June 21, 2018
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State’s failure to pay its bills hurts Blue Hill hospital

By Dr. Erik Steele

Lawmakers in Augusta soon will be kicking around the idea of drop-kicking our little hospital in Blue Hill with another $400,000 annual cut in state reimbursement for the care of Maine Medicaid, aka MaineCare, patients. As they do, I want legislators to know a little bit about Blue Hill Memorial Hospital.

We have been through a heck of a year here, laying off more than 25 of our fellow workers, closing our beloved obstetrical program, taking pay cuts at senior management levels and going without pay raises and pension plan contributions. We have paid off our debts and climbed most of the way out of a $4 million financial hole. Through all of that we have continued to give great care to our friends and neighbors.

At Blue Hill Memorial Hospital, however, we haven’t borne just our pain. We’ve already borne a lot of the state government’s pain. Its MaineCare program already pays us less than it costs to care for MaineCare patients, owes us $4 million in overdue bills with about $3,000 more added each day, and helped put us into debt in the past with its failure to pay MaineCare bills.

We are a place that does not spend a darn nickel on anything unnecessary. We lease expensive patient care equipment when we can and avoid buying the newest X-ray and other gizmos unless patients will clearly benefit from an upgrade. If anyone out there wants to donate a new parking lot for us, we sure could use one.

To add staff or anything else here that costs more than a nickel, you have to run an administrative gauntlet that would punish an NFL runningback to tears. I roll around my office there in a chair that should have been replaced about 2,000 meetings ago. For the last year, highly trained surgical nurses and techs have been clean-ing the operating rooms so we could save on housekeeping.

We all laughed happily and sadly when a young woman recently delivered the hospital’s first baby of the new year in our emergency department, because most babies born to Blue Hill area moms now come into the world at Maine Coast Memorial Hospital in Ellsworth. That’s because we could no longer afford to deliver them at our hospital; now our mission is to provide the care our patients need, and not all the care we might want to give.

We understand that the best care some of our patients can get is initial care from us, and then definitive care somewhere else. That means we don’t try to be all things to all people, only to do the things we are really good at, and send the most complex patients up the road to Bangor.

Sometimes, if we were not here, patients would never make it somewhere else. A couple of times a month the docs, physician assistants and nurses in our ED pull patients about to die back from the abyss and give them one more chance, cramming in tubes and lines, pushing meds, muttering prayers and rushing them by ground ambulance or LifeFlight to Eastern Maine Medical Center.

I am admittedly biased, but of the 17 small hospital EDs I have worked at in Maine, I think Blue Hill’s is one of the best.

Doctors, nurse practitioners and physician assistants who are employed by our hospital provide all of the primary care for about 20,000 people on the Blue Hill Peninsula. That means we provide most of the mental health care, pediatric care, well woman care, chronic disease care, geriatric care, and tons of tender loving care, to people who otherwise would either have to travel too many miles for it or not get it at all. No one is lining up to keep those primary care providers here if this hospital folds, because primary care in Maine that takes all comers generally loses money.

At Blue Hill Memorial Hospital, we are tightfisted, driven, compassionate, talented people providing great, basic, lifesaving, life-sustaining and life-improving care to more than 20,000 Mainers. We are used to pain, but are tired of being drop-kicked way more than our share by the government of the state of Maine.

Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region. He is also the interim CEO at Blue Hill Memorial Hospital.

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