BELFAST — Between a rock and hard place: That’s where Waldo County General Hospital sits amid an impending decision about its unification with the MaineHealth system.

As a board member first of Waldo County General Hospital in Belfast, and then of Coastal Healthcare Alliance following a partnership with Rockport-based Penobscot Bay Medical Center, I’ve watched Waldo County General Hospital being squeezed and pressed in its uncomfortable position for the past year. Next week it will finally be irrevocably reshaped, and I don’t yet know how.

My fellow Coastal Healthcare Alliance board members and I each will cast a vote Tuesday to either become part of the growing MaineHealth machine or remain a semi-independent entity. For months our board meetings have been consumed by deep discussions regarding the merits of unification. We’ve hosted supplemental workshops and outreach programs for both the Waldo and Pen Bay areas. Each of us has struggled alone and as a group with the predicted financial, health and community repercussions of unification.

I regularly voice my opinion to my fellow board members that this decision about unification is actually a choice about control of the balance sheet, not health care. If our two hospitals are part of MaineHealth, our two revenue streams – and deficits – are also part of MaineHealth. Funds from all of MaineHealth’s hospitals will move around the entire state to create a balanced budget. For Pen Bay, which suffers annual losses, MaineHealth’s control will be a benefit, zeroing out its debt. For Waldo County General Hospital, which enjoys a healthy surplus, MaineHealth’s control will result in a huge loss of the funds that could benefit its immediate community.

This imbalance in the bottom lines of the two Coastal Healthcare Alliance hospitals helps to divide the votes across our board. Members with closer ties to Pen Bay are much more likely to support the unification, which would ease its financial burden. Many of us who hail from Waldo County feel like Waldo County General Hospital’s surplus – the result of the leadership’s careful navigation of the health care system’s regulations – will be appropriated unfairly by organizations that haven’t been as forward-thinking as ours.

During our deliberations several months ago, we considered dissolving Coastal Healthcare Alliance so the two hospitals could vote independently about unification with MaineHealth. That motion never made it to a board vote, so we remain together, yet slightly divided.

When we look beyond the dollars and cents, we see other potential bureaucratic costs that we can’t forecast. Will our local hospitals lose control of their destinies when MaineHealth exerts its control? Will we need approval for every new piece of life-saving equipment, new doctor or new facility? And what happens to the quality of our hospitals if we don’t get it?

These fears are shared by many of our doctors and health staff. Our board can’t appease their anxieties; we have no clear vision of a “unified” future. We either take the chance with MaineHealth and believe in the good intentions of its executives, or we push back and see if we can make it on our own without the corporate safety net.

I often struggle to believe in those good intentions when our ongoing negotiations with MaineHealth fall flat. As part of the unification, MaineHealth has guaranteed that Waldo County General Hospital and Pen Bay each will have a MaineHealth board representative for five years. After that period, no hospital – other than Maine Medical Center – is guaranteed a seat at MaineHealth’s decision-making table. Our Coastal Healthcare Alliance board has asked MaineHealth multiple times to reconsider our board seats, but it won’t budge.

What if we at Coastal Healthcare Alliance decide not to budge? We wouldn’t be thrown out of MaineHealth, but we would begin an uncharted course. Our hospitals would become outliers in the system. Just as our doctors are concerned they might not get much-needed equipment if we unify with MaineHealth, our board is concerned we might not get critical support for our hospitals if we don’t unify.

Should next week’s vote support unification, our organizations will move into a very expensive planning phase for the merger, which will take a significant amount of time and resources. Should the vote be against unification, we’ll begin our daunting journey into the future of health care alone.

As both a Waldo County resident and as a Maine business leader, I’m squeezed between that rock and hard place with little room to breathe before next Tuesday’s vote.

— Special to the Press Herald