Strong Opposition to Governor's Budget Cuts

Physicians, Businesses, High School Students and Public Health Professionals Strongly Oppose Governor’s Cuts to Maine’s Community Public Health and School-Based Tobacco Prevention Programs

(AUGUSTA) Calling the governor’s budget “flawed and short-sighted”, physicians and public health professionals are expressing united opposition to the proposal to cut $10 million from Maine’s community public health programs in order to maintain current Medicaid reimbursement levels for primary care physicians in Maine.

A large crowd attended a press conference at the State House just prior to the public hearing before the Appropriations and Health and Human Services Committees.  Speakers included physicians, high school students, representatives from Maine’s largest health systems, and business leaders in Maine’s rural counties.

“The proposed budget presents a false choice to policy makers,” said Doug Michael, President of the Maine Public Health Association and Chief Community Healthy Officer at Eastern Maine Health Systems in Bangor.  “It reflects a lack of understanding about how our collective health system works in Maine, particularly the interconnected relationship between community public health and primary health care.  We also know that preventing tobacco addiction saves lives and reduces health costs.  Abandoning our efforts to help kids resist tobacco use will have the opposite effect, just as it has in other states.”

The Affordable Care Act (ACA) included a provision to slightly increase primary care reimbursement rates for two years. But this federal provision has ended and states have to decide whether to continue it. The LePage administration has proposed using the Fund for a Healthy Maine to maintain this slightly higher reimbursement rate. Opponents were united in expressing support for the higher reimbursement rates, but warned against cutting community health to pay for them.

“To cut community programs to fund primary care is like robbing Peter to pay Paul, or really, killing Peter to pay Paul,” said Dr. Daniel Onion, a primary care physician from Augusta.  “Community health issues, like smoking, are most effective when coordinated jointly between public education programs and primary care clinicians to change a community’s culture. We need both. They save lives and money.  And of all the things we can do to lower sickness and mortality in Maine, smoking cessation is the most important. It prevents smoking related cancers, chronic lung disease, low birth weights, heart disease, and stroke. It is very cost effective because it prevents disease before it happens.”

The Fund for a Healthy Maine is a special annual revenue stream - not taxpayer dollars - that result from the 1998 legal settlement with the tobacco industry.  Maine was one of 46 states to participate in that settlement.  Since the Fund for a Healthy Maine was created, Maine has seen a 48% decrease in youth smoking (from 24.8% in 2001 to 12.8% in 2013).
More than one third (35%) of students who smoke and were seen at a school-based health center reported that they reduced their smoking or quit smoking as a result of their visit.

Jessica Scheno, a senior at Maranacook Community High School spoke passionately about the importance of school-based health centers, which are slated for elimination in the governor’s budget.  She stated, “My grandmother started smoking at a very young age.  By the age of 54 she developed lung cancer. They had to make a hole in her throat so she could breath and a year later she passed away. No one wants their child, friend or family member to end up like that. That’s why we have to make a change. Every day in this country 700 kids who have already experimented with cigarettes become new daily smokers. If we are only able to rely on a doctor’s visit, you will see a major increase in smoking among teens. We need to stop targeting kids and start targeting the tobacco industries. We refuse to sit quietly and be the industry’s replacement smokers.”

The Campaign for Tobacco Free Kids reports that kids are twice as sensitive to tobacco advertising as adults and are more likely to be influenced to smoke by cigarette marketing than by peer pressure. One-third of underage experimentation with smoking is attributable to tobacco companies’ advertising.  The tobacco industry spends approximately $40.9 million in Maine every year marketing their products.  Also in Maine 2,400 adults die each year from their own smoking.  Approximately 27,000 kids now under 18 and alive in Maine will ultimately die prematurely from smoking.  And 1,300 kids under the age of 18 become new daily smokers each year.

According to the Maine Center for Disease Control website, the Healthy Maine Partnerships are “where communities, schools, hospitals, businesses, and volunteers are working together at the state and local level to make Maine a healthier place to live and work”.

