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

The campaign rally for Paul LePage started at a Dunkin' Donuts parking lot, across the street from Central Maine Medical Center in Lewiston. The crowd, chanting "Pay your bills!" and sprinkled with children holding signs that read "Save our hospitals," eventually migrated to the sidewalk.

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

LePage, running for governor on a platform that included making a $248 million debt payment to Maine hospitals, hoped to get the rally onto the CMMC grounds.

But the sidewalk was as close to the hospital as he and his campaign operatives would get.

"We'd asked to do it on campus, but the hospital wouldn't allow it," said Dan Demeritt, then LePage's spokesman, of the 2010 event. "They are very careful not to engage in partisan activity."

Three years later, Maine's Republican governor has a much closer relationship with the state's hospitals. He delivered on the debt payment he called for at the CMMC rally. He hired Mary Mayhew, lead lobbyist for the industry's trade group, the Maine Hospital Association, as commissioner of health and human services -- which oversees hospital regulation in Maine.

And with a re-election campaign pending next year, LePage has made payment of another $484 million in hospital debt a centerpiece of his vision for how to order the state's finances.

The hospital association has reinforced LePage's message over the last few weeks with a flurry of paid advertisements and newspaper opinion columns.

It's an alignment that makes Democrats queasy. Party leaders agree that the hospital debt must be paid. But some are suspicious of what they view as the industry's apparent coziness with LePage. They say hospitals didn't acknowledge that the debt payment was largely made possible by leftover money from John Baldacci's Democratic administration, which had made payments that resulted in $3.7 billion going to hospitals since 2002.

They note that Baldacci also approved a new Medicaid reimbursement system that pays hospitals on a weekly basis, replacing a system that state officials partially blame for the current debt.

"This governor paid the hospitals with money that we saved for them," said Sen. Margaret Craven, D-Lewiston, chairwoman of the Health and Human Services Committee. "He takes credit for it every time he turns around."

Steven Michaud, president of the hospital association, says there's no connection between hospital lobbying for debt payments and LePage's campaign or policy messages.

"The irony is that the hospitals couldn't be more apolitical," Michaud said. "I don't know why both sides didn't grab ahold of the issue. One (Republicans) did, and we had nothing to do with it. They (Democrats) didn't like it, but I don't know what to do for them."

He added, "We weren't part of any campaign. We educate everybody all the same."

The partisan tension underscores the political and economic influence of hospitals and policymakers' desire to stay in their good graces. Over the past decade, hospitals or their political action committee have spent $1.2 million on lobbying and campaign contributions, according to state campaign finance and lobbying expenditure reports.

The trade group says its members employ more than 22,000 people. Eleven hospitals are among the state's top 30 employers, according to the Maine Department of Labor, and four are in the top 10.

In some rural communities, hospitals are the largest employer.

"They are the 800-pound gorilla in terms of jobs and community leadership and local investment," said Demeritt, the former LePage spokesman.


Community attachment to hospitals is tangible, and in some cases unbreakable: Children are born there. Loved ones are cared for. People remember.

Last year, residents in Boothbay Harbor launched a petition drive to prevent the conversion of St. Andrews Hospital and Healthcare Center into a strictly urgent-care facility.

(Continued on page 2)

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