Published in the Current
Despite last-minute “concessions” required by adults nervous about causing unnecessary anxiety, a fake drunk-driving car crash that “killed” two kids and “injured” five in Cape Elizabeth made its point.
“At first it was going to be a surprise,” said Katie Tammaro, one of the student organizers and an accident victim. They had approval and assistance from town and school officials.
“Under a week left, that was changed on us,” said another student organizer, Alex Weaver.
In a meeting with high school Principal Jeff Shedd, it became clear that an explanatory letter would have to go home with all students in advance. “It had been a surprise everywhere else” the program was conducted, including Deering High School, Old Town and Wells, Weaver said.
A local lawyer had also called the Cape Coalition – the group of parents and students organized in town to address substance abuse who organized last week’s crash – to express concern that a surprise event would cause “unnecessary trauma or unnecessary anxiety.”
Weaver said they had expected hurdles and challenges, but were not prepared for feedback on the event two days before it happened, before people had a
chance to see it unfold.
In the end, advance notice may not have made much difference. “It worked anyways, and we’ll never know,” said Tammaro. “People were still captured and were very emotional,” Weaver said.
At the accident scene
One student, who asked that her name not be used, was in tears.
“There’s so many kids that do this (drink and drive) and don’t even think about it,” she said.
She had known about the event beforehand, but was unexpectedly overcome by emotions, memories and fear. “I thought I’d be fine with coming up
here” to see the accident, she said through her tears. “This really affects you.”
“It’s so scary,” she said. “People just don’t think that this sort of thing can happen. They think Cape is small – they can make it home” after being out drinking.
Superintendent Tom Forcella was at the crash scene. “I’m hoping the kids get the message,” he said. “Not drinking, versus not drinking and driving. A designated driver is not enough.”
“It was scary. I felt it was real,” said Tammaro, who had been inside one of the cars. She was showered with glass, but not injured, when rescue workers cut the roof off the car she was in.
During the school day, to drive home the point that every 15 minutes a person in the U.S. dies in an alcohol-related accident, student volunteers were pulled out of class, handed a tag with a time of death and given a black shirt to wear. Now considered “dead,” the student was not supposed to talk all day.
At lunch, however, a table filled with black-shirted people played blackjack.
After school, the “dead” students and their parents wrote letters to each other to describe their feelings. The letters began, “Today I died. I never got the chance to tell you…”
The morning after
At a school-wide assembly the following morning, the two students who had “died” in the accident, and their parents, read their letters aloud.
Many seniors were not there to hear. Attendance was not mandatory, but the lack of seniors didn’t worry Tammaro, as long as the younger students were there.
“Those are the people we’re going to affect the most,” she said.
Weaver said he had feared more would skip the assembly. “There were a lot of naysayers,” he said. “When it actually came (to the event), a lot of those same people were there.”
Derek Roy told his parents, “Of all the thankless things you have done for me over the years, not a single one went unnoticed.”
His mother said, “We’re relieved that we told you that we love you because yesterday morning was the last time that we saw you.”
Chris Owens, who had played the part of drunk driver in the accident, read his letter. “Many of us have chosen to drink,” he said. This time was different: “My friend is dead.” He backed away from criticizing teen drinking, saying “I don’t want to intrude on your lifestyle,” but asked students not to drink and drive.
Then Emily McConnell got up to speak, to tell Cape students about her own experience, when her brother Nathaniel and two other teens were killed when their friend, driving drunk, flipped a car off Tukey’s Bridge in January 2002.
“I woke up on the morning of Jan. 13 to hear my mother screaming, ‘Nathaniel and Crystal are dead. Nathaniel and Crystal are dead.’”
“At 18 years old I had to help write my brother’s obituary,” she said. At the funeral home, “I tried to stroke his cheek, but it was cold.”
“Now we have two lives,” she told the audience. “The one before the accident and the one we are left with. Nathaniel and Crystal are dead.”
Weaver closed the meeting. “Cape Elizabeth has had a tragic history” with its youth and substance abuse. “Many people have learned to expect a tragedy like this every couple of years.”
A number of students have told Tammaro the program made them think about the consequences of their actions, not just for themselves, but for others.
The assembly hit home. “The place was dead silent the whole time (McConnell) was talking,” Weaver said.
Coalition organizer Bob Flynn said parents have told him they have been talking about the issues with their kids, and some are getting more involved with the Cape Coalition as well.
