Monday, December 9, 2013
By Steve Mistler firstname.lastname@example.org
State House Bureau
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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
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.
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