Hospital bill faces criticism from all sides

By JOSIE HUANG, Portland Press Herald Writer

Copyright © 2005 Blethen Maine Newspapers Inc.

E-mail this story to a friend

AUGUSTA — Gov. John Baldacci's effort to reduce hospital spending in Maine and pass some of the savings on to patients is not quite good enough - and that's coming from supporters. Members of a commission that studied Maine's $2.7 billion-a-year hospital industry say legislation from the governor omits too many of its recommendations to make a major difference. Representatives of the hospital industry, meanwhile, say the bill goes too far in some areas.

For William Haggett, the former Bath Iron Works CEO who chaired the commission, the legislation is so watered down that he considered not testifying at a public hearing on the bill Tuesday.

"I could as easily speak in opposition to this legislation as I can in support of it," Haggett told lawmakers.

On Friday, the bill will be the topic of a work session of the Health and Human Services Committee, whose members must race in the waning days of the legislative session to decide whether to recommend passage by the full Legislature.

Commission members have told lawmakers that they like how the bill tries to make it easier for hospitals to collaborate on improving quality and lowering costs without worrying about anti-trust laws. They also support a proposal to standardize financial data submitted by hospitals to the state so the public can better understand the health care system.

But their list of complaints runs much longer. They note that the bill ignores their recommendations related to wellness, electronic medical records, Medicaid underpayments to physicians and the formation of a voluntary statewide hospital consortium that would encourage cooperative ventures.

Commission members were also disappointed that the bill calls for a study of the certificate-of-need program, which is the state's approval process for expensive medical expansion projects. The commission had already identified an understaffing problem, and Haggett said such a study would only delay progress in improving the program.

"You don't need to study that - just fix it," Haggett said. "Studies sometimes lead nowhere."

Implementing change among hospitals has turned out to be a difficult business for Baldacci, even though his bill stresses compromise and small changes, according to Trish Riley, director of the governor's Office of Health Policy and Finance.

Riley said the governor "selected areas where there was general consensus." Now proposed amendments are coming from all directions.

The Maine Hospital Association, for example, is asking that the governor's office change language about voluntary caps on hospital profits. While agreeing with the idea in concept, the trade organization says caps should apply only to hospital systems, rather than individual hospitals. The system approach would reflect the fact that most Maine hospitals subsidize physicians' practices, nursing homes and home-health agencies.

Otherwise, "you're going to target a hospital that failed to meet its cap when that hospital may have needed additional revenue to support" a community service, said Mary Mayhew, lobbyist for the hospital association.

Others want the governor to go farther and make the voluntary hospital spending targets permanent; in the bill, they expire after three years. They also want to extend voluntary expenditure targets to insurers.

Joseph Ditre, a commission member representing Consumers for Affordable Health Care, said he worries that savings achieved on the hospital side will go toward insurance company profits, rather than be passed to insurance customers.

Sen. Art Mayo, D-Bath, is the bill's sponsor as well as co-chairman of the Health and Human Services Committee. Given that only a week or so is left in the legislative session, Mayo asked Riley at Tuesday's hearing to prioritize components of the bill.

"I'd rather do a little well than a lot poorly," Mayo said.

Riley said priority should be given to provisions that begin standardized hospital reporting and continue voluntary targets on profits and cost increases at hospitals.

However, Riley said after the hearing, "if there's a great deal of dissent, it could squelch action, which is regrettable for a process that took more than a year."

The commission, formed by the governor's Dirigo Health reform law in 2003, has met more than 30 times since November 2003, taking testimony from nearly 50 expert witnesses.

It delivered its recommendations in a 137-page report in February.

Staff Writer Josie Huang can be contacted at 791-6364 or at:

To top of page