By David K. Shipler 

            This is astory about high-handed Maine state officials proposing to jeopardize islandresidents’ emergency access to mainland hospitals. It is a local outrage, smallin comparison to the sweeping outrages that are uprooting global security and underminingAmerican democracy. But its significance is immense, because it’s a case studyin how anti-government sentiment can be generated among good citizens whodepend on key services. Nationwide, that disaffection has been a key element inthe country’s dramatic political shifts.

            The issueis straightforward. For 65 years, since the state launched car ferry service,the boats have docked overnight on four islands, which don’t have hospitals butare populated year- round and have a surge of summer residents. So, the Maine StateFerry Service provides sleeping quarters on the islands for the crews, who canbe roused if there’s a medical emergency in the middle of the night. An island ambulancedrives onto the ferry and drives off on the mainland.

That system might be scrapped forthree of the islands in two or three years, if the state has its way. Thecommissioner of transportation, Bruce Van Note, and the director of the ferryservice, William Geary, say they’re considering docking the ferries overnighton the mainland. They are in the Democratic administration of Governor JanetMills, whose press secretary, Ben Goodman, did not answer my emailed requestfor an explanation of her position.

Under the proposal, there would beno transportation by ambulance between the last ferry run of the day and thefirst the next morning. I’m biased, because I spend four to five months a yearon Swan’s Island: I’ll try to arrange my stroke or heart attack in the daytime.

            There areother 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 atnight, but here’s the catch: not in thick fog, which is endemic in Maine.

            Lobstermenand 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 havementioned small rescue boats as an option. But an ambulance couldn’t drive onto any of them. Getting a stretcher-bound patient down a steep ramp to afloating dock and onto a mostly open boat is a dangerous, tricky exercise,especially on an icy winter night with rough seas and freezing wind. Andoutside an ambulance with medical equipment and trained emergency volunteers, apatient in an acute condition runsa high risk. Watch thisvideo of the transfer of a patient via lobster boat from the island ofNorth Haven.   

             North Haven, Swan’s, and Islesboro would losetheir overnight boats under the plan. The fourth island, Vinalhaven, is servedby two boats, so one could still spend the night there. (Two other islands,Frenchboro and Matinicus, get only infrequent runs by state ferries, and boatshave never berthed there overnight.)

            The state citestwo reasons for mainland docking: First, it would save money on crew quartersbecause workers could live at home and commute. But many crew live too far fromthe mainland terminals to make daily drives, and some have told islanders thatthey’d quit—this during a shortage of able-bodied seaman qualified to staff theboats.

            The secondargument holds that new boats will be hybrid diesel-electric, whose batteriescannot be charged on islands, which get electricity via submarine cables andhave insufficient power infrastructure. Can’t that be upgraded? Let’s pretendwe’re living in the 21st century!

            Aside fromthe medical issue, islanders are worried about their children, many of whom commuteby the first morning ferry at 6:45 to high school on the mainland. Somestudents board with families on the mainland instead of going home every night,which might become unavoidable under the state’s docking plan.

            Frictionbetween island communities and the state ferry service is longstanding, mostlyabout rising fares, breakdowns, and missed runs because of crew shortages. Butwhat might be even more important than the nuts-and-bolts of particulardisputes is the sense of powerlessness among folks utterly dependent on adistant agency that seems to listen to them reluctantly, if at all. The stateferry service is essentially a monopoly, and it’s not fun when you have tomobilize to obtain basic respect for your dignity.

On the other hand, the ferries areheavily subsidized by the state government, and no private company could runthem 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 theislands, though, because the fares are high enough to cause pain. The stateraised them by 15 percent last summer and wants another 15 percent increasethis year. Summertimeroundtrip rates for a passenger to most islands would be $23 for a 40- to60-minute journey, and $55 for a vehicle and driver. That means $78 to take aloved-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 theirisland constituents aren’t taking any chances. A bill requiring nighttimedocking on the islands has been introduced by eight state legislators—four Democratsand 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 DemocraticHouse member in Washington, DC.

Ferry schedules are but one assaulton people’s well-being. Health care in Maine and elsewhere is being damagedmore broadly by Republicans in Washington. The cuts they are considering toMedicaid, the insurance program for low-income citizens, would hurt everyone,not just recipients. Because many rural hospitals and clinics rely on Medicaidpayments, some would have to reduce services or even close. And the Trumpadministration’s sudden, chain-saw halt of medical research into antiviraldrugs, cancer, heart disease, and the like will cause long-term harm to the nation’sfuture health.

            Nevertheless, tamperingwith islands’ lifelines to hospitals has an immediacy that everyone across thepolitical spectrum can understand. If Democrats want to win back rural, working-classvoters, this would be a good place to start. That includes you, Governor Mills,wherever you are.