“We’d much rather it be something like this than have it be an actual tragedy,” Weaver said.
Thursday, April 17, 2003
Fake drunk driving crash raises concerns, awareness By Kate Irish Collins Staff Writer It’s a weekend night in Scarborough. A group of three freshmen girls are making plans to hang out together and watch a movie. One of the friends says she has been invited to go to a party by a senior boy she’s had a crush on all year. Cut to the party where a group of kids are smoking pot and drinking. Beth, the freshman girl, and Andy, the senior boy, sneak off together and go to an upstairs bedroom. This is the scenario that was enacted by a group of high school students at a Scarborough High School teen forum held Tuesday. The forum was designed to make parents and members of the community aware of risky teen behaviors from drinking to smoking marijuana to casual sex. “These things are happening in Scarborough every weekend,” kids in the theater troupe told parents. More than 50 attended the forum and principal Andrew Dolloff and other organizers said they were thrilled to see so Teens talk about drug use and sex By Rich Obrey Staff Writer It’s the calm between the storm in Cape Elizabeth, as boys basketball coach Jim Ray prepares to appeal his dismissal before the school board. Ray, a teacher at the high school for 18 years and head coach of the varsity team since 1994, was fired as coach at the end of March. High School Principal Jeff Shedd evaluated Ray and did not recommend to school Superintendent Tom Forcella that Ray be rehired – a decision Forcella accepted. Bruce Smith, the attorney for the board, said Wednesday morning he was scheduled to meet with members in executive session later in the day to discuss the case. “After the meeting we may have a better idea of what’s going to happen and when,” he said. Representing Ray during his appeal will be longtime Cape resident Gerald F. Petruccelli, an attorney with a practice in Portland, who also works as adjunct professor at the University of Maine Law School. Asked what would be the crux of Ray’s appeal, Petruccelli said, “In general terms, we think this decision (to fire Ray) was wrong. We also think that it was the result of a process which I will suggest in a number of respects was not as well-designed or operated as it should have been.” “The process” has been at the center of the controversy ever since most Cape residents first learned of Ray’s firing by reading a help wanted ad for a new coach in the Maine Sunday Telegram. “Budgets” see page 10 “Crash” see page 10 Margaret Palmer focuses on her juggling skills at last week’s Gym Dandies community performance. Staff photo by Rich Obrey The fake accident scene. Staff photo by Jeff Inglis “Teens” see page 10 Supt. Tom Forcella. Cape coach appeals firing as super explains actions “Forcella”
Thursday, April 10, 2003
Signs of the times: Theater painter Roland Borduas, 1908-2003
Published in the Portland Phoenix
Roland Borduas, born in Biddeford in 1908, spent summers at his father’s cottage in OOB, making signs for local businesses. He didn’t know then that he would end up painting show cards and posters for theater and movie houses in New York and in Maine. He describes his work simply: " I used to paint posters in Old Orchard Beach, " he said.
Roland Borduas, born in Biddeford in 1908, spent summers at his father’s cottage in OOB, making signs for local businesses. He didn’t know then that he would end up painting show cards and posters for theater and movie houses in New York and in Maine. He describes his work simply: " I used to paint posters in Old Orchard Beach, " he said.
One man told him he should head to New York because he was such a good artist. " My father didn’t want me to go to New York. I was 20 years old and I’d never left home, " Borduas said. A friend who lived in the city assured Borduas’s father that the young man would get to church every Sunday, so his dad relented. (He fulfilled his promise, too — Borduas was involved in church activities for his whole life.)
Borduas was close to show business from the get-go: His friend was an acrobat in one of the troupes set up by then–Police Commissioner Theodore Roosevelt to promote fitness among the men on the police force. And his friend’s wife was a Tiller Girl, one of the predecessors of the Rockettes.
Shortly after arriving in the city, he picked up a copy of the New York World to check out the help-wanted section. " There was an ad in there on a Sunday for a banner man for a theater, " Borduas remembers. His friends told him not to apply because the market was tight; they didn’t want Borduas to get discouraged. He went anyway, and had to make a sample poster. On his application he said he was from OOB, figuring folks might know that town better than Biddeford.
" Wednesday, I got a call. I had the job, " he said. After a week of work, his boss, Joseph Jowett, asked if he ever went fishing or hunting. As it turned out, Jowett loved Maine and had been several times to hunt and fish in the state’s wilderness, and had hired the young artist as much for his talent as for his connections to the Pine Tree State.
The job was hard. Much of the work was promoting movies, and turnaround times were fast. " If they said ‘Charlie Chaplin,’ I had to remember the name of the picture he was in, " as well as whether it was sound or silent. " I was young and I had a good memory then, " said Borduas.
He worked around the New York area for several years, painting for theaters, movie houses, and businesses, until a doctor told him to go " somewhere with a lake " to relax for a month. Borduas went home to Old Orchard instead, and kept working. The man who owned the Palace Ballroom hired him to promote events there. " I got to meet a lot of the big orchestras, " Borduas said, and painted portraits of their leaders and stars.
He also worked at the Ogunquit Playhouse, and remembers that when Ethel Barrymore came to do a show, " she came down one Saturday and ordered everyone out of the theater so she could rehearse. " It made his job a bit harder: " I had to make the poster that day on the hood of an automobile, " he said.
He was about ready to head back to New York when the State Theatre opened in Portland. The regional manager, Arthur Morrow, hired him to do the posters. He ended up working for the Strand, the Jefferson, the Empire, and the Maine Theater as well.
To keep his income up, Borduas also " made cards " for local businesses. He opened his own shop and kept trying new things. " I was the first one to do silk-screen work in Maine, " he said. He also made the first airplane banner in the state.
He continued to paint for theater and music halls for years, including the Lycaeum Theater on Stevens Avenue. " I used to do the stage scenery when they’d have a play, " Borduas said. He made signs for a play in Biddeford, too, and knew the actors. " I never thought that guy would play a duke, " he said of one old friend who made it up on stage. He loved watching theater, and used to sit through auditions to see how different people did.
And even after he retired, he kept painting. He took watercolor lessons with local painter Sarah Knock and painted over 50 scenes of the homes of his family and friends, to give them as gifts. But he was a sign-maker, not a showman. " I did a lot of work for orchestras and I never learned how to dance, " he said.
Author’s note: Roland Borduas died March 2, less than two weeks after the interview for this story was conducted. His work can still be seen in St. Patrick’s Church in Portland.Opinion: Live in Maine? Pay me
Published in the Current
I’m 29 years old, I hold a master’s degree, and I live in Maine. The state should pay me to stay here. In November 2001, the State Planning Office issued its “30 and 1000” report, saying that the two keys to improving and stabilizing Maine’s economy, income level and state tax revenue are having 30 percent of adults over age 25 with a four-year degree, and spending$1,000 per worker on research and development into new products and possibilities.
Evan Richert, who was director of the SPO when that report came out, spoke in Cape Elizabeth recently and continued his push toward that goal.
In terms of the 30 percent goal, he said about 23 or 24 percent of adults in Maine now have four-year degrees, up from 19 percent in 2001.
As for research and development money, it can be hard to come by in a state with a big budget crunch. The Maine Technology Institute, which provides seed money for R&D, is losing 10 percent of its funding under Gov. John Baldacci’s proposed spending for 2004-2005.
There is a lot of talk, but little action yet, about spending a few million to retool the state’s technical colleges into community colleges, and the UMaine system is also looking for money to spend on R&D, even as its budget belt tightens.
But there is an easy way to move closer to the “30” benchmark: Help the Mainers who already have four-year degrees. We’re already looking to other states for opportunities, especially those of us who are young. It’s cheaper to live in other states, and incomes are higher too.
Why should we stay in Maine, and why should people move here from elsewhere, when the cost of living is substantially similar, wages are much lower and there are fewer good jobs?
I would like to feel that the state recognizes my presence here as contributing to its economic well-being both now and in the future. Right now, I feel unappreciated by the state that is my home.
The simple solution is money, but how do you allocate it fairly?
One way would be through the state income tax. The state and individuals already use the income tax to exchange money. If I paid too much, the state gives it back; if I didn’t, I write the state a check.
Maine should add a box to the income tax form: “Check here if you are over the age of 25 and have a four-year degree.” Checking that box would permit a taxpayer to add, say, $500 to the standard deduction amount. For single filers, that would bump the amount of money exempt
from taxes up from $7,550 to $8,050. Married filers would go up from $6,775 to $7,275 per person.
