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Rural healthcare services, hospitals, and physician practices are at risk. Now even Waterville. With healthcare payment reform, this may no longer be a problem.
I served on the board of a small Maine hospital a few years ago, and at a random board meeting, the treasurer reported that we would not be able to meet next week’s payroll, not unless several payments came through from health insurance companies. Of course, the meeting agenda suddenly changed. The treasurer came back in an hour and said two payments had just cleared and we would be OK, for now.
In our current “money making” system, there is no money to be made in rural healthcare, clinical practices included. Low volumes for people with good insurance and high volumes for those without — such as mental health, addiction, and the rural poor — don’t make for a predictable bottom line.
Other countries with universal and government financed systems don’t leave their rural practices or hospitals with a concern of fiscal survival. Instead with yearly budgets these hospitals seem to organize themselves around the needs of the community. They lead out in the community through health districts and consider local needs.
Any hospital board member would rather hear how the local rural health district has opened new offices for addiction treatment, mental health, or any clinical offices, rather than just struggling to meet payroll. So why don’t rural hospital board members advocate for healthcare payment reform?
Henk Goorhuis, MD
Auburn
