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There’s little debate that our health care system is out of whack, maybe even broken. Patients can’t afford rising prices for care — more than 40 percent of Maine households have medical debt, and most of them are insured. At the same time, many hospitals in Maine are on shaky financial footing, struggling to maintain services and revenue.
We understand the financial challenges for many hospitals, but the strain on Maine people cannot be overlooked. Already, half of Mainers report struggling to pay for their medical care. Many have delayed care because they can’t afford it. This puts their wellbeing in danger and, often, ends up leading to much more expensive care down the road.
Against this backdrop, lawmakers are right to take a deep, hard look at medical spending and costs. They are faced with difficult choices and a lack of easy answers.
A bill that initially sought to put caps on the amounts hospitals can charge, LD 2196, furthers that discussion. The bill initially sought to cap costs for many Maine hospitals at 200% of the Medicare rate, a rate set by the federal government that providers say is too low. The bill has been revised to limit the growth in hospital prices, with the exception of some critical access facilities.
Rhode Island has successfully used such a model to slow the growth in patient costs, resulting in nearly $90 million in annual savings.
What lawmakers shouldn’t do is punt this problem down the road.
Maine doesn’t need a study committee on medical costs. It essentially already has one, and it brought forward the idea for caps on hospital prices.
Maine lawmakers in 2021 created the Office of Affordable Health Care. That office is charged with tracking health care spending in Maine and proposing solutions to lower costs for Mainers.
The office has found that, in the past 25 years, per capita hospital expenses have grown more than six times more than Maine’s median household income and more than three times more than inflation. Spending on hospital services has far outpaced the growth in utilization of those services, the office reported in a presentation to lawmakers last month.
In addition, the office reported, prices at some Maine hospitals are among the highest in the country. Maine Medical Center in Portland, for example, was in the 88th percentile for per patient prices for an in-person hospital stay. That means only 12% of hospitals nationwide charged more. Northern Light Eastern Maine Medical Center was in the 82nd percentile, according to the affordability office. By contrast, Northern Maine Medical Center and St. Mary’s Regional Medical Center charged far less than the national average.
“If we want to meaningfully improve affordability and change the trajectory for Maine people, we really need to get at those underlying costs,” Meg Garratt-Reed, the agency’s executive director, said recently.
Hospital leaders warned of collapse if the original version of LD 2196 went into effect. That’s a very real concern, but can’t be a reason for inaction.
“It’s not a solvable problem. The affordability crisis is not solvable,” Steve Michaud, who left his job as president of the Maine Hospital Association on March 1, recently told The Maine Monitor. “And by the way, I challenge anybody to look across the globe. Nobody has solved it.”
We’d point out that numerous countries around the world have health care providers and payment systems that don’t drive people into bankruptcy when they receive costly medical treatment. But, that’s a bit of a tangent.
Michaud is right that trying to contain costs to protect consumers while not driving hospitals out of business is a very difficult task. But proclaiming it is unsolvable means not trying to offer relief to the Maine families that are struggling to afford medical care along with the other necessities of daily living.
That should be unacceptable to everyone.