Let’s say you live in or near the western Maine town of Bridgton.
You’ve been following this Obamacare repeal business, sort of, and you think you heard something last week about the Republicans in the U.S. Senate finally unveiling a bill that’s supposed to be less “mean” than the one passed last month by the Republican-controlled House.
Now, a question. Have you visited Bridgton Hospital lately?
“Anybody who will listen, I’m talking to,” said David Frum, the hospital’s president and CEO, in an interview Friday. “In the barbershop, I might be getting my hair cut, but I’m still preaching.”
His message: If you’re not paying close attention to what’s happening to health care in this country, start.
And if you’re partial to your community hospital – Bridgton is one of 16 small, critical-access hospitals scattered across Maine that stand to lose big league under the bill released last week by Senate Majority Leader Mitch McConnell – you have precious little time to speak up.
“We generally think more people on insurance is a better thing,” Frum said. “Whether it’s a Republican model or a Democratic model or somewhere in between, people being insured means they’re healthier.”
And make no mistake about it. From massive cuts in Medicaid to sky-high premiums on private policies to five-figure deductibles that many Mainers couldn’t begin to pay, the so-called “reforms” circulating on Capitol Hill aren’t just bad news for patients.
They’re a potential death knell for Maine’s small hospitals.
Bridgton Hospital, founded 100 years ago as the Northern Cumberland Memorial Hospital, is no Maine Medical Center.
A tour of the 22-bed facility on Friday took just over 20 minutes. As tour guide Nicki Van Loan, R.N., coordinator for the emergency department, put it: “We’re family. It’s kind of a palpable feeling that you get. We’re happy.”
At the same time, they’re essential.
The hospital logs about 1,100 inpatient admissions annually, while 12,000 people – locals and vacationers alike – seek treatment in its emergency department. Physician office visits number between 35,000 and 40,000 each year.
In addition to the cuts, bruises and those other calamities Nurse Van Loan lumps under “Hold my beer, watch this!” – Bridgton Hospital offers treatment through 17 specialty clinics: a six-chair infusion room for chemotherapy and other treatments, a two-room labor and delivery unit for the 100-plus babies born there each year, a diabetes clinic, medical nutrition, urology … the list goes on.
But here’s the rub: Reduce the number of people coming through the door with insurance cards, as the legislation now before Congress most definitely will do, and some of those clinics will start to disappear.
Drive up the hospital’s “bad debt” via those with no insurance or those with mammoth deductibles that far exceed their ability to pay and, sooner or later, the hospital’s very survival comes into question.
Bridgton, along with the neighboring Rumford Hospital, has been recognized nationally for its efficiency and quality of care. They’re both part of Central Maine Healthcare, which also includes Central Maine Medical Center in Lewiston, and they both represent community medicine at its finest.
To wit: Last summer, a man who was terminally ill and on palliative care had only one request – and a big one at that – before he died. He wanted to marry his sweetheart.
“So we pulled off, over one weekend, a wedding,” Frum proudly recalled. “The staff found flowers, they got a few key family members together. And it wasn’t a justice of the peace – it was an ordained minister who happened to be the relative of one of our staff members.”
Compare that with being hospitalized an hour or more away in Lewiston or Portland, where everyone is a stranger and visitors are few – if they can make it at all.
Or worse yet, compare it to skipping this week’s infusion therapy, or that life-or-death MRI, because it’s snowing outside and there’s no safe way to get to an appointment, let alone pay the bill.
“There’s a portion of the population that, if the service is not available locally, they just won’t get it,” Frum said.
As threatening as the current political climate might be to the Bridgton area, it’s even more so in the farthest reaches of Maine.
Calais Regional Hospital currently is phasing out its obstetrics department and will shut it down completely by the end of the year.
By the end of this summer, the Jackman Community Health Center will no longer provide overnight emergency service – forcing those in need to drive more than an hour to Skowhegan for help.
And all of that comes before the latest assault on health care – not just in the back rooms of Washington, D.C., but also in a state budget (assuming one ever passes) that cuts Medicaid, or MaineCare, reimbursement rates and ratchets up the state hospital tax.
Jeff Brickman, CEO of Central Maine Healthcare, said in a separate interview Friday that he’s seen the numbers faced by Maine’s most remote hospitals and “they’re quite dire. I don’t know how many of those organizations will be able to survive much longer.”
And should they fall, it won’t just be bad for local folks’ health. The loss of a community hospital – and all the jobs that come with it – also undermines a local economy.
Bridgton Hospital, with close to 350 people on its payroll, dwarfs any other workplace in the entire Lakes Region.
That explains why President and CEO Frum has spent much of his time lately speaking to service clubs, church groups, anyone willing to learn more about this oncoming train wreck.
He urges them, for starters, to get involved: Call Maine Sen. Susan Collins, a pivotal vote in the coming days, and tell her in no uncertain terms that Maine can’t afford to lose Bridgton Hospital – or the 15 others like it.
But in order to do that, Frum said, everyone first must sit up and pay attention.
“Take the time and effort to fully understand the truth,” he implored. “It’s not an issue that can be resolved by a sound bite. It just can’t.”
Sitting behind Frum as he spoke was a large white board, covered with a roughly drawn map of western Maine and all the health facilities in places like Bridgton, Norway, Rumford, even North Conway, New Hampshire.
It was part of a recent strategic planning exercise, Frum explained.
But at the same time, it stands as a stark reminder of how much the “other Maine,” the Maine without a huge medical center minutes away, stands to lose should the Affordable Care Act collapse into a mammoth tax cut for the rich and misery for everyone else.
In the past few years, Bridgton Hospital’s bad debt has more than doubled to $5 million. The hospital is legally required, after all, to treat anyone and everyone, with or without insurance, who comes through the door – but how long can that door remain open?
“In a small setting like this, we truly believe we are a critical asset to a community,” Frum said. “They’re also our neighbors, our family and our friends.”
Forcing a weary smile, he added, “We’d like to have another 100 years.”
Bill Nemitz can be contacted at:
bnemitz@pressherald.com
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