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From YouTube: Committee on Government Operations on April 10, 2018
Description
Docket #0386 - Hearing Regarding the Proposed 13 Hospital Merger of Caregroup, Inc.(Parent Company of Beth Israel Deaconess Medical Center) and Lahey Health System
A
Council
at
large
michael
clarity,
the
chair
of
government
operations.
We
are
here
today
to
discuss
docket
zero.
Three
eight
two.
It's
an
order
for
hearing
regarding
the
proposed
thirteen
hospital
merger
of
care
group
incorporated
it's
the
parent
company
of
Beth
Israel
Deaconess,
Medical
Center,
as
well
as
Lahey
Health
System.
This
matter
was
sponsored
by
my
colleague
city
counsel,
Tim
McCarthy,
along
with
my
colleague,
city
counsel,
red
Flynn,
referred
to
the
Committee
on
March,
the
7th
of
2018.
A
This
hearing
order
seeks
to
bring
together
all
the
stakeholders
in
the
impacted
groups
of
the
proposed
merger,
the
Commonwealth's
health
policy,
Commission
HPC,
the
Attorney,
General's
Office
and
other
authorities
are
currently
reviewing
the
application
for
this
merger.
Components
of
the
application
include
the
mergers
impact
on
access
to
healthcare
costs
in
overall
healthcare
marketplace
note,
while
the
AG's
office
was
invited
they're
not
attending
due
to
the
ongoing
discussions
in
this
matter,
however,
Kevin
Tabb
from
mass
health
policy
Commission
was
also
invited
as
well,
but
had
a
scheduling
conflict.
A
So,
if
approved,
the
merger
would
result
in
creating
another
powerful
Hospital
market
on
par
with
partners,
healthcare
and
increased
market
leverage
for
the
record.
As
the
chair
of
government
operations,
I
would
like
to
note
that,
while
this
hearing
is
hosted
by
the
respective
committee,
the
Boston
City
Council's
not
have
any
legislative
oversight
on
the
merger,
and
thus
no
formal
vote
will
be
taken
in
support
or
against
the
merger.
This
is
purely
an
educational
in
informational,
public
discussion.
A
B
B
So
when
we
were
alerted
to
the
fact
or
to
the
thought
that
this
merger
may
cause
some
issue
with
those
citizens,
we
felt
it
was
our
duty
to
at
least
have
an
educational
forum
to
get
both
sides
of
this.
And,
as
council
Flaherty
stated
so
eloquently,
we
do
not
have
any
jurisdiction
here,
but
we
certainly
can
haven't
and
be
educated
on
this
topic
and
and
speak
for
our
citizens
and
for
our
constituents
regarding
the
murder.
B
C
C
Moreover,
Beth
Israel
Lahey
health
would
control,
maybe
one
in
three
hospitals
in
eastern
Massachusetts
and
become
the
biggest
health
provider
in
the
region.
I
want
to
say
thank
you
to
a
council
fiery
council
McCarthy
for
their
efforts
and
I'm
happy
to
work
with
them
to
raise
awareness
on
this
issue.
This
merger
may
or
may
not
have
a
major
effect
on
the
most
fragile
residents
in
our
community.
Therefore,
I
believe
that
it
is
necessary
to
hear
from
the
experts
in
those
impacted
before
any
decisions
finalized.
C
My
focus
on
this
issue
stems
from
significant
CERN's
that
we
have
heard
in
recent
years
regaining
to
potential
hospital
mergers.
At
the
same
time,
public
discussion
centered
on
the
impact
a
potential
merger
could
have,
in
terms
of
increasing
market
power,
the
ability
to
negotiate
with
insurance
companies
in
raising
health
care
spending.
It
is
my
hope
that
this
hearing
will
also
enable
us
to
learn
more
as
Council
McCarthy
said
about
this
merger
in
the
impact
it
would
have
on
other
hospitals
as
well
as
local
community
health
centers
here
in
the
city
Boston.
C
Perhaps
this
hearing
will
also
help
us
understand
what
effect
if
any,
this
merge
would
have
on
access
to
healthcare
for
middle
and
low
income
residents,
communities
of
color,
our
immigrant
communities,
the
elderly,
the
poor,
the
disabled.
You
know
our
most
vulnerable
and
I'm,
also
looking
forward
to
hearing
from
the
experts
but
I'm,
also
looking
forward
to
hearing
from
a
group
from
South
Boston
South
Boston
accion,
a
group
of
Hispanic
leaders
in
the
community
dedicated
to
helping
those
get
access
to
health
care,
Thank
You,
mr.
Chanin
Thank.
A
D
In
support
of
this
merger
and
I
was
joined
by
many
of
our
mission,
Hill
residents
and
neighbors,
who
are
speaking
to
the
positive
impact
these
institutions
have
had
on
our
neighborhood,
both
as
good
neighbors,
both
good
neighbors,
but
in
particular
I
think
the
Baptist
does
have
a
special
place
in
the
heart
of
many
of
my
constituents
up
on
Mission
Hill
and
it's
been
a
wonderful
institutional
neighbor
over
the
years.
I
certainly
share
the
concerns
of
I.
D
Think
probably
everyone
in
this
room
about
rising
health
care
costs,
inequity
and
I
look
forward
to
to
learning
more
today
to
following
up
and
also
entrusting
the
process
through
the
health
policy.
Commission,
the
Attorney
General's
review
and
the
many
other
stages
of
review
over
here
is
I've,
been
reminded
by
some
of
my
colleagues
before
you
know.
D
This
body
does
not
always
have
legislative
authority
over
some
of
the
hearing
matters
we
have
here,
but
this
is
an
important
venue
for
residents
of
the
city
of
Boston
and
surrounding
communities
to
learn
more
about
issues
like
this
that
affect
them
in
their
day
to
day
lives
and
certainly
in
their
healthcare
needs.
So
I'm
happy
to
have
this
hearing.
I
do
just
want
to
reiterate
my
my
support
and
the
partnership
I've
had
with
these
institutions
over
the
years.
D
E
Good
morning,
Thank
You
mr.
chair
I
also
want
to
recognize
and
thank
the
sponsors
of
this
hearing
and
also
appreciate
the
panel
before
us
and
all
those
in
attendance
I'm
here
to
listen
and
to
learn.
Unfortunately,
I'm
not
going
to
be
able
to
say
the
entire
time,
but
look
forward
to
watching
the
video
Thank.
A
F
Good
morning,
Thank
You
councillor
planner
McCarthy,
for
elevating
this
important
conversation
about
public
health
in
our
city.
This
merger
will
have
the
second
largest
inpatient,
outpatient
and
primary
care
market
shares
in
the
state
nearly
equal
partners.
We
must
practice
our
due
diligence
to
ensure
we
understand
all
the
factors
before
and
after
this
merger
for
our
current
residents,
their
public
health
and
also
the
impact
on
this
workforce,
especially
interested
in
what
that
will
be.
F
A
You
council
Presley
that
so
this
time,
when
I
turn
it
over,
if
folks
are
kind
enough
to
introduce
themselves
for
the
record
when
they
get
a
chance
to
speak.
We're
gonna
stack
with
doctor
Dean
Lewis
was
a
cardiologist
and
chief
systems,
development
and
strategic
officer
for
beth
israel,
deaconess.
So
welcome
to
the
boston
city,
council
chambers
and
you
have
the
floor.
Sir.
Thank.
G
You
Thank
You
councillor
Flaherty
and
members
of
the
council,
and
thank
you
all
for
inviting
us
here
today
to
speak
to
you
about
our
plans
to
create
a
new
integrated
healthcare
delivery
system
for
the
benefit
of
the
residents
of
the
city
of
Boston
and
beyond.
My
name
is
dr.
Stan
Lewis
I
am
a
cardiologist
and
serve
as
well
as
a
chief
system,
development
and
strategy
officer
for
Beth
Israel,
Deaconess
Medical
Center
in
Boston.
G
It's
our
goal
today
to
provide
you
and
my
goal
to
provide
you
with
background
information
on
bi
DMC
and
the
new
and
ylim
Baptist,
and
why
we
are
coming
together
with
other
organizations
to
create
this
new
system
of
care.
By
way
of
background,
the
founding
institutions
of
bi
DMC
were
created
more
than
120
years
ago
to
specifically
serve
underserved
populations
in
the
Greater
Boston
community
and
today,
I
think
we're
all
proud
to
say
that
bi
DMC
remains
true
to
that
founding
mission.
G
Both
bi
DMC
and
the
Baptist,
our
critical
health
care
providers
in
the
city
of
Boston,
providing
24
by
7
trauma
care,
highly
complex
hospital
care,
world-class
orthopaedic
care
and
a
range
of
important
medical
and
behavioral
health
services
for
the
benefit
of
all
of
the
patients
in
this
community,
regardless
of
their
insurance
status
or
ability
to
pay.
While
we're
a
major
level
one
trauma
center
and
a
world-renowned
medical
research
and
Harvard
teaching
hospital.
We
are
truly
privileged
to
serve
and
will
always
serve
as
the
local
community
hospital
from
many
Boston
residents.
G
We
have
strong
clinical
affiliations
and
provide
clinical
programming
and
financial
support
to
several
community
health
centers
throughout
the
neighborhoods
of
Boston.
The
community
health
centers
are
on
the
front
lines
of
service
to
vulnerable
patients
and
would
otherwise
lack
access
to
local
primary
care,
mental
health,
substance
abuse
and
dental
care.
These
health
centers
specifically
include
the
Boden
Street
Health
Center
in
Dorchester
Charles,
River
health
and
brighten,
the
demux
Center
in
Roxbury
Fenway
health
in
Boston
and
South
Co,
Community,
Health
Center
in
Chinatown.
G
As
you
all
know,
bi
DMC
and
the
Baptist's
are
major
employers
in
the
city
of
Boston.
Together,
we
employ
well
over
11,000
people
and
provide
thousands
of
needed
jobs
to
Boston
residents,
with
over
one-third
of
our
workforce,
I'm,
proud
to
call
Boston
their
home.
Our
employees,
the
heart
and
soul
of
our
organizations,
continue
to
provide
feedback.
That's
critical
and
counsel
on
our
journey
to
create
this
new
high
quality,
lower
cost
health
care
system,
and
we
are
delighted
to
celebrate
together
the
unanimous
approval
of
our
new
system
by
the
Commonwealth's
Public
Health
Council.
Just
last
week.
G
We
our
long-standing
and
committed
partners
to
a
host
of
neighborhood
and
community
based
nonprofit
organizations
across
the
city.
These
organizations
are
dedicated
to
serving
our
youth,
our
elderly,
our
newcomers
and
other
vulnerable
populations.
And
later
you
will
hear
from
the
director
of
community
relations
at
BI,
DMC
Jane
mat
law
who
will
discuss
this
important
issue.
Further
bi
DMC
was
proud
to
serve
on
the
City
of
Boston
pilot
task
force
that
created
the
city's
new
pilot
program.
G
We
are
proud
to
have
paid
more
than
14
million
dollars
in
voluntary
pilot
payments
since
fiscal
year,
2012,
along
with
providing
community
benefits
for
the
City
of
Boston
residents
exceeding
30
million
dollars
in
that
same
time
frame.
As
you
all
know,
the
health
care
environment
is
changing
rapidly
and
as
we
shift
focus
to
keeping
patients
and
communities
healthier
and
reducing
the
need
for
expensive
hospitalizations.
G
Through
our
work
with
bit
Co,
we
partner
with
providers
to
improve
quality
of
care
while
effectively
managing
medical
expenses
and
together
we
have
worked
hard
to
maintain
healthy
and
thriving
organizations,
not
just
within
the
city
of
Boston,
but
also
within
communities
surrounding
Boston,
including
Brockton
Cambridge,
Everett,
Lawrence,
Milton,
Needham
Plymouth,
among
others.
While
we've
had
some
success,
we
recognize
that
to
truly
make
a
difference
in
the
unacceptable
growth
in
health
care
costs
in
the
Commonwealth.
We
need
to
come
together
with
complementary
organizations
that
also
are
of
lower
cost
and
high
quality
together.
G
H
H
With
that
in
mind,
I
want
to
talk
a
little
bit
about
the
goals
and
objectives
of
this
system
separately.
Each
of
our
organizations
stan
has
talked
about
Beth
Israel
he's
talked
about
New
England,
Baptist
I
represent
leahy
Health
System
and
I
would
like
to
point
out
that
Lahey
Clinic,
dr.
Lahey,
started
at
the
Baptist
and
there
is
a
Lahey
Clinic
wing
at
the
new
English
hospital.
So
in
some
ways
we
see
this
as
a
coming
together
of
old
friends.
We
are
complementary
systems.
H
Giving
up
one's
own
economy
and
becoming
part
of
a
much
larger
system
is
not
always
easy.
The
eye
and
Lahey
have
been
in
discussions
about
this
possibility
for
three
years.
All
of
us
have
been
in
discussions
with
others
too,
but
in
the
end
we
had
a
complimentary
geography.
Lahey
and
its
community
hospitals
serve
largely
the
northeast
area
of
Massachusetts,
bi
and
Baptist
serve
Boston
and
the
southern
communities.
H
Largely
Mount
Auburn
is
a
major
provider
in
Cambridge,
so
we
have
complementary
geographies
and
we
had
the
opportunity
to
create
a
system
that
would
cover
ask
eastern
Massachusetts
and
provide
all
citizens
of
eastern
Massachusetts
access
to
a
high
quality.
Very
much
lower
cost
system.
We
actually
have
not
we're
not
just
being
here
to
give
you
aspirations
of
what
we
might
be
able
to
do.
Each
of
us
has
done
it.
H
Our
community
hospitals
have
thrived,
lay
clinic
Medical
Center
five
years
ago,
brought
in
Beverly,
Hospital
and
Addison
Gilbert
Hospital
then
brought
in
Winchester
hospital
bi
has
brought
in
its
three
community
hospitals,
all
of
them,
I
would
say
in
sharp
contrast
to
many
community
hospitals
across
this
system
have
thrived.
We
have
pushed
care
to
those
hospitals,
we
have
pushed
specialties
to
those
hospitals.
We
have
made
lower
cost
health
care
accessible
to
communities
in
which
people
live,
so
they
don't
have
to
drive
to
the
large,
more
expensive
tertiary
care
settings.
H
Lahey
Medical
Center
is
full.
We
are
not
seeking
more
patience
for
Lahey
Medical
Center,
we
move
patients
who
agree
and
their
doctors
agree
to
local
settings.
Bi
is
full,
it
does
exactly
the
same
thing
we
survive
and
we
provide
high
quality
care
by
moving
care
into
the
right
place.
The
best
quality
clinical
care
at
a
significantly
lower
cost
and
our
lower
cost
and
our
lower
tme
has
been
documented
over
and
over
and
over
again
again,
this
is
not
aspirational.
This
is
what
each
of
us
have
done
separately.
We've
done
it
well
together.
H
We
can
do
it
much
better.
I
could
give
you
multiple,
multiple
examples,
but
I'll
just
pick
a
couple
of
them:
Lahey
Health
System
has
a
one
of
the
largest
behavioral
health
divisions,
corporations
in
the
state.
We
even
have
a
site
in
Boston
the
fact
that
Beverly
Hospital
kept
that
going
is
a
remarkable
statement
of
community
pride.
We
have
kept
it
going
think
about
what
health
care
looks
like
now.
What
do
we
really
know
about
health
care,
mental
health
and
behavioral
issues,
skyrocket,
the
cost
of
care
I,
don't
even
have
to
mention
the
opioid
crisis.
H
Bi
care
group
does
not
have
that
capability.
We
will
be
able
to
share
that
capability
across
the
system
to
better
meet
the
needs
that
we
know
are
there
home
care
is
another
home
care
is
a
far
less
expensive
place
to
treat
people
the
faster.
You
can
go
home.
The
better
I
had
hip
surgery.
Four
years
ago,
I
went
home
the
next
morning.
I
could
have
gone
home
that
night,
but
that's
because
there
were
support
systems
at
home.
We
will
spread
that
throughout
the
system
to
significantly
reduce
price.
H
The
New
England
Baptist
is
the
standard
bearer
for
how
to
treat
many
or
the
orthopedic
procedures.
The
doctors
from
New
England
Baptists
are
not
going
to
suddenly
go
out.
You
know,
go
up
to
the
North
Shore,
the
South
Shore,
but
the
standards
they
have
developed
over
many
many
years,
which
are
recognized
nationally
as
being
state-of-the-art.
We
will
be
able
to
bring
out
to
all
of
our
other
pots
and
our
orthopedic
departments.
Best
practices
can
be
spread
throughout
the
system
and
again.
H
I'm
gonna
make
a
quick
little
sort
of
legal
editorial,
because
you
will
often
hear
that
evidence
suggest
to
you
that
when
you
get
bigger,
you
get
higher
prices,
and
certainly
we
saw
that
example
here
in
Massachusetts
from
the
system
that
was
created
20
years
ago.
There
is
no
case,
none
in
the
country
of
an
organization
getting
larger
in
a
market
place
when
there
is
already
a
very
dominant
provider.
None.
There
are
no
cases
similar
to
like
Massachusetts.
We
are
the
most
highly
transparent
state
in
the
country.
H
I
repeat
that
we
are
the
most
highly
transparent
state
in
the
country.
All
of
our
metrics
are
costs.
Our
DME,
our
services
to
populations
are
reviewed
and
published
every
single
year,
the
chances
and
what
we
also
know
is
we
have
a
stack
of
papers,
this
high,
that
talks
about
what
is
wrong
with
our
marketplace.
24
separate
reports,
I
was
a
help,
help
author,
the
first
one
from
the
attorney
general's
office.
H
It
talks
about
what's
wrong
with
our
marketplace
in
the
disparity
and
the
fact
that
too
many
people
are
treated
in
too
high-cost
settings,
so
we
know
what
it
what's
wrong
with
it.
We
know
how
to
fix
it.
We
will
bring
a
competitive
marketplace
alternative
and
again
we're
not
aspirational.
We've
done
this
over
and
over
and
over
again
by
ourselves,
we'll
do
better.
When
we
come
together
a
quick
note
about
the
regulatory
process,
we
are
being
intensively
reviewed
by
four
separate
agencies.
H
This
will
be
probably
the
most
intensive
review.
It
clearly
be
the
most
intensive
review
of
consolidation
in
Massachusetts,
and
it
may
well
be
the
most
intensive
review
of
a
consolidation
in
the
country.
We
were
being
reviewed
by
the
Department
of
Public
Health.
They
gave
unanimous
approval,
they
believe
us,
but
they
have
the
right
if
something
comes
up
later
in
this
process
that
they
didn't
take
into
account
to
reopen
it,
they
moved
in
accordance
with
the
schedule,
that's
required
of
them,
but
again
I
emphasize.
They
have
the
right
to
reopen
this.
H
We
are
being
reviewed
by
the
health
policy
Commission,
which
is
unique
to
Massachusetts
and
which
is
reviewing
this
thoroughly.
We
have
the
Attorney
General's
office
with
its
antitrust
and
it's
consumer
protection
powers
in
which
I
worked
for
for
seven
or
eight
years.
It
is
reviewing
this
thing
intensively.
The
Federal,
Trade
Commission,
is
reviewing
this
intensively.
We
have
produced
over
twenty
million
pieces
of
paper
interviews,
emails
conversations
and
it's
ongoing.
H
So
anyone
who's
concerned
that
this
is
not
the
tires
are
not
going
to
be
kicked
on
this
we're
just
hoping
the
tires,
don't
explode
from
all
the
kicking.
It's
there
we're
anxious
and
willing
and
open
to
going
through
this
process.
We
welcome
the
review,
although
I
will
tell
you
at
times
it's
rather
painful,
but
it
is
happening
and
there
is
not
a
stone
that
is
going
to
be
unturned.
H
My
final
statement
and,
of
course,
I
will
always
be
here
to
answer
questions
is
that
when
you
look
at
the
concern
on
the
part
of
various
communities
as
to
whether
this
will
impact
their
care,
it
will,
for
the
better
we're
gonna,
be
lower
priced
we're
gonna
be
high
quality.
We
are
gonna,
be
able
to
connect
their
care
through
every
portion
of
their
trip
through
the
medical
system.
We've
done
it
before.
We
will
do
it
again,
but
together
we
will
do
it
better.
Thank
you.
I
appreciate
the
opportunity.
I
Morning,
thank
you
for
the
opportunity
to
speak.
My
name
is
Joanne
Bukowski
and
I'm.
The
director
of
workforce
development
at
Beth,
Israel,
Deaconess,
Medical,
Center
and
I'm
here
to
express
my
support
for
the
proposed
merger.
I've
worked
for
13
years
at
Beth,
Israel,
Deaconess,
Medical
Center,
and
in
that
time
I've
developed
a
great
appreciation
for
the
commitment
of
all
employees,
to
the
x/2,
excellent
patient
care
and
to
improving
the
health
of
our
community.
One
way
that
bi
DMC
supports
the
health
of
our
community
is
by
being
a
great
employer.
I
Our
jobs
start
at
$15
offer
benefits
and
are
open
to
a
broad
spectrum
of
educational
levels.
We
recently
signed
on
as
an
employer
champion
in
Mayor
Walsh's
Boston
hires
campaign
to
assure
the
Boston
residents
connected
good
jobs
that
pay
well
and
offer
benefits.
We
have
a
robust
internal
career
mobility
program
inside
the
Medical
Center.
We
regularly
run
pipeline
programs
to
train
our
employees
up
into
higher
skilled
jobs
that
were
having
trouble
filling
over
150
employees
have
moved
to
new
jobs
as
a
result
of
these
targeted
programs.
I
I
We
do
a
lot
of
support
and
advising
for
our
employees
and
their
pass
rates
in
these
courses
range
from
83%
to
98%.
In
addition,
any
employee
can
meet
with
a
career
counselor
at
the
medical
center
and
get
some
advice
on
moving
their
career
forward.
In
ten
years,
we've
served
twelve
hundred
and
eighty-five
employees.
Through
this
initiative
we
also
offer
our
employees
free
ESOL
classes,
a
financial
counseling
program,
tuition,
reimbursement,
scholarships,
computer
classes
and
citizenship
classes.
If
you're
a
good
worker
who
never
got
a
college
degree.
I
Beth
Israel,
Deaconess,
Medical
Center,
is
an
excellent
place
to
advance
your
education
and
build
a
career
prior
to
working.
A
bi
DMC
I
was
the
director
of
Boston
career
link.
A
one-stop
Career
Center
in
Roxbury
working
at
the
Career
Center
I
was
frustrated
how
difficult
it
was
to
connect
our
jobseekers
to
hospitals.
Our
jobseekers
would
apply
online
then
hear
nothing
and
my
team
and
I
would
try
to
call
the
hospitals,
but
our
phone
calls
didn't
get
returned
when
I
came
to
be
IT
MC.
I
One
of
my
goals
was
to
better
connect
community
residents
to
BI
DNC
jobs,
now
bi
DMC,
actively
partners
with
many
Boston
area
community-based
organizations
that
are
interested
in
connecting
their
job
seekers
to
opportunities
at
the
Medical
Center.
We
host
about
20
internships
a
year
from
Y
MCA
training,
Inc,
st.
Mary's
Center
for
Women
and
Children
Bunker,
Hill,
Community,
College
JVs
and
the
HACC
diversity
program.
I
We
also
partner
with
about
15
organizations
in
Boston
who
refer
about
a
hundred
job
candidates
to
us
annually,
and
we
make
sure
we
get
a
really
warm
referral
for
those
candidates
via
DMC
hires,
about
over
40
summer
high
school
interns
a
year
and
two
paid
internships.
An
organization
server
for
these
young
people
to
us
include
the
Boston
private
industry,
Council,
the
John
Deere
Brian
school
ABCD,
Parker,
Hill,
Bowden,
Street,
Community,
Health
Center,
the
Mary
Lyon
Pilon,
High
School
in
Boston
and
others.
I
J
My
name
is
Jane
mat
law
and
I
am
director
of
community
relations
at
Beth,
Israel
Deaconess,
Medical
Center
I've
worked
at
the
Medical
Center
for
over
36
years,
having
started
as
a
social
worker
and
I'm
the
beneficiary
of
upward
mobility
at
the
Medical
Center
and
I've,
been
in
this
position
now
for
23
years.
In
my
work
at
the
Medical
Center
and
out
in
the
community,
I
have
the
privilege
of
working
with
over
60
community
organizations
in
the
Boston
area.
J
Last
December,
the
Department
of
Public
Health,
held
a
series
of
public
hearings
on
the
proposed
new
system,
including
one
here
in
the
city
of
Boston
at
Roxbury
Community
College
I'd
like
to
share
with
you
a
list
of
those
partners
who
came
to
the
hearing
and
shared
their
reasons.
Why
they
think
that
this
is
this
new
system.
Will
benefit
their
clients
and
the
residents
of
the
city
of
Boston.
J
The
letters
are
posted
on
the
DPH
website
for
the
benefit
of
the
public
to
see,
and
we
have
included
a
link
in
your
package,
so
those
organizations
included
the
Greater
Boston
Food
Bank,
the
Lewis
D
Brown
Peace
Institute
Jewish
vocational
services,
the
Boston
Center
for
independent
living,
the
Hyde
Square
task
force,
the
mass
immigrant
and
refugee
Africa
advocacy
coalition
health
care
without
harm
the
Brookline
Public
Health,
Department
and
Jewish
community
housing
for
the
elderly.
These
are
among
the
most
respected
leaders
in
Boston
who
care
deeply
about
the
clients
that
they
serve.
J
A
K
Sure
thank
you
good
morning.
My
name
is
philomene
lab
test
and
I
am
the
executive
director
of
Bowdoin
Street
Health
Center.
First
I
want
to
share
with
you
my
personal
story
on
how
I
got
to
Bowdoin,
Street
and
I'm
gonna
tie
it
back
to
Beth
Israel,
so
I
have
two
daughters,
12
and
6
I'm.
A
lifelong
resident
of
Bowdoin
Street
still
lived
there
with
my
family
and
when
my
oldest
daughter
had
turned
she'd
just
turned
1
I
got
a
call
from
my
mom
saying
that
she
was
sick.
K
I
left
my
job,
downtown
and
I
came
to
my
home,
and
my
mom
said
you
know
my
aunt
answered
the
door
and
said
your
mom
is
not
here.
She
took
your
daughter
to
Bowdoin,
Street
and
I.
Remember
saying
why
did
you
take
her
to
voting
Street
she's?
Not
even
a
patient
there,
so
I
get
to
vote
in
street
and
was
greeted
by
the
staff
explained
my
situation.
My
daughter's,
not
a
patient
there
and
I
walked
into
one
of
the
exam
rooms
and
I
think
that
I
can
share
that.
K
What
I
saw
as
a
mom
was
any
parent's
worst
nightmare,
where
you
would
see
your
child
not
really
responding
very
lethargic
and
just
moaning
and
crying
and
just
having
turned
one,
not
able
to
explain,
explain
or
Express
what
was
happening
to
her
from
there.
We
were
rushed
to
Children's,
Hospital
and
I.
K
Remember
being
there
and
trying
to
explain
to
the
attending
physician
what
was
happening
or
what
had
been
shared
with
me
and
then
he
stepped
away,
and
he
took
a
phone
call
and
I'm
thinking
I'm,
trying
to
explain
to
this
man
what's
happening
and
he
walks
away
to
take
a
phone
call
but
unbeknownst
to
me
that
was
dr.
Bonacci
from
Bowden
Street
calling
to
explain
to
him
his
assessment
of
my
daughter
later
that
night
I
received
a
phone
call
at
the
nurse's
station
and
they
asked
me
to
you
know
there
was
a
call
for
you.
K
Can
you
come
out
and
take
this
call
and
I
did
and
again.
This
was
about
9:30
at
night
and
it
was
dr.
Bonacci
calling
to
see
if
I
was
okay
and
if
I
understood
what
had
happened
with
my
daughter,
it
turns
out
that
she
ingested
a
small,
tiny
high
blood
pressure
pill
that
had
fell
on
the
floor
from
father
by
accident.
I
was
looking
for
a
new
job
opportunity.
Several
months
later
and
my
friend
said
you
know,
check
our
website
I
work
for
Beth
Israel.
You
know
you
see
what
you
find
and
I
said.
K
No
I
want
to
do
meaningful
community
work,
I,
don't
want
to
work
for
a
big
or
large
organization,
and
but
I
went
anyway,
and
I
saw
a
position
for
manager
of
community
health
at
Bowden,
Street,
Health,
Center
and
I.
Remember
thinking,
oh
my
goodness!
This
can't
be
real.
I
called
her
I
said
you
guys
are
affiliated
with
Bowden
Street
and
she
says
yes,
actually
that's
one
of
our
departments.
We
have
an
affiliation
with
them,
so
I
don't
think
it
was
by
accident
that
I
worked
at
Bowden.
K
Street
I
do
believe
that
it
was
fate
that
brought
me
there.
We
are
Bowden,
Street
was
started
many
years
ago
and
when
we
actually
did
a
survey
with
our
community
residents,
what
hospital
would
you
like
to
be
affiliated
with
when
we
were
looking
for
another
community?
Another
hospital
to
partner
with
the
overwhelming
majority,
said:
Beth
Israel.
We
are
a
department
of
Beth
Israel,
Deaconess,
Medical
Center.
We
have
access
to
the
resources
and
services
that
are
provided
there.
K
We
have
providers
that
come
over
specialty
providers
like
orthopedics
podiatry
optometry
that
come
over
and
treat
our
patients
in
Dorchester
in
Bowdoin
Geneva,
as
opposed
to
them
having
to
travel
to
go
there.
So
this
merger
means
a
lot
to
us
because
not
only
do
we
have
patients
that
reside
in
the
boat
in
Geneva
area.
There
are
many
patients
who
may
have
lived
there
many
years
ago,
but
have
strong
ties
to
the
community
that
come
back
to
Bowdoin
Street
because
of
their
personal
connection.
K
I
think
that,
having
the
opportunity
to
go
someplace
that
would
be
closer
to
them
as
a
part
of
this
merger
or
as
a
result
of
this
merger,
would
not
only
help
with
coordinated
care
but
for
affordable
care
or
to
lower
the
total
medical
expenses
for
the
entire
organization.
I.
Thank
you
for
having
an
opportunity
for
me
to
speak
and
I'd
be
happy
to
take
any
questions
at
the
end.
Regarding
our
experience
as
a
community
health
center
with
the
organization.
A
L
Name
is
Nelson
Lu
I'm
the
board
president
for
the
South
Dakota
Community
Health
Center
I
want
to
thank
the
City
Council
in
the
community
for
the
opportunity
here
to
comment.
I'm
as
I
said,
the
current
board
president
I've
been
a
board
member
for
six
years
now,
South
Cove,
Kamini,
Health
Center
has
served
the
Greater
Boston
and
extending
communities
in
Quincy
and
Malden
soon
and
Boston
in
particular,
for
forty
five
years.
We
see
a
hundred
and
eighty
visits
a
year
and
have
employed
300
plus
staff
locally
at
each
of
these
locations
from
the
community.
L
Our
relationship
with
p.m.
BI
DNC
goes
back
over
20
years
and
that
relationship
has
benefited
our
patients,
our
staff
and
our
overall
organization,
in
particular
for
our
patients.
Many
of
them
who
do
not
speak
English
fluently
nor
in
some
cases,
unfortunately
have
the
ability
to
pay
for
the
care
I
personally
have.
What
I
would
argue
is
a
valuable
family
connection
through
my
own
care,
at
times
through
families
who
within
who
have
had
the
birth
of
a
child
and,
unfortunately,
the
death
of
grandparents.
L
There
are
significant
linguistic
barriers
throughout
our
community
that
we
serve,
but
beyond
and
I
believe
that
this
partnership
will
help
to
alleviate
some
of
those
concerns
that
our
patients
continually
have
in
terms
of
their
access
to
care.
I
appear
before
you
here
today
on
behalf
of
our
board,
an
organization
to
offer
our
support
to
whole
heart
of
the
ask
that
you
support
this
partnership
and
I'm.
Also
here
available
to
answer
any
questions
that
you
may
have
in
regards
to
our
service
at
South
Cove
to
the
community.
B
You
all
very
much
for
being
here
that
was
a
an
incredibly
in-depth
synopsis
of.
What's
what
what
you
plan
on
doing.
I,
certainly
appreciate
that
my
questions
were
generally
about
the
the
merger
entity.
You
know
in
you
it's
that
doctor
David,
to
be
honest
with
you
regarding
prices,
doubling
and
tripling
in
other
scenarios,
I'm
eager
to
hear
you
know
there
was
a
press
release
that
that
had
that
question-
or
you
know,
stated,
as
fact
which
concerns
me,
but
you
you
addressed
it
very
well
and
with
the
health
communities
of
community
centers.
B
Being
here,
that's
very
helpful
as
well,
so
I
guess
the
only
the
real
question
I
would
have
is.
Can
you
better
explain
to
me
just
the
cost
and
procedures
that
merged
entities
before
their
they
doubled
in
tripled
in
prices?
How
how
does?
How
does
your
merger
differ
from
the
previous
merger
years
ago?.
H
So
we
know
why
we
have
that
price
variation.
We
also
know
why
we
have
such
high
prices.
We
put
people
in
tertiary,
quaternary
institutions,
it's
sometimes
two
to
three
times
the
national
average.
When
you
look
at
Medicare
results
too
much
care
goes
into
our
very
high-priced
academic,
medical
centers,
which
provide
great
research,
great
care,
look
of
our
communities
of
criticism
there,
but
we
put
too
much
care
into
those
facilities.
H
So
in
that
sense,
when
I
look
at
what
we
are
doing
and
why
we
will
be
different
number
one
remember:
the
price
increases
that
one
Institute
one
system
was
able
to
extract
from
the
marketplace
occurred
when
there
was
no
virtually
no
oversight.
There
was
virtually
no
even
understanding
of
what
what
that
meant.
That
oversight
did
not
start
until
the
last
five
to
eight
years.
H
I
would
also
state
that
we're
trying
to
bring
true
competition
to
Massachusetts.
There
is
none.
We
do
not
have
a
competitive
marketplace,
that's
been
documented
over
and
over
again,
no
one
is
able
to
mount
a
competitive
challenge
to
that
system.
That
will
not
be
named
we-well
for
the
first
time,
we'll
be
able
to
create
that
we
have
not
fixed
our
problem
by
legislation.
We
have
not
fixed
our
problem
by
law
enforcement.
H
The
only
way
we're
gonna
fix
our
problem
to
have
price
and
quality
actually
be
a
competitive
part
of
the
marketplace
where
we
can
begin
to
put
challenges
to
those
who
have
high
prices
where
we
can
get
to
a
point
where
insurance
companies
will
offer
price
products
to
families
based
upon
the
provider.
They
choose
right
now:
hyper
high-value
providers,
those
with
high
costs
and
high
quality.
H
Excuse
me,
they're
the
local
value
providers,
high
costs
and
high
quality
basically
are
being
supported
and
subsidized
through
the
insurance
company
by
those
of
us
who
choose
high
value
providers,
low
cost
same
high
quality.
We
have
so
many
problems
with
this.
Our
medical
system.
You
have
great
care,
but
the
price
is
a
real
problem
and
where
you
get
the
prick
care
is
a
real
problem.
H
B
H
Population
will
have
a
positive
effect.
Medicaid
patients
want
high-quality
clinical
care,
they
want
care
that
is
not
fragmented,
where
their
doctors
aren't
talking
to
their
other
doctors.
They
want
to
be
part
of
a
system
where
their
medical
record
follows
them,
where
their
care
provide
them.
Where
and
indirectly,
they
want
lower
cost
care
because
the
extent
to
which
we
can
bring
cost
down
across
the
Commonwealth,
their
possibilities
of
access
will
increase.
H
A
H
At
times,
well,
first
of
all,
yes,
there
were
no
metrics
when
I
started.
You
know
we
typed
on
a
manual
typewriter.
The
metrics
we
have
now
are
startling
gathering
the
metrics
is
not
all
that
complicated.
The
advantage
we
have
now
with
electronic
medical
records
with
computer
technology
means
that
we
all
know
at
this
point.
You
know
medicine
is
no
longer
art.
H
H
This
will
be
the
most
thoroughly
documented
case
of
what
happens
when
you
create
a
legitimate
competitor
in
a
market.
That's
already
dominated,
you
will
know,
has
it
impacted
our
payer
mix?
Has
it
impacted
our
prices?
Has
it
impacted
our
tme?
Has
it
impacted
our
ability
to
provide
services
to
disadvantaged?
Has
it
impacted
our
ability
to
provide
mental
health
services,
we're
going
to
have
a
scorecard
and
it's
longer
than
anything
any
of
any
of
us
ever
saw
it
saw
in
school,
and
it's
going
to
be
with
us
for
the
foreseeable
future
and
beyond?
It's.
C
I
understand
part
of
the
the
reason
for
merging
is
to
save
cost
through
efficiencies
reduced
administrative
costs.
How
will
this
impact
staffing,
what
this
merger
do
you
envision?
Laying
anybody
off
I
also
see
just
in
my
own
experience.
Dealing
with
healthcare
is
the
courageous,
professional
job
of
our
nurses
across
a
state.
They
do
an
excellent
job
there,
the
practically
unsung
heroes
in
the
medical
field.
H
Answer
to
that
is,
we've
made
no
plans
for
any
layoffs,
and
but
there
were
not
going
to
be
any
layoffs
when
and
the
people
who
touch
patients
the
people
who
issue
bills,
the
people
who
clean
the
people
who
monitor
compliance.
We
are
you
have
to
remember
this
is
not
a
merger
of
two
institutions
that
sit
across
the
street
from
each
other.
These
are
two
geographic
areas.
The
only
areas
in
which
any
efficiencies
may
come
from
staff
decisions
are
at
my
level
at
the
CEO
level.
At
the
very
top
end
of
you
know
the
executive
suite.
H
G
Laid
off
on
the
contrary,
I
think
it's
clear
from
what
you're
hearing
that
we
expect
to
grow.
We
expect
to
expand
services.
We've
demonstrated
that
as
two
legacy
organizations
already
I
think
the
track
record
speaks
for
itself
and
we
fully
anticipate
that
to
be
the
outcome
of
successfully
executing
on
what
we
are
proposing.
G
C
H
C
H
Didn't
mention
for
whatever
we
didn't
mention?
The
answer
is
no
our.
We
don't
have
a
community
health
center,
for
instance
in
in
Gloucester,
but
our
the
programs
that
we
have
built
out
in
Gloucester
have
been
documented
over
and
over
again.
That
is
a
small
community
hospital
that
serves
a
limited
population
on
what
they
always
acknowledge
is
an
island.
H
Addison
Gilbert
had
been
rumored
to
close
for
20
years.
It
is
now
flourishing.
It
has
higher
volumes
than
it's
ever
had
before
it's
financially
stable.
We
have
opened
up
clinics,
drug
programs,
97%
of
the
people
who
come
to
our
emergency
room
can
now
actually
be
treated
on
k-band
so
again
for
every
community
health
center
every
community
program.
This
combination
will
enhance
the
strength
of
the
system
and
enhance
the
ability
of
us
to
deliver
those
kinds
of
services
that
are
out
of
the
hospital
but
are
critical
to
our
populations.
H
Health
and
remember
again,
we
do
this
for
ethical
reasons,
because
we're
mission
delivered,
but
as
we
move
more
and
more
into
population
health,
where
we're
not
paid
on
a
fee-for-service
basis
were
paid
on
our
ability
to
keep
people
healthy.
Those
programs
are
essential.
So
we
do
it
because
it's
our
mission
and
we
do
it
because
it's
good
business-
and
sometimes
you
can
trust
good
business
more
than
mission.
So
I
think
we
have
a
dual
reason
for
continuing
to
do
that
and
we'll
do
it
much
better
and.
C
G
I
think
the
impact
on
the
most
vulnerable
will
be
similar
to
the
impact
across
the
board.
We
expect
that
the
outcome
of
what
we
are
creating
here
will
be
the
ability
to
deploy
more
resources,
expand
access,
create
more
availability
in
terms
of
specialty
services
in
local
communities,
so
we
would
fully
anticipate
the
impact
to
be
a
very
positive
one.
F
Chairman
and
many
of
my
several
of
my
questions
were
asked
and
answered
relative
to
the
impact
on
neighborhood
and
community
based
health
centers,
and
also
the
impact
on
traditionally
underserved
communities.
I
did
just
want
to
revisit
a
couple
of
things.
Could
we
just
drill
down
a
little
bit
more
on
workforce
I'm
curious
as
to
how
many
people
you
actually
employ?
F
If
you
have
any
sense
as
to
that
I'm
just
curious,
you
know
as
an
employer
and
appreciate
your
verbally
expressed
commitment
here
around
a
workforce
retention,
because
I
imagine
that
many
of
these
employees
have
been
of
service
and
giving
of
themselves
for
many
many
years,
and
so
not
only
do
we
want
to
make
sure
that
they're
still
able
to
provide
for
their
families.
We
certainly
don't
want
the
quality
of
care
to
be
impacted,
and
so
also
picking
up
on
counselor
Flint's
point,
which
was
also
a
question
of
mine.
F
We
know
that
there
is
a
nursing
staffing
shortage
crisis
and
not
only
is
that
a
burden
on
our
already
overextended
and
dedicated
nursing
staff,
but
also
does
impact
the
quality
of
patient
care.
So
when
you
say
you're
looking
for
more
I'd
be
curious
as
to
sort
of
where
we
are
in
terms
of
nurse
to
patient
ratio
and
how
we'll
make
sure
that's
still
one
that
is
a
fair
for
the
workforce
and
also
make
meeting
the
needs
of
patients.
So
those
are
my
two
questions
before
I
get
into
a
Medicaid
question.
Well,.
G
F
F
Wonderful,
thank
you.
I'm.
Sorry,
I
missed
that
point
earlier
and
again,
thank
you
for
your
commitment
to
to
retain
them.
We
always
worry
about
layoffs
and
these
sorts
of
mergers.
Okay
and
then
on
the
nursing
side.
Is
there
any
statistics
that
you
could
share
sort
of
in
the
aggregate
or
no
just
lumped
in
okay?
I?
Don't
have
that
okay
I
know.
H
That
we
provide
high
quality
care,
we
value
our
nurses
and
we're
always
looking
for
more
so,
but
I
mean
I'm
very
comfortable
with
our
clinical
care.
I
think
we've,
you
know,
no
one
has
ever
disagreed
that
our
care
is
not
high
quality
and
it's
been
showed
by
patient
satisfaction.
Statistics
over
and
over
again
and
nurses
are
largely
part
of
your
patient
satisfaction.
H
F
And
then
on
the
Medicaid
side,
I
just
didn't
know:
if
previously
there
are
specific
strategies
or
something
that
you
might
point
to
so
far
as
increasing
access
to
those,
regardless
of
their
insurance
status,
sort
of
it's
not
something
that
just
happens
by
default
or
organically.
Are
there
best
practices
or
strategies
that
you've
used
in
order
to
increase
access
to
Medicaid
users,
I.
G
H
G
Just
add
because
we
sometimes
don't
recognize
this,
but
in
some
of
our
community
of
Philly
it's
including
places
like
the
ID
Plymouth.
There
is
also
significant
Medicaid
populations
and
I.
Think,
as
is
the
theme
throughout
our
presentation,
we
have
a
great
track
record.
It's
great
when
the
facts
are
on
your
side
of
deploying
resources
of
building
new
services,
of
creating
access
to
that
population,
which
is
quite
significant
in
that
region.
A
You
we've
also
been
joined
by
my
colleague
city
councilor,
a
nice
rossabi
Jorge
any
questions
of
this
panel
at
this
time
very
good.
So
that
will
conclude
the
first
panel.
Let
me
just
say
that
you
know,
as
a
city
we
boast
of
having
the
best
hospitals
and
network
of
community
health
centers
in
the
world,
you're
our
largest
employers,
you
leaders
of
strategic
partnerships
and
you're
our
neighbors.
So
we
appreciate
your
time
and
attention
this
morning
and
the
Florida
continued
working
together.
So
thank
you.
Thank
you
very
much.
Thank
you
and
I
see
that
dr.
A
A
M
Thank
you
good
morning
councillors
and
thank
you
for
the
opportunity
to
testify
this
morning
and
taking
time
to
ensure
there
is
greater
transparency
around
a
proposed
health
care
merger
that
will
have
a
very
large
impact
for
the
city
of
Boston
in
the
entire
state.
My
name
is
dr.
Michael
Wagner
I'm,
the
CEO
of
Tufts
Medical
Center
in
the
floating
Hospital
for
Children.
Our
hospitals
are
part
of
a
larger
system
called
well
force
that
includes
physicians
and
hospitals
in
Boston,
Lowell,
Melrose,
Medford
and
other
vital
communities
throughout
eastern
Massachusetts.
M
Our
system
has
been
recognized
for
its
commitment
to
keep
care
local
and
providing
the
highest
quality
of
care
at
lower
cost.
Our
essential
role
in
the
marketplace
has
been
recognized
by
the
globe:
the
Attorney
General
Health,
Policy,
Commission
and
others.
We
are
committed
to
improving
the
health
care
of
diverse
and
underserved
communities
in
Boston
in
Massachusetts
I'm
here
today
to
express
my
deep
concern
over
the
proposed
merger
between
beth,
israel,
deaconess
and
Leahy.
M
Health
I
have
great
respect
for
these
two
organizations,
but
I
have
grave
concerns
about
what
the
merger
of
these
two
systems
could
do
to
health
care
costs
and
access
in
Boston
and
eastern
Massachusetts.
My
concerns
are
that
this
merger
will
result
in
increased
disparities,
increased
costs
while
reducing
access,
especially
for
underserved
communities.
M
Let
me
first
discuss
the
impact
on
disparities.
The
proposed
merger
will
essentially
create
two
large
systems
duopoly
in
which
54
percent
of
the
commercial
healthcare
volume
in
the
state
would
exist
within
these,
two
mega
systems
emerged,
be
ilayhi
system
which
has
selected
partners
from
largely
more
affluent
Massachusetts
communities
would
have
the
lowest
percentage
of
Medicaid
care
of
any
system
in
eastern
Massachusetts,
just
14
percent
14
percent.
M
By
contrast,
the
welfare
system
is
21%
Tufts,
31
percent
of
our
patients,
walking
into
our
doors
and
being
admitted
to
our
Hospital,
our
MassHealth
patients,
66
percent
of
the
kids
we
care
for
are
MassHealth,
Medicaid,
kids.
Why
is
this
important?
This
merger
would
widen
the
disparities
by
creating
a
two-tier
system,
those
who
are
focused
on
the
commercial
population
partners
in
the
merged
bi
lay
system
and
those
who
have
a
disproportionate
share
of
MassHealth
patients,
our
state's
most
vulnerable
population.
M
Unlike
the
argument
used
by
these
systems
in
the
past,
providers
such
as
well
force
and
Tufts,
and
the
floating
do
actually
use
commercial
reimbursement
to
cross
subsidize
our
higher
proportion
of
Medicaid
care
and
costs.
Additionally,
hospitals
such
as
Tufts
Medical
Center
in
the
well
for
sister
organizations,
along
with
many
other
hospitals
who
are
not
part
of
either
of
these
systems,
are
high
Medicaid
providers
and,
as
of
March
1st,
are
now
participating
in
the
state's
MassHealth
ACO
that
was
mentioned
earlier.
M
This
scenario
creates
a
situation
which
the
hospitals,
with
the
greatest
risk
exposure
in
the
MassHealth
ACO
also
had
the
least
opportunity
to
cross
subsidize
from
commercial
payment
on
top
of
this
ad.
On
top
of
this,
an
already
existing
price
disparity
that
was
talked
about
earlier,
where
high
Medicaid
hospitals
have
lower
commercial
reimbursement,
that's
creating
a
double
jeopardy
for
our
safety
net
system
of
care
for
the
poor
and
underserved
in
human
terms.
This
means
disparities
across
Massachusetts
will
be
exacerbated.
M
The
second
piece
I
would
like
to
discuss
is
the
argument
that
this
new
system
would
create
a
competitor
to
partners.
It
follows
from
the
assertion
that
the
new
system
would
take
patients
from
partners
and
since
partners
is
a
higher
paid
provider,
this
movement
would
reduce
healthcare
costs.
However,
this
is
a
false
argument.
The
new
combined
Beth
Israel
Leahy
system
would
likely
siphon
the
room:
maining
commercial
patients
from
Nam
partners,
hospitals,
community
health,
centers
and
physicians.
This
possibility
is
more
likely
to
occur
than
the
argument
being
proposed
that
they
will
move
market
share
from
partners.
M
The
shift
of
patients
from
high
Medicaid
hospitals
and
providers
to
the
new
combined
lebih
high
BI
leahy
system
will
actually
increase
costs
due
to
the
price
disparity
that
exists
between
the
proposed
merged
entities
and
those
who
are
high.
Medicaid
providers
who
are
lower
paid,
thus
destabilized
the
healthcare
providers
serving
the
most
vulnerable
populations.
The
last
piece
I
want
to
bring
to
your
attention
is
the
likely
impact
on
price
disparities.
The
current
pricing
disparities,
which
are
again
mentioned
earlier
by
mr.
M
Spackman
in
the
eastern
Massachusetts,
have
been
well
outlined
by
the
globe
the
AG's
office
HPC
and
Chia.
In
fact,
David
Stockman
played
in
key
role
in
helping
to
bring
this
to
light.
There
has
not
been
any
movement
to
change
the
reality
of
those
price
and
disparities.
However,
the
question
we
should
be
asking
is:
what
is
the
impact
of
this
newly
combined
B
ilayhi
system
on
pricing
in
the
marketplace?
M
Well,
the
new
system
remain
where
they
are
well,
they
reduce
their
price
because
they're
able
to
deliver
synergistic
savings,
or
will
they
increase
pricing
due
to
their
increased
leverage
in
the
marketplace?
The
evidence
from
other
markets
is
that
prices
will
increase.
The
B
ilayhi
system
will
ultimately
move
their
pricing
to
approximate
the
market
leader
partners.
Currently,
there
are
no
restrictions
in
the
merged
entity's
ability
to
raise
their
prices.
M
M
Why
do
I
feel
strongly
that
the
newly
created
bi
Leahy
system
will
raise
prices
to
approximate
or
come
close
to
partners
price
structure
because,
as
bi
Leahy,
which
they
talked
about,
looks
to
grow,
they
will
need
to
recruit
physicians
if
they
are
paid
below
partners
rates,
they
will
not
be
able
to
attract
new
physician
to
satisfy
their
growth
plans.
Both
partners
and
the
newly
formed
bi
Leahy
system
will
have
an
aggressive
growth
plans
and
in
order
for
them
to
recruit
physicians,
their
prices
will
need
to
be
comparable.
M
Make
no
mistake
when
they
grow,
they
will
focus
on
moving
commercial
patients
from
non
partners
and
non
bi
leahy
system
systems
and
providers.
So
I
think
it's
important
to
ask.
How
is
this
merger
good
for
our
community?
How
will
this
merger
actually
reduce
healthcare
costs
for
the
residents
and
businesses
of
Boston?
What
protection
can
what
protections
can
be?
Put
in
place
to
ensure
costs,
don't
increase
and
consumers
for
consumers
and
services
for
low-income
communities,
especially
aren't
jeopardized
at
Tufts,
where
we
care
deeply
about
our
commitments
and
the
communities
that
we
serve.
M
A
B
B
M
One
of
the
things
that
I
think
is
important
to
say
and
David
David
mentioned
this-
is
that
I
think
all
systems
end
up
talking
to
each
other
at
some
point
around
potential
discussions
and
mergers,
as
it
was
well
publicized
that
Tufts
and
PMC
wearing
merger
conversations
in
2015
to
say
that
organizations
are
in
some
form
of
informal
or
formal
conversations.
It
happens
all
the
time,
but
this
specifically
we
weren't
involved
in
the
conversation.
Okay,.
B
M
B
A
M
So
sure
so
one
is
clearly
around
pricing
and
pricing
structure.
We
do
have
a
pricing
disparity
issue
in
the
marketplace.
It
does
create
a
very
uneven
playing
field
and
it
also
creates
a
situation
in
which
those
hospitals,
as
they
mentioned,
have
very
high.
Mass
health
populations
are
in
a
more
vulnerable
position,
especially
as
they
take
on
more
risk
in
the
MassHealth
ACL.
So
pricing
I
think
is
very
important
and
that's
important
for
our
employers
and
those
who
are
paying
for
health
care
in
terms
of
from
a
conditional
perspective.
M
I
think
other
things
to
look
at
is
the
the
affiliation
in
flow
in
connection
with
relationship
to
doctors.
Physicians
in
the
in
these
mergers
and
it's
oftentimes
overlooked
to
also
consider
what
number
of
physicians
where
they're
located
and
how
they
are
aligned
with
the
health
system.
I
think
this
is
a
very
important
component.
M
We
do
a
lot
of
work
in
pediatrics
and
in
communities
in
mostly
underserved
areas
is
how
are
we
as
a
Commonwealth,
going
to
assess
the
potential
negative
impact
as
services
in
those
communities
may
be
negatively
impacted
by
the
financial
performance
of
the
pillar?
Organizations
that
are
left
left
well.
We're
left
standing
alone,
Thank.
C
You
counsel,
Flaherty
and
council
McCarthy.
Thank
you
doctor.
As
you
know,
Tufts
Medical
Center
is
in
my
district.
I
am
concerned
about
jobs.
If
this
merger
is
allowed
to
go
through,
how
do
you
believe
it
will
impact
Tufts,
Medical
Center's
ability
to
compete?
It
couldn't
Altima
ly
impact
the
number
of
jobs
at
Tufts,
yeah.
M
They're
many
so
first
of
all,
I'll
make
a
comment.
Many
of
the
health
care
organizations
in
the
city
made
a
commitment
around
a
15
hour
living
wage
and,
as
was
mentioned,
B
I
made
a
commitment
and,
as
BMC
and
Tufts
also
made
that
commitment
our
workforce.
We
have
five
thousand
five
hundred
employees.
We
have
another
six
hundred
physicians
at
work
out
of
our
downtown
campus
and
we've
worked
hard
to
grow.
We've
actually
added,
probably
somewhere
around
six
hundred
jobs
over
the
last
several
years,
because
we've
had
an
aggressive
growth
plan
like
all
healthcare
organizations.
M
I
worry
about
our
ability
to
continue
to
provide
services
in
pediatrics
in
the
community,
which
would
have
a
downtown
impact
in
terms
of
our
pediatric
enterprise.
I
do
worry
about
our
ability
to
continue
to
recruit
physicians
and
do
it
effectively.
As
my
earlier
comment
regarding
physician
recruitment,
our
growth
we've
grown
aggressively
and
taken
advantage
of
the
fact
that
we
are
the
smallest
academic
medical
center
in
town,
we're
not
looking
to
fill
beds.
We
actually
work
collaboratively
with
Lowell
general
and
with
hallmark
in
increasing
their
care
in
the
community.
C
M
So
what
I
worry
about
is-
and
it's
you
know-
maybe
I'm
too
concerned
about
this,
but
what
I
worry
about
is
that
we
will
more
than
likely
see
hospital
closures.
We
saw
it
in
North
Adams,
you
saw
it
in
Quincy,
and
the
question
is
is
if
we
see
further
Hospital
closures
because
of
a
reduction
in
inpatient
utilization
and
consolidation,
it's
a
consolidation
is
predominantly
focused
around
commercially
more
affluent
communities
and
those
that
are
in
high
medicaid
MassHealth
communities
are
excluded
or
disadvantaged
in
the
marketplace.
M
C
A
President
andre
campbell,
no
questions
at
this
point
so
doctor.
Thank
you
for
your
time
and
attention.
Thank
you
work
that
you
do
as
well
as
the
great
care
that
your
hospital,
your
doctors
and
nurse
might
as
well
as
your
staff
here.
Community
relations
and
government
fees.
Folks
are
a
pleasure
to
work,
but
so
so
thank.
G
N
A
A
N
Name
is
Hanoi
areas
and
I
am
a
resident
of
Jamaica
Plain
I'm.
Also
a
spokeswoman
for