Maine health and sickness
To the Editor:
Hospitals in Maine, and in many places around the county, are hurting financially.
Reimbursements are down, accounts receivable are up…particularly from the State of Maine, who still owes Maine hospitals millions of dollars for services already rendered to thousands of patients and unpaid for years.
Unfortunately, the population of Maine has not been increasing, and lucrative services have declined. To attract insured patients, the most legitimate and ethical means is to improve quality and access to patients in your region.
Unable to do that, Maine Health is attemping to coerce the state into approving an insurance plan that will force patients to avoid high quality medical care close to where the live, and to travel to Maine health facilities just to avoid insurance penalties that otherwise could amount to thousands of dollars billed to them for "out of network" care.
To be sure, one great tragedy of the U.S. healthcare system is the private health insurance industry, designed primarily , it seems, to avoid paying medical bills, rather than to facilitate prompt payment for services rendered (like, for example, the German healthcare insurance companies).
There are multiple businesses created to help administer the confusing and complex regulations related to this hodgepodge health insurance industry. Hospitals often waste hundreds of dollars per patient consulting with services that help them classify whether a patient should be considered an “inpatient” or an “outpatient”…Such classification is completely unnecessary in countries like France or England, but is critical in the U.S. health industry, since it has major implications about who will pay the bills: insurance, patient, or government. These are healthcare dollars that do not pay for healthcare and raise the cost of care for everyone.
Our state representative and justices should be acting in a fiduciary capacity to ensure the welfare of all the state’s citizens. They should understand that the Maine Health -- Anthem plan is a backhanded attempt to leverage the care of patients and to debilitate those hospitals that remain independent from the ever expanding control of Maine Health.
Pure and simple, an attempt to create a monopoly for healthcare in the state. If they cannot attract the entire patient population by quality care, or by being the closest place for everyone in the state, they will try to do it by this economic leverage, to the detriment of our local hospitals in L-A, Bridgton, Brunswick, and Rumford. Don’t let them get away with it.
More than 10 years ago, the Maine State Government granted CMMC a “Certificate of Need” to develop a cardiac center, known as the Central Maine Heart and Vascular Institute. Approving this plan, makes a mockery of that decision. It should be opposed and denied approval.
William Phillips, MD, FACC,
Director of Cardiology, CMHVI