It appears that Gov. Malloy may be making ill-advised decisions and enacting policies that threaten immediate and significant harm to patient care. As physicians who provide medical care to the patients of this community, we feel compelled to voice our concerns over the increased tax burden being placed on Connecticut’s hospitals by Malloy.

Knowing that our hospital is under increasing financial duress, our foremost concern is whether we will be able to provide the same level of care and the same services to keep patients out of harm’s way. Many of us worry whether our hospital will survive. We feel that our mission to care for the people in our community is in jeopardy.

As physicians, we are aware that we must find ways to provide higher quality care at lower cost. In fact, the entire health care team faces this pressure every single day. Hospitals in Connecticut already collect data and report on several quality of care measures that are then compared to federally mandated benchmarks. Whether hospitals are paid or financially penalized is tied to how well the hospital performs.

Some quality measures look at rates of hospital-acquired infections, re-admission rates for those recently discharged, and how well care is coordinated among the many services that are used during the patient’s hospitalization. Other mandates are tied to meeting regulatory requirements for electronic health records.

Hospitals are also tasked with managing costs associated with care so we can provide the best value for care rendered. Over the last 18 months, L+M Hospital meticulously dissected its own service lines for cost savings that ran the gamut from intravenous contrast for diagnostic imaging exams to vendor contracts for items used in surgery to drug formularies and even to papergoods. These mandates assume that care will be delivered as safely, effectively, and efficiently as possible. The irony is that it costs money — a lot of it — to have the infrastructure and technology in place to satisfy these mandates.

A look at the numbers show that the proposed state hospital tax now stands at $556 million with $8.7 million levied against L+M Hospital alone. State hospitals are paid 42 cents on the dollar by Medicaid (making us dead last in the country) and we also know that 1 in 5 people (approximately 750,000) receive Medicaid in Connecticut. So while the governor contends that hospitals should benefit because more patients are now covered by some type of insurance, he fails to acknowledge that Medicaid pays significantly less than the cost of care.

We must also confront decreasing patient volumes as high deductible health plans shift more cost to the patient. We know those without insurance are more likely to put off seeking care. When the health of our citizens suffer, the health of our state and economy suffer. That is the real crisis. With the loss of 530 jobs from Connecticut hospitals statewide since July 2015, the economic implications are real: it is a constant struggle to find and keep certain physician specialists and other health care providers in southeastern Connecticut.

We do not have all the answers, but we do know that we want to take care of you and your families. We know that we need to invest money to remain financially strong, competitive, and attractive — and look forward to our affiliation with Yale as an opportunity to benefit our community directly. Yet the affiliation by itself will not overcome the proposed tax increase that weakens our efforts to promote quality now. We also know that if these cuts and taxes go through as planned that we will enter dystopian times. We must consider the harsh reality of reduced access to or complete absence of vital services in our local areas. As your doctors, we trained to take care of you. We know that every person’s health and well-being — the health of our community — is worth fighting for.

As your community hospital physician leaders who serve on the Medical Executive Committee at L+M Hospital, our concerns are valid and well-informed. We ask that you, your family members, and neighbors join us in this groundswell effort to change the course of the governor’s punitive and unyielding actions. Please contact your state legislators and demand a special session to be convened to repeal the “sick tax” and allow Connecticut hospitals to survive and thrive in their mission to care for the health of our communities.

Dr. David Reisfeld is chairman of Medical Executive Committee at L+M Hospital and medical staff president and Dr. Victoria Reyes, chair of the Department of Pathology. This commentary was signed by the 23 members of the Medical Executive Committee.