Maine’s rural hospital systems are suffering, and urgent care is needed. Northern Light Healthcare is an integrated system with 10 Hospitals that stretch from Portland to Presque Isle: they include Critical Access Hospitals, Tertiary Care Hospitals, Community Hospitals as well as a Behavior Health Hospital. They have 973 beds and each hospital has its own diagnostic services.But like many institutions in this Post-COVID era, rising costs has forced management to take a hard look at the services they offer.Did you know the Northern Light Cancer Center in Brewer, one of the largest and newest facilities in Maine, is now limiting new patients due to a lack of oncologists? Did you know, as of 12/31/2022, Northern Light will have discontinued its Acute Inpatient Rehabilitation Services, which have served patients with Traumatic Brain Injuries, or Strokes as well as recovery from surgeries or complex medical conditions? Furthermore, Northern and Eastern Maine individuals will have to go to Portland or out of state to get those services.Did you know Northern Light and St. Joseph’s Hospital in Bangor have limited beds to offer new patients due to severe and persistent staffing shortages? Indeed, some days neither Hospital has had an available bed for a new patient. Part of the problem involves shortages at nursing homes, which create a bottle neck; it can be difficult to transfer short-term hospital patients to beds at long-term care facilities due to lack of staffing.Did you know Northern Light is selling all of its 10 in-hospital Laboratory Services to Quest Diagnostics in an all cash deal effective February, 2023? Isn’t it troubling that Northern Light is abandoning critical services and selling assets? The pandemic and the state’s response to it have cost us severely. Hospitals and patients suffered when elective surgeries were limited; staffing was over worked and too often compelled to accept an unwanted vaccine. We knew 5 years ago that the state was facing an impending shortage of some 5,000 nurses. It was a crisis then, and it is a disaster now. And yet our Chief Executive has proposed to use almost $160 million of federal Medicaid matching funds that had been allocated and appropriated to reimburse services intended for our most vulnerable citizens. This Federal Medical Assistance Percentage (FMAP) surplus should not be diverted to subsidize other purposes. In light of what is happening to our hospitals and not happening to our significant wait lists, is it really a surplus?This story is repeated throughout New England. On December 12, the Boston Globe published an article by Felice Freyer entitled: “We don’t see the end: In daily juggling act, overstretched hospitals try to maintain services.”Northern Maine is not alone. The cost of traveling per diem staff threatens our rural healthcare delivery system. The refrain is common place. “We have been unable to hire staff to serve our wait list populations.” Unfortunately, it is not just the wait list populations that are being underserved.Many people are currently angling for a share of Maine’s surplus money. As Maine’s legislators perform triage, the thousands of individuals still on wait lists deserve top priority. By taking the bulk of the surplus money and using it responsibly to attract and retain staff, we can finally serve our most vulnerable citizens. As of September 2022, Maine had 3,997 individuals waiting for services. These include the brain injured, those recovering from surgery, and the developmentally disabled. It is important to remember that caring for these individuals also helps their families. When a family member needs to quit their job to care full time for their loved one, that family loses much needed income, and the Maine economy loses another part of its work force.Governing responsibly involves making difficult decisions that involve prioritizing our limited resources. Mindful of the adage that “a civilization is measured by how it treats its weakest members,” we urge the Maine legislature to fully fund long-term solutions in the upcoming biennial budget. Co-written by:Richard Malaby, Wiscasset, Board member of Maine Coast Memorial Hospital, former state representative on the Health and Human Services legislative committee (2010 to 2018). Heather Sirocki, Scarborough, former state representative on both the Health and Human Services legislative committee and the Appropriations and Financial Affairs (2010 to 2018).
Why the CIA No Longer Works—and How to Fix It
The following is adapted from a talk delivered at Hillsdale College on October 3, 2023, during a conference on “U.S. Intelligence: History and Controversies.” We need the CIA, but we also need to recognize the uncomfortable reality that the CIA is not performing at the level we require. It is not keeping us safe. It
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