A man's word, or a woman's, goes a long way in the pine-scented foothills of western Maine. In the rugged community of Farmington, pop. 7,400, where logging and farming provide seasonal work and unemployment is twice the national average, pride runs deep. A handshake binds a contract almost as often as a signature. So when a local writer walked unannounced into the office of Franklin Memorial Hospital president Richard Batt to explain that he could not pay for his son's hospitalization, Batt wanted to help the man meet his obligation honorably. After agreeing to adjust the bill, Batt asked--in an afterthought really--if the writer would help rework the hospital's brochures. "It was a transforming experience," Batt says. "This man arrived in tears and left feeling good that he could help us."
The incident got Batt thinking: How could his small, 70-bed community hospital offer low-income patients a way to pay for the rising cost of health care? Could they trade their skills for medical treatment? After all, barter may have fallen on hard times, but it's an American tradition: for decades people exchanged services for goods, not dollars. A country doctor's fee might be a bushel of potatoes or a freshly baked pie.
Batt tried out his idea on colleagues. Many were dubious. But hospital board chairman Darryl Brown, son of a Maine dirt farmer who cut brush on the county road to pay his property taxes, weighed in with his opinion. They would try it.
The first patient to benefit from the pilot program was Della O'Leary, 60, a part-time receptionist with no health insurance and an $8,000 bill for gallbladder surgery. Would she be interested in using her keyboard skills to enter data into a hospital computer? O'Leary agreed. After she worked 20 hours a week for four months, her debt was paid. "I was brought up to take care of my bills," O'Leary says. "Without this program, I was going to be paying little by little for the rest of my life."
Alisa and Christopher Everett faced a $14,000-plus bill following the birth last August of their son Alston. The pregnancy, complicated by Alisa's diabetes, had required numerous medical tests. And while Everett, 37, a $26,000-a-year mechanic in a local woolen mill, has health insurance, he was still responsible for almost $3,000 in unreimbursed expenses. The hospital's solution: to pay half the bill, Everett agreed to sand, repaint and refurbish hospital lawn chairs; Alisa is assembling a hospital photo album of doctors, staff and equipment to explain medical care to children who become patients. "I used to be ashamed to go to the post office and get all those hospital bills," Alisa says. "But when you give back a little something, you feel better about yourself."