“Keeping employees healthy doesn’t start at the doctor’s office,” said Theresa Fowler, Director of the Central Aroostook Chamber of Commerce.  “It starts on Main Street, in our schools, at worksites and in communities.  Keeping employees healthy starts with community conversations, partnerships among businesses, non-profits, and local governments.  It starts with disease prevention and health promotion efforts at the community level that help prevent tobacco use and substance abuse, support physical activity and healthy eating, and provide supportive environments that make it easy to make a healthy choice.  A business’s most important asset is its employees.  Businesses need a strong community public health system in order to grow and thrive.  We need to be doing more, not less to keep our children and workers healthy – that’s an investment in Maine’s future and in Aroostook County’s future.”

Public health opponents say that by proposing to cut almost 40 Maine CDC positions, representing about 10% of their workforce, and cutting funding to Maine’s community-based public health infrastructure, Governor LePage’s budget leaves Maine people vulnerable to the impact of infectious disease outbreaks, public health emergencies, and emerging public health threats.

Deborah Deatrick, Senior Vice President for Community Health for MaineHealth, the state’s largest health system that employs more than 17,000 people, joined the call to reject the proposed cuts.  “Maine’s health system is unique, but it works,” said Deatrick. “We need a strong public health system at the state and local levels to assure that the health of entire communities, not just the patients of an individual doctor or hospital, is protected and promoted.  Now is not the time to put the health of our people at risk.  Last December, Maine’s overall health ranking slipped to number 16 in the country, its lowest ranking in more than two decades.  Only four years ago, we were ranked 8th healthiest in the nation – not too shabby, considering the huge challenges of the recession and a slowly recovering economy.  We can regain what has been lost, but not by cutting positions and programs.  Not by eliminating 40 key positions in the Maine CDC that are filled by epidemiologists and public health nurses and others.  Not by eliminating the TB control and STD programs.  And not by gutting the Fund for a Healthy Maine.”

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Senators Udall, Collins to Introduce Bipartisan Plan to Strategically Implement Otherwise-Arbitrary Sequestration Cuts

Legislation Would Allow Executive Branch to Direct Cuts But Give House, Senate Appropriate Oversight

WASHINGTON, D.C.-- Following the U.S. Senate's failure to pass either the Democratic or Republican proposals to avert the arbitrary, automatic, indiscriminate budget cuts, commonly called sequestration, Senators Mark Udall (D-Colo.) and Susan Collins (R-Maine) announced that they will introduce a plan to allow the federal government to propose more targeted cuts while also allowing for appropriate congressional oversight.

            The bipartisan legislation would allow individual federal departments and agencies to propose how they each would more strategically implement the otherwise-thoughtless, automatic cuts. The bill would require that the U.S. Senate and U.S. House of Representatives appropriations committees work with the administration to provide oversight and ultimately approve the spending plans.

            "Blunt, shortsighted budget cuts are not the responsible way to reduce the deficit," Udall said. "This bipartisan plan ensures that the White House and Congress would work together to replace arbitrary cuts with smarter, focused spending reductions. Although I would have preferred that Congress had passed a comprehensive and balanced deficit-reduction plan to replace the sequester, the Udall-Collins plan is the only immediate way to temper the effects the sequester will have on our economy and national security."

            "Rather than dueling partisan plans that everyone knows have no chance of passing, our bipartisan plan would help mitigate the harmful effects of sequestration by allowing agency heads more flexibility to set priorities in reducing their budgets," Collins said. "While I continue to talk with colleagues on both sides of the aisle, and with the White House, on how we could produce a sound, long-term fiscal plan to replace the indiscriminate cuts of sequestration, I believe our plan shows that it is possible to work together on a responsible, thoughtful plan to reduce our deficit, protect the jobs of hard-working Americans, and avoid mindless, meat-ax spending cuts."

            The Udall-Collins bill does the following:

• It empowers the executive branch to work with Congress and propose the best way to administer what would otherwise be automatic, arbitrary budget cuts required under the Budget Control Act;
• The Administration's spending proposal for a given department would be given to the Senate and House Appropriations Committees for review and approval, providing appropriate Congressional oversight and input.
• Finally, the legislation provides authorities for the Department of Defense to start new projects and programs that have been approved, but have been on hold due to the inability of Congress to adopt a full-year defense appropriations bill.