Too Local, Too Costly

Posted March 19, 2009, at 6:24 p.m.

Beyond the sad news that Blue Hill Memorial Hospital has had to discontinue offering obstetric services lies a greater truth that Maine must confront — we are no longer a collection of isolated towns and villages strung across the countryside like islands in a bay.

The hospital, like many small rural medical facilities, is struggling to close a gap between expenses and revenues. Ironically, it actually excelled in its obstetrics services. People often traveled many miles to give birth at Blue Hill Memorial Hospital, even passing larger hospitals on that anxious drive as labor started.

But the hospital had to make hard choices, and rather than remain a full service facility, it eliminated some health care options in order to survive. It’s a process that has played out and will continue to play out at other businesses and institutions throughout Maine.

The force behind this trend is geography, something that blesses and curses Maine.

Although Maine is in the populous Northeast, the central, eastern and northern parts of the state are relatively remote from Boston and other urban centers. That isolation was especially keen before the interstate system was built. And Maine towns and villages were remote from each other, especially before secondary roads were maintained for winter travel. But now roads and vehicles are designed to allow people to safely commute 75 miles or more in a day for work.

Blue Hill Memorial Hospital is less than 15 miles from Maine Coast Memorial Hospital in Ellsworth, an easy drive, even with an anxious father-to-be at the wheel. That immutable geographic fact will continue to drive decisions at the smaller institution. Similar geographic facts should dictate the scope of other institutions, especially those relying on public funds.

Island communities can justify having their own schools — regardless of how low enrollment is — their own trash and recycling facilities, their own law enforcement, post offices, medical clinics, grocery stores and utilities. But the little villages that cling to eastern Maine peninsulas — such as Castine, Stonington, Winter Harbor and Jonesport — are no longer like islands.

State regulators will likely be more skeptical about issuing approvals for small hospitals to add services. It’s a sad reality whose only alternative is to pay far more for self-sufficient living.

http://bangordailynews.com/2009/03/19/opinion/too-local-too-costly/ printed on September 30, 2014