill Nemitz can be contacted at 791-6323 or at: