[Congressional Record (Bound Edition), Volume 150 (2004), Part 6]
[Extensions of Remarks]
[Page 7680]
[From the U.S. Government Publishing Office, www.gpo.gov]




                      HEALTH CARE'S BREWING STORM

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                           HON. BARNEY FRANK

                            of massachusetts

                    in the house of representatives

                        Tuesday, April 27, 2004

  Mr. FRANK of Massachusetts. Mr. Speaker, earlier this week I had the 
pleasure of inserting into this forum a very good editorial from the 
Boston Globe about the excellent work that is done by Bristol Community 
College, which I have been privileged to represent for more than twenty 
years. It is important for us to spread good news. But it's also 
important for us to give people the bad news, especially when it is bad 
news that could be made worse if we do not act.
  One of the most important institutions in the part of Massachusetts 
which I represent is the Southcoast Health System, which joins major 
hospitals in Fall River, New Bedford and Wareham. The President of that 
system, John Day, is an extremely knowledgeable student of health care 
in America, and not only does a first-rate job of administering the 
hospital system, he also has been an important source of information 
for me and others about health care policy.
  Sadly, but honestly, he recently wrote an op-ed piece in the Boston 
Globe which began with the quote ``warning'' that ``a devastating 
health care crisis is closer than you think.'' John Day is deeply 
committed to providing the health care that people need, and he has 
been a leader in providing it to people of below average income in a 
part of the state of Massachusetts where that has been an issue. His 
eloquent plea for a change in our health care policy, and his dire--but 
hardly exaggerated--warnings about what will happen if we do not 
change, deserve our attention and I ask that his article be printed 
here.

                      Health Care's Brewing Storm

                            (By John B. Day)

       Warning: A devastating health care crisis is closer than 
     you think. Like the side-view mirrors on our cars that warn 
     us ``objects are closer than they appear,'' a rupture in the 
     Massachusetts health care system is more of a real threat 
     than it seems at first or even second glance. The 
     professional health care that patients receive today has 
     given us a false sense of security over the imperiled state 
     of the entire system.
       Patients across Massachusetts have been insulated from this 
     reality by the health care community's medical, moral, and 
     legal obligation to fulfill its mission at all costs. 
     Patients continue to receive an abundance of health care 
     services even as the economic vise on hospitals tightens.
       The warning signs are easily recognizable--from the 
     previously unacceptable delays in gaining access to doctors 
     to the intolerably long waits in emergency rooms to 
     ambulances being diverted from hospital to hospital. Because 
     these cracks in the system have been incremental and the 
     degeneration of the system gradual, we have come to accept 
     them as routine when they are anything but. They are, in 
     fact, alarm bells signaling the onset of a crisis.
       Today's delays, long waits, and diversions are mere 
     inconveniences compared to what may lie ahead. Do you want to 
     see the day when patients are flatly turned away for lack of 
     beds? Or when critical and costly services, such as 
     psychiatric care, are eliminated? Or when resources become so 
     scarce that only the fortunate few will have enough money and 
     power to afford access to the advanced technologies and 
     treatments to which many currently feel entitled?
       Such dire scenarios may seem unthinkable in a state whose 
     health care system was once the model for the nation. But 
     there's a rapidly advancing storm poised to wreak havoc, 
     already leaving shuttered local hospitals in its wake. In 
     1980 there were 118 hospitals in Massachusetts. Today there 
     are 67.
       As president and CEO of one of the largest community 
     hospital systems in the state--and the largest employer in 
     southeastern Massachusetts, it is my responsibility to issue 
     the storm warning, before it hits us head-on.
       I entered Massachusetts health care just after the famous 
     blizzard of 1978, an act of nature that caused more 
     destruction than most of us had ever experienced. The cost of 
     the destruction and the loss of life might have been less had 
     we the capability to warn people just how bad it was going to 
     be.
       Already, we are seeing the state eliminate insurance 
     coverage for those who can least afford it. Health care 
     providers are refusing to provide essential services because 
     they cannot receive reimbursement for those services. For the 
     first time, many of my colleagues at hospitals have begun to 
     discuss the elimination of health care services.
       SouthcoastHealth System, which I oversee, gives me a close 
     look at this dilemma. Our patient population is older, 
     sicker, and poorer than elsewhere in Massachusetts. More than 
     75 percent of our patients rely solely on Medicare and 
     Medicaid, which reimburse hospitals substantially below our 
     actual costs. Unlike public safety-net hospitals, community 
     hospitals like Southcoast have no statutory entitlement to 
     local or state funds in order to underwrite the cost of 
     providing free care to the uninsured.
       Our merger of St. Luke's Hospital in New Bedford, Charlton 
     Memorial Hospital in Fall River, and Tobey Hospital in 
     Wareham allowed us to stabilize the financial footing of our 
     region's health care system. By cresting efficiencies of 
     scale and sharing resources, we now provide care where it is 
     needed most--in our own community. A decade ago there did not 
     exist the continuum of care that is available today for tens 
     of thousands of families in southeastern Massachusetts.
       But while we are proud of these accomplishments, we know 
     that mergers, consolidation, and cost-cutting maneuvers are 
     not enough. The continuing state and federal funding cuts 
     leave many hospitals with no choice but to cut core clinical 
     services--services everyone expects to receive at their local 
     community hospital.
       During the blizzard of '78, many coastal residents refused 
     to believe they were in real danger until the waves were 
     crashing against their door. Let us not wait until we are on 
     the brink of disaster to accept the dire circumstances that 
     await us. It is time we recognize the tide is rising against 
     the health care industry. It is imperative that state and 
     federal governments, health care providers, industry leaders, 
     and patients work cooperatively to find sustainable solutions 
     to ensure that core medical services remain available to 
     every resident of Massachusetts.

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