If the state wanted to, it could require a photocopy of a college transcript be filed with the return – most of us have one somewhere, and I’d find it if it meant money in my pocket.
The tax rate on taxable earnings after the first $16,950 is 8.5 percent. By offering an increase in the standard deduction, the state would be losing in tax revenue 8.5 percent of that $500, per person with a degree, or $42.50 a head.
If one-fourth of the 1,275,000 people in Maine have a degree, there are just under 320,000 of us. It’s a rough estimate, but that would cost $13.6 million in lost revenue for the state.
That’s far less than the $43 million being allocated for R&D, and less than the $50 million to assist students in paying for higher education. It would be about 1 percent of what the state now collects in income tax – just over $1 billion – and less than 0.2 percent of what the state spends.
That $42.50 wouldn’t hurt the state budget much, or permit me to buy a lot, but it would say Maine’s government was thinking about me and valued my presence here. If Maine is trying to up the number of folks with college degrees, it should look at keeping what it has as a starting point.
I’m 29 years old, I hold a master’s degree, and I live in Maine. The state should pay me to stay here. In November 2001, the State Planning Office issued its “30 and 1000” report, saying that the two keys to improving and stabilizing Maine’s economy, income level and state tax revenue are having 30 percent of adults over age 25 with a four-year degree, and spending$1,000 per worker on research and development into new products and possibilities.
Evan Richert, who was director of the SPO when that report came out, spoke in Cape Elizabeth recently and continued his push toward that goal.
In terms of the 30 percent goal, he said about 23 or 24 percent of adults in Maine now have four-year degrees, up from 19 percent in 2001.
As for research and development money, it can be hard to come by in a state with a big budget crunch. The Maine Technology Institute, which provides seed money for R&D, is losing 10 percent of its funding under Gov. John Baldacci’s proposed spending for 2004-2005.
There is a lot of talk, but little action yet, about spending a few million to retool the state’s technical colleges into community colleges, and the UMaine system is also looking for money to spend on R&D, even as its budget belt tightens.
But there is an easy way to move closer to the “30” benchmark: Help the Mainers who already have four-year degrees. We’re already looking to other states for opportunities, especially those of us who are young. It’s cheaper to live in other states, and incomes are higher too.
Why should we stay in Maine, and why should people move here from elsewhere, when the cost of living is substantially similar, wages are much lower and there are fewer good jobs?
I would like to feel that the state recognizes my presence here as contributing to its economic well-being both now and in the future. Right now, I feel unappreciated by the state that is my home.
The simple solution is money, but how do you allocate it fairly?
One way would be through the state income tax. The state and individuals already use the income tax to exchange money. If I paid too much, the state gives it back; if I didn’t, I write the state a check.
Maine should add a box to the income tax form: “Check here if you are over the age of 25 and have a four-year degree.” Checking that box would permit a taxpayer to add, say, $500 to the standard deduction amount. For single filers, that would bump the amount of money exempt
from taxes up from $7,550 to $8,050. Married filers would go up from $6,775 to $7,275 per person.
If the state wanted to, it could require a photocopy of a college transcript be filed with the return – most of us have one somewhere, and I’d find it if it meant money in my pocket.
The tax rate on taxable earnings after the first $16,950 is 8.5 percent. By offering an increase in the standard deduction, the state would be losing in tax revenue 8.5 percent of that $500, per person with a degree, or $42.50 a head.
If one-fourth of the 1,275,000 people in Maine have a degree, there are just under 320,000 of us. It’s a rough estimate, but that would cost $13.6 million in lost revenue for the state.
That’s far less than the $43 million being allocated for R&D, and less than the $50 million to assist students in paying for higher education. It would be about 1 percent of what the state now collects in income tax – just over $1 billion – and less than 0.2 percent of what the state spends.
That $42.50 wouldn’t hurt the state budget much, or permit me to buy a lot, but it would say Maine’s government was thinking about me and valued my presence here. If Maine is trying to up the number of folks with college degrees, it should look at keeping what it has as a starting point.
Hospitals struggle to care for patients, selves
Published in the Current
Healthcare costs are so high that one of Greater Portland’s major hospitals is considering dropping its private insurance coverage and setting up its own in-house insurance plan for employees.
Medical service and insurance costs are heading up, primarily because of rising demand for and increasing costs of healthcare, decreasing state and federal payments for Medicaid and Medicare and public demands that all levels of medical services be available everywhere.
Eileen Skinner, president and CEO of Mercy Health System of Maine, which runs Mercy Hospital and other facilities, including a Westbrook primary care center, said her company is considering saving money by self-insuring its staff. Mercy Hospital’s staff already has voted to up health insurance premiums for most of the staff, to keep premiums constant for the lowest-paid employees.
And it’s not alone in looking for ways to deal with the rising costs of care.
“We are struggling, like all hospitals in the state and in the country for that matter,” said Vincent Conti, president and CEO of Maine Medical Center, which has facilities in Scarborough and Portland.
Pressure is coming from a wide range of sources, including rising costs of technology, skyrocketing health insurance, government bioterrorism initiatives and the falling stock market, which is gutting non-profit endowments nationwide.
Medical technology continues to advance, making saving lives more expensive, though more effective. “All this wonderful technology doesn’t come at no price,” Conti said.
Staffing shortages have driven many medical jobs’ salaries higher, too. Nurses, pharmacy technicians and radiology technicians are among those who are seeing wages rise because of hospitals’ competition for employees.
An aging Maine population means more demand on services. With more and more people on Medicare and Medicaid, hospitals are feeling the pinch from state and federal budget cuts. “We get paid less than it costs us” to provide services, Conti said.
For every dollar the hospital bills Medicare and Medicaid – together 70 percent of the hospital’s patients – Maine Med only receives 80 cents. At Mercy, 57 percent of patients are on either Medicare or Medicaid. The difference has to be made up by charging more to people who have private insurance. “We’ve got to make money on that,” Conti said.
They also have to make enough from private payers to cover the costs of government-mandated bioterror initiatives. “Bioterrorism is a national security issue, and one would think that the cost of it should be borne by the general population,” said Mercy’s Skinner.
Higher premiums
This is where insurance companies come in. When HMOs came to Maine, they cut prices to attract customers. Their revenues were not enough to cover their costs, but by attracting more plan members the insurance companies were able to fill the gap temporarily.
Most left the state rather than face increased regulation and declining profits. Now that only Anthem is left, premiums are rising. “Premiums have gone up because health insurance companies are catching up,” Conti said.
Instead of charging discounted rates, they are trying to recoup their costs entirely from premiums, putting businesses and individuals in a financial crunch. The hospitals’ rising charges to private insurers only make that crunch worse.
Because the hospitals are raising prices to make up for shortfalls in government payments, they are effectively “taxing the people who walk through the front doors of the hospital” – the sick and the injured, Conti said.
To limit the impact, Maine Med is trying to cut costs where possible. It works with other hospitals to purchase services and devices in bulk, to keep costs as low as they can. Conti warns against cutting back in services and research.
Changing the system
Skinner, who came to Mercy a year ago from Louisiana, said the system needs to be changed.
“Conceptually, health insurance has become a pre-payment,” Skinner said. The only way people or employers can buy health coverage is to purchase a total plan, rather than the services that are needed at the moment. Employers who can’t afford a complete package don’t buy any coverage for their workers, and people who don’t need medical care now don’t pay for it either.
That leaves large numbers of people uninsured because the initial price point is too high. If there was a way to lower the entry price, many more people would have access to some care, Skinner said.
Each person should have a medical spending account, to which an employer could contribute, without having to shell out the full cost of total insurance. The state could put in some money to help poor people, and individuals could contribute to their own accounts. People who wanted more coverage could then buy a high-deductible insurance plan.
The improved access would reduce long-term costs, though initially more people than ever before would seek medical care they had postponed for lack of funding.
“When you insure a group of underinsured people, the utilization gets very high,” Skinner said. But that only lasts a short time. If, on the other hand, the structure remains the way it is, many people will only seek medical care when it becomes an emergency, at high costs to insurers and hospitals.
Doctors and nurses in emergency rooms are often stuck with an ethical dilemma. When faced with an uninsured person needing care, they either sign the hospital up to lose money or they turn away someone who is sick or injured.
“It’s not really fair for these people to make health care policy decisions on the spot,” Skinner said.
Planning medical services
Some of the long-term thinking could come from planning healthcare facilities intelligently, Conti said.
Though it may at first seem counterintuitive, putting a full range of medical services in every town would still not be the best thing to do.
“The distribution of (services) needs to be clinically appropriate,” Conti said. There is a balance that must be struck between geographic proximity to healthcare, and the cost and quality of that care.
When medical centers are more widely spread across an area, the staff at each location gets less practice, meaning lower quality care for its patients. And each center needs to purchase a certain basic amount of equipment to have on hand, increasing the overhead costs to pass on to patients.
Conti said some services should be widely available, such as first aid and delivering babies. Those will be used enough even in thinly populated areas to keep medical staff at the top of their games.
More specialized services like heart surgery, which is used less frequently than emergency care, should be in centralized facilities for a wider area, Conti said.
Choosing the locations for those centralized facilities should be based on medical needs, but often becomes a political discussion, Conti said. And requiring heart patients from all across Maine to come to Portland is not convenient, but ensures the best quality of care and the best price, Conti said.
Healthcare costs are so high that one of Greater Portland’s major hospitals is considering dropping its private insurance coverage and setting up its own in-house insurance plan for employees.
Medical service and insurance costs are heading up, primarily because of rising demand for and increasing costs of healthcare, decreasing state and federal payments for Medicaid and Medicare and public demands that all levels of medical services be available everywhere.
Eileen Skinner, president and CEO of Mercy Health System of Maine, which runs Mercy Hospital and other facilities, including a Westbrook primary care center, said her company is considering saving money by self-insuring its staff. Mercy Hospital’s staff already has voted to up health insurance premiums for most of the staff, to keep premiums constant for the lowest-paid employees.
And it’s not alone in looking for ways to deal with the rising costs of care.
“We are struggling, like all hospitals in the state and in the country for that matter,” said Vincent Conti, president and CEO of Maine Medical Center, which has facilities in Scarborough and Portland.
Pressure is coming from a wide range of sources, including rising costs of technology, skyrocketing health insurance, government bioterrorism initiatives and the falling stock market, which is gutting non-profit endowments nationwide.
Medical technology continues to advance, making saving lives more expensive, though more effective. “All this wonderful technology doesn’t come at no price,” Conti said.
Staffing shortages have driven many medical jobs’ salaries higher, too. Nurses, pharmacy technicians and radiology technicians are among those who are seeing wages rise because of hospitals’ competition for employees.
An aging Maine population means more demand on services. With more and more people on Medicare and Medicaid, hospitals are feeling the pinch from state and federal budget cuts. “We get paid less than it costs us” to provide services, Conti said.
For every dollar the hospital bills Medicare and Medicaid – together 70 percent of the hospital’s patients – Maine Med only receives 80 cents. At Mercy, 57 percent of patients are on either Medicare or Medicaid. The difference has to be made up by charging more to people who have private insurance. “We’ve got to make money on that,” Conti said.
They also have to make enough from private payers to cover the costs of government-mandated bioterror initiatives. “Bioterrorism is a national security issue, and one would think that the cost of it should be borne by the general population,” said Mercy’s Skinner.
Higher premiums
This is where insurance companies come in. When HMOs came to Maine, they cut prices to attract customers. Their revenues were not enough to cover their costs, but by attracting more plan members the insurance companies were able to fill the gap temporarily.
Most left the state rather than face increased regulation and declining profits. Now that only Anthem is left, premiums are rising. “Premiums have gone up because health insurance companies are catching up,” Conti said.
Instead of charging discounted rates, they are trying to recoup their costs entirely from premiums, putting businesses and individuals in a financial crunch. The hospitals’ rising charges to private insurers only make that crunch worse.
Because the hospitals are raising prices to make up for shortfalls in government payments, they are effectively “taxing the people who walk through the front doors of the hospital” – the sick and the injured, Conti said.
To limit the impact, Maine Med is trying to cut costs where possible. It works with other hospitals to purchase services and devices in bulk, to keep costs as low as they can. Conti warns against cutting back in services and research.
Changing the system
Skinner, who came to Mercy a year ago from Louisiana, said the system needs to be changed.
“Conceptually, health insurance has become a pre-payment,” Skinner said. The only way people or employers can buy health coverage is to purchase a total plan, rather than the services that are needed at the moment. Employers who can’t afford a complete package don’t buy any coverage for their workers, and people who don’t need medical care now don’t pay for it either.
That leaves large numbers of people uninsured because the initial price point is too high. If there was a way to lower the entry price, many more people would have access to some care, Skinner said.
Each person should have a medical spending account, to which an employer could contribute, without having to shell out the full cost of total insurance. The state could put in some money to help poor people, and individuals could contribute to their own accounts. People who wanted more coverage could then buy a high-deductible insurance plan.
The improved access would reduce long-term costs, though initially more people than ever before would seek medical care they had postponed for lack of funding.
“When you insure a group of underinsured people, the utilization gets very high,” Skinner said. But that only lasts a short time. If, on the other hand, the structure remains the way it is, many people will only seek medical care when it becomes an emergency, at high costs to insurers and hospitals.
Doctors and nurses in emergency rooms are often stuck with an ethical dilemma. When faced with an uninsured person needing care, they either sign the hospital up to lose money or they turn away someone who is sick or injured.
“It’s not really fair for these people to make health care policy decisions on the spot,” Skinner said.
Planning medical services
Some of the long-term thinking could come from planning healthcare facilities intelligently, Conti said.
Though it may at first seem counterintuitive, putting a full range of medical services in every town would still not be the best thing to do.
“The distribution of (services) needs to be clinically appropriate,” Conti said. There is a balance that must be struck between geographic proximity to healthcare, and the cost and quality of that care.
When medical centers are more widely spread across an area, the staff at each location gets less practice, meaning lower quality care for its patients. And each center needs to purchase a certain basic amount of equipment to have on hand, increasing the overhead costs to pass on to patients.
Conti said some services should be widely available, such as first aid and delivering babies. Those will be used enough even in thinly populated areas to keep medical staff at the top of their games.
More specialized services like heart surgery, which is used less frequently than emergency care, should be in centralized facilities for a wider area, Conti said.
Choosing the locations for those centralized facilities should be based on medical needs, but often becomes a political discussion, Conti said. And requiring heart patients from all across Maine to come to Portland is not convenient, but ensures the best quality of care and the best price, Conti said.
Board questions Kertes’ commitment
Published in the Current
Cape School Board member Kevin Sweeney questioned the wisdom of appointing longtime teacher and coach Kerry Kertes to serve as eighth-grade softball coach this spring because Kertes has threatened to quit over the firing of hoop Coach Jim Ray.
Sweeney made his comments at Tuesday’s regular School Board meeting, during discussion of proposed spring sports coaches.
Kertes, who also coaches the award-winning swim team, said last week that he would resign from his teaching and coaching jobs if Ray was not reinstated.
Sweeney said that statement called into question Kertes’ status as softball coach this season, because it was unclear whether Ray would be reinstated. “It would be unfair to that team to appoint a coach” who might walk away, Sweeney said.
Board members Jennifer DeSena and George Entwistle III spoke in defense of Kertes. DeSena said, “I would be surprised if he would leave the team
high and dry in the middle of the season.” She expected Kertes would give notice if he did decide to leave.
“This coach is committed to the team,” said Entwistle, who also noted the softball season had already started. Middle School Principal Nancy Hutton said the team’s first meeting was Tuesday.
Board member Susan Steinman agreed with Sweeney, but no other board members did, and Kertes was appointed to the position, along with a slate of other middle school spring-season coaches.
Cape School Board member Kevin Sweeney questioned the wisdom of appointing longtime teacher and coach Kerry Kertes to serve as eighth-grade softball coach this spring because Kertes has threatened to quit over the firing of hoop Coach Jim Ray.
Sweeney made his comments at Tuesday’s regular School Board meeting, during discussion of proposed spring sports coaches.
Kertes, who also coaches the award-winning swim team, said last week that he would resign from his teaching and coaching jobs if Ray was not reinstated.
Sweeney said that statement called into question Kertes’ status as softball coach this season, because it was unclear whether Ray would be reinstated. “It would be unfair to that team to appoint a coach” who might walk away, Sweeney said.
Board members Jennifer DeSena and George Entwistle III spoke in defense of Kertes. DeSena said, “I would be surprised if he would leave the team
high and dry in the middle of the season.” She expected Kertes would give notice if he did decide to leave.
“This coach is committed to the team,” said Entwistle, who also noted the softball season had already started. Middle School Principal Nancy Hutton said the team’s first meeting was Tuesday.
Board member Susan Steinman agreed with Sweeney, but no other board members did, and Kertes was appointed to the position, along with a slate of other middle school spring-season coaches.
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