News that Portland’s Mercy Hospital is considering becoming part of a for-profit hospital chain is a cause of concern.

The hospital has been a key provider of quality care, including charity care, for decades, and the greater Portland region would be in a very dangerous position if it were to lose the services that Mercy now provides. The hospital is known to be in financial trouble already, so it’s hard to see how it would be able to produce profits for its proposed owners without raising fees or cutting free services.

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There is reason for cautious optimism about the impact a bigger network with more resources could have on the cost and quality of health care in the state if Mercy Hospital is sold to a for-profit chain. Carl D. Walsh/Staff Photographer

But we are encouraged by the statements by Mercy’s leadership and the Steward Health Care System LLC of Massachusetts and are cautiously optimistic about the impact a bigger network with more resources could have on the cost and quality of health care in the state.

State and federal regulators should conduct a thorough evaluation of this proposed new player on the health care scene and determine if these goals can truly be met.

The proposed sale comes as the nation looks for an alternative to the fee-for-service health care financing model in which doctors and hospitals are paid for tests and procedures, regardless of their outcome. What this has produced is health care that gets more expensive every year and varies widely in quality. There is no financial incentive to keep people well or costs down, which results in inflation and what amounts to economic rationing. The care can be the best in the world if you can afford it, but the number of people who can’t afford the best rises all the time.

As a result of the Affordable Care Act, the industry is developing new financing models under which providers are paid by the patient rather than the procedure and such a system could save money without sacrificing quality. A large health care enterprise that has built-in incentives to keep people well by providing them with appropriate primary care and support, such as drug, alcohol and smoking cessation programs or even a ride to the doctor’s office instead of an ambulance to the emergency room would be a welcome addition.

That is the kind of system that Mercy’s administrators and Steward say they intend to create here, and a knee-jerk opposition to a for-profit tax structure should not close minds to this proposal.

The American health care system is broken and needs to be changed. We should carefully consider proposed changes like this one and see if they might be changes for the better.

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