By David K. Shipler
This is a
story about high-handed Maine state officials proposing to jeopardize island
residents’ emergency access to mainland hospitals. It is a local outrage, small
in comparison to the sweeping outrages that are uprooting global security and undermining
American democracy. But its significance is immense, because it’s a case study
in how anti-government sentiment can be generated among good citizens who
depend on key services. Nationwide, that disaffection has been a key element in
the country’s dramatic political shifts.
The issue
is straightforward. For 65 years, since the state launched car ferry service,
the boats have docked overnight on four islands, which don’t have hospitals but
are populated year- round and have a surge of summer residents. So, the Maine State
Ferry Service provides sleeping quarters on the islands for the crews, who can
be roused if there’s a medical emergency in the middle of the night. An island ambulance
drives onto the ferry and drives off on the mainland.
That system might be scrapped for
three of the islands in two or three years, if the state has its way. The
commissioner of transportation, Bruce Van Note, and the director of the ferry
service, William Geary, say they’re considering docking the ferries overnight
on the mainland. They are in the Democratic administration of Governor Janet
Mills, whose press secretary, Ben Goodman, did not answer my emailed request
for an explanation of her position.
Under the proposal, there would be
no transportation by ambulance between the last ferry run of the day and the
first the next morning. I’m biased, because I spend four to five months a year
on Swan’s Island: I’ll try to arrange my stroke or heart attack in the daytime.
There are
other ways to get off the islands. LifeFlight has highly equipped helicopters,
but only five for the whole state. If there’s one available, it can fly in at
night, but here’s the catch: not in thick fog, which is endemic in Maine.
Lobstermen
and other island residents have boats, of course, and when things get tough,
people step up to help. The Coast Guard might come, and state officials have
mentioned small rescue boats as an option. But an ambulance couldn’t drive on
to any of them. Getting a stretcher-bound patient down a steep ramp to a
floating dock and onto a mostly open boat is a dangerous, tricky exercise,
especially on an icy winter night with rough seas and freezing wind. And
outside an ambulance with medical equipment and trained emergency volunteers, a
patient in an acute condition runs
a high risk. Watch this
video of the transfer of a patient via lobster boat from the island of
North Haven.
North Haven, Swan’s, and Islesboro would lose
their overnight boats under the plan. The fourth island, Vinalhaven, is served
by two boats, so one could still spend the night there. (Two other islands,
Frenchboro and Matinicus, get only infrequent runs by state ferries, and boats
have never berthed there overnight.)
The state cites
two reasons for mainland docking: First, it would save money on crew quarters
because workers could live at home and commute. But many crew live too far from
the mainland terminals to make daily drives, and some have told islanders that
they’d quit—this during a shortage of able-bodied seaman qualified to staff the
boats.
The second
argument holds that new boats will be hybrid diesel-electric, whose batteries
cannot be charged on islands, which get electricity via submarine cables and
have insufficient power infrastructure. Can’t that be upgraded? Let’s pretend
we’re living in the 21st century!
Aside from
the medical issue, islanders are worried about their children, many of whom commute
by the first morning ferry at 6:45 to high school on the mainland. Some
students board with families on the mainland instead of going home every night,
which might become unavoidable under the state’s docking plan.
Friction
between island communities and the state ferry service is longstanding, mostly
about rising fares, breakdowns, and missed runs because of crew shortages. But
what might be even more important than the nuts-and-bolts of particular
disputes is the sense of powerlessness among folks utterly dependent on a
distant agency that seems to listen to them reluctantly, if at all. The state
ferry service is essentially a monopoly, and it’s not fun when you have to
mobilize to obtain basic respect for your dignity.
On the other hand, the ferries are
heavily subsidized by the state government, and no private company could run
them at the existing fares, which don’t cover the rising costs of fuel, wages,
and maintenance. You don’t hear rhapsodies of gratitude for this fact on the
islands, though, because the fares are high enough to cause pain. The state
raised them by 15 percent last summer and wants another 15 percent increase
this year. Summertime
roundtrip rates for a passenger to most islands would be $23 for a 40- to
60-minute journey, and $55 for a vehicle and driver. That means $78 to take a
loved-one for chemo, for example, a hardship for a good many islanders.
The ferry service holds hearings,
as the law requires, but some legislators listening to the uproar from their
island constituents aren’t taking any chances. A bill requiring nighttime
docking on the islands has been introduced by eight state legislators—four Democrats
and four Republicans—in a region that is politically divided. Swan’s Island,
for example, lies in a district that gave its one electoral vote to Trump
(Maine splits its electoral votes), and yet is represented by a Democratic
House member in Washington, DC.
Ferry schedules are but one assault
on people’s well-being. Health care in Maine and elsewhere is being damaged
more broadly by Republicans in Washington. The cuts they are considering to
Medicaid, the insurance program for low-income citizens, would hurt everyone,
not just recipients. Because many rural hospitals and clinics rely on Medicaid
payments, some would have to reduce services or even close. And the Trump
administration’s sudden, chain-saw halt of medical research into antiviral
drugs, cancer, heart disease, and the like will cause long-term harm to the nation’s
future health.