NOTE: in the interest of full disclosure, I am not an authorized spokesperson for ANA-Maine. The opinions expressed are mine alone, unless of course, you happen to agree with them, in which case they will also be yours! I urge all readers to contact ANA-Maine and offer help in addressing the drastic cuts to services for vulnerable Mainers. there is work to be done!
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Mainer-in-Exile
From here in Honolulu I still read the Maine News. Yes folks, I have become a Mainer-in-Exile. Economic opportunity in my chosen field caused me to move here to Hawaii in 2005. I still have family members in Maine along with many friends and professional colleagues. I pay my license fee to the Maine State Board of Nursing and I still belong to ANA-Maine, the professional association for nurses in the Pine Tree State.
To the Nurses of Maine, and everyone who ever was sick or will be sick.
And this message is directed at nurses in Maine, especially.
The news has not been good, from the Pine Tree State. I was back east for Thanksgiving, got to experience driving during the storm we had the day before, and I could still navigate the conditions – even though the rental car handled like a boat at times. But everyone I talked to seemed a bit pessimistic about the future, anticipating a hard winter; and I saw a bunch of for sale signs outside shuttered business locations, as I drove from Kittery to Mt Desert where one of my daughters is wintering over.
What I am talking about though, is the Bangor Daily News article on State House demonstrations over the Maine Care budget. what is on the table is hundreds of millions of dollars for services to: Mainers with Alzheimer’s Disease ( does anybody really think those victims are going to go out and get a part time job? is this a joke to imply that the Alzheimer’s victims of Maine are somehow able-bodied but milking the system?); people with substance abuse problems; low-cost medication assistance; – the list goes on. Sixtyfive thousand people now receiving MaineCare will be removed from the rolls.
It’s not new that a supplemental budget is on the table. A supplemental budget is always an opportunity to make mid-course corrections so that each fiscal year ends okay. What is new here, is that LePage and the GOP-controlled legislature passed a tax break for the wealthy, last summer, and the amount that was turned away from state coffers seems to be just about the amount Maine now has as a “deficit.” Isn’t that just an amazing coincidence?
Shock doctrine
One letter-to-the-editor writer made the reference to the Shock Doctrine, the best selling book about strategies to loot and pillage democracy. Here it seems as though the Governor thinks he has the mandate to go ahead with this plan.
Maine went down this leave-no-stone unturned road about seven years ago under the Baldacci Administration. The state had a budget shortfall and the legislature put a bunch of items on the table that were almost the same list – aid to individuals living with cerebral palsy, mental illness, etc. I remember it well, because there was a coalition called “Maine Can Do Better” of which ANA-Maine joined. the hearing that time, was held in the Civic Center, and the place became the site of a sort of strange and sad convention, a gathering of disabled and needy Mainers – a spectacle of people who normally stay out of the limelight. All of whom prefer it that way. I recall thinking at the time, what an affront to dignity it must for these persons to be forced to parade themselves in front of the legislature in order to be able to get help they need if they are going to live their lives with any kind of dignity.
Who are we, really?
To this day, I still don’t think the measure of any democratic society is whether the people who appear at the legislature to ask for things, are served. The measure of a society is how it treats the forgotten, the vulnerable people who stay in a room somewhere who aren’t able to help themselves in some major way. whether it is a person with chronic mental illness or lifelong mental retardation or who is aged and infirm. These folks can’t travel to the legislature. they depend on somebody else to make the case.
Who speaks for those persons who are homebound, or who are tucked away in institutional care? Right now we are seeing that same coalition of people I remember from seven years ago, taking time to educate the legislature about the responsibilities of government.
A Job for Nurses
But another complementary approach is needed. Nurses need to be speaking up. The battle to help our fellow Mainers can not only be fought in Augusta, it needs to take place on the home front – every legislative district. every hospital, every home health agency, every nursing home, needs to make sure that the local legislator learns who the agency is, who the agency serves , and what they do. Nurses are trained very carefully to respect the privacy and dignity of the people they serve, and with HIPAA there are strict laws that address these concerns from the patient’s viewpoint. But nurses are among the most respected professions, and the code of ethics for nurses says that nurses must speak out when advocacy is needed.
Legislative Buddy?
Years ago, ANA-Maine started a “legislative Buddy” program, and they went out of their way to find at least one nurse in each district who would make an effort to serve as a pipeline for accurate information to their local legislator. This was helpful at the time and Maine needs something like this now. But don’t wait to join some group that is doing it, find out who your legislator is, right now, and contact them. Offer to show them what you do all day. Don’t assume that they know anything.
Resist the Urge
One of the shining moments from the budget crunch back along,was a speech I heard from the then-Speaker of the Maine House of Representatives, Patrick Colwell. He said (and I paraphrase) “The main challenge for the legislature is to resist the urge to save the same money twice. Our system depends on hospitals, long term care, home care, and self-care. One season, the legislature looks at long-term care costs and decided to tighten up the regulations on long-term care, for example, which results in patients ready to be discharged from the hospitals but who take up a hospital bed longer than need to because they aren’t ready to go home and there is nowhere else to go. Then hospital costs go up the following year. Or we change the home health regulations and people are forced to get more care from the local Emergency Room.”
It was a clever way to say that a certain amount of health care is going to be needed, no matter what you do, and the system by which the people obtain it will adapt, even if it’s in some unpredictable way that costs more in the long run. I saw the photo of the Governor standing in front of a graph showing how Maine needed to adjust MaineCare so that only a certain number of people would receive it. Yes sir, you got a point. But the question is how to decrease the rolls, exactly? In some third world countries, this is accomplished by letting people die before they can get to medical care. If you are going to make fancy graphs of Things That Are Needed in Maine, you might as well count the number of Pine Trees and say we need to replace them with Palm Trees (and higher temps. Now, there is a subject that lends itself to a chart format, and a program most Mainers would get behind, especially this time of year.). The fact is, the elderly and infirm are not so easy to get rid of.
There are countries where health is not valued. My book is about one of those places. Nepal is a wonderful country as long as you never get sick or weaken.
The bottom line is, LePage’s view is to simply remove funding from the system and let everyone fend for themselves. That is not a plan. That is not responsible government. Even if the end result is to scrutinize the budget and leave most of it in place, when this kind of plan gets put on the table it causes these vulneralble persons to become anxious for no reason. Human suffering is magnified by economic uncertainty.
You can’t eat money
Nurses also need to know that money does not cure people – it’s the things that money buys, and the payrolls that are funded, which cure people. It is foolish to think that any agency in Maine will not be cutting back on nursing jobs, because when fewer services are reimbursed, fewer agencies will be able to pay salaries. this goes for doctors and every one else in health care.
I am proud to say that most Maine nurses don’t do it for the money – but at the same time, they can’t afford to do it without the money.
We have the power of the internet to keep us informed and get us organized.
Let’s use it, and let’s mobilize.
Nursing in Hawaii 
Well said Joe. But the problem is not restricted to Maine but essentially every state in the Union/ Don’t forget that poor people don’t vote as often as wealthy people and certainly don’t contribute to re- election campaigns. Hence your governor’s disdain for them.
Also you should remember that nurses are the most trusted profession – according to Gallup polls for the last 9 or 10 years.
It’s always those who can’t speak up for or defend themselves that are the victims of these cuts, and the well-heeled lining the pockets up the politicians who benefit.
A phenomenon not unique to Maine to be sure. It’s the same thing playing out on the national level.