July 14, 2009

Dear Friends,

Due to the importance and complexity of the debate relating to HEALTH CARE REFORM, I am very interested in obtaining broad based commentary from you on the draft before us today. You may click here to review the proposed House legislation which was released this afternoon. The bill is lengthy and we will post links on my website to summaries or section-by-section outlines as they become available.

Democratic leadership still hopes to complete action on this landmark legislation this year but, as you can imagine, there are differences of opinion and competing priorities on a whole host of issues that are too numerous to detail in this newsletter.

The most publicized aspect of the debate over health care reform concerns whether or not a public insurance option should be part of any package. I strongly support such an option but there are many Members, including some Democrats, who feel just as strongly that a public option should not be included. Even amongst those of us who want such an option, there are significant differences of opinion over the design and funding of a public plan. Another and equally difficult question is how to pay for health care reform. These are only two of the many issues we will have to resolve. Despite the challenges, the House still may vote on a bill by the end of the month.

For me, the two most important aspects of health care reform are (1) whether the bill advances the important goal of universal access to health care, and (2) how the bill impacts Massachusetts. Disparities in medical care and in medical outcomes between rich and poor Americans are more than troubling. They are morally unacceptable. I am aware also of the responsibility I bear, as a Member of Congress, to cast votes with the best interests of my constituents in mind. On this issue, that would include whether the proposal preserves health care related jobs in Massachusetts and whether we can preserve our regional pre-eminence in academic medicine and biomedical research.

Right now, 97% of Massachusetts residents already have some form of health insurance. According to the Centers for Disease Control and Prevention (CDC) the national average in 2008 was 83%. In light of these facts, I am compelled to ask: How much can fairly be asked of Massachusetts residents and taxpayers to bring the rest of the country up to our level of commitment? I do think most of my constituents would be willing to pay a little more so that all Americans could have access to health care. That said, I think it is also fair to ask:

• What improvements will we see in Massachusetts as compared to what we have already?
• If there are significant changes in the delivery of health care, would they benefit Massachusetts?
• If there are cuts in the current Medicare and Medicaid programs, how will they impact Massachusetts?

In addition to those questions, I am also keenly aware of the direct economic impact that health care has on Massachusetts. Our regional economy is unique. In my district alone, there are approximately 70,000 employees of hospitals. Tens of thousands more work for Community Health Centers, nursing homes, rehabilitation facilities and other health-care related businesses. Others work for health insurance companies and in jobs related to health care — like the people who clean the laundry for hospitals, the engineers and designers at medical instrument companies whose work is used in hospitals across the country, and lab technicians who conduct hospital-related research.

Furthermore, many of my constituents work at hospitals and other health care related jobs outside the 8th Congressional district — like Lahey Clinic in Burlington, Good Samaritan in Brockton, and UMass Medical in Worcester, just to name a few. Massachusetts is the proud home to hundreds of thousands of health care jobs.

One of my most important responsibilities is to protect the jobs of Massachusetts citizens. Therefore it is my duty to ask —

• How many of those jobs might we lose from the proposed reform?
• How many might we gain?
• Are the job shifts (especially if there is a large loss of jobs in Massachusetts) worth the benefits?

To give you an example of one aspect of the debate here in Washington — some Members of Congress are pushing hard to increase spending in rural areas at the expense of urban hospitals. I support equitable access to health care but I cannot do so at the expense of my own constituents.

As I weigh my vote on health care reform, I will have to be convinced that the final package will ultimately make the lives of my constituents better, not worse. We must also defend the interests of our great research institutions and teaching hospitals. Medical education and scientific research are not simply relevant for the 8th Congressional district, they are essential to the health and well-being of all American citizens. Everyone needs the doctors we educate and everyone benefits from the new discoveries in Massachusetts laboratories.

We cannot expect to achieve legislative perfection on health care reform. Realists know that is an impossible goal. Like almost every other bill before me, I will have to weigh the components that are on target against those that are not. I am working hard to shape the end result into a bill I can support.

I am very much interested in your thoughts on health care reform, particularly as we get closer to a vote in the House. Everyone is in favor of "reform". That is easy. However, I would like to know your opinion as to whether the proposal currently before the United States Congress — the proposal on which I must vote "yea" or "nay" — meets the needs and desires of the citizens of Massachusetts. Please call the office or send us an e-mail if you’d like to weigh in on the proposal.

Regards,
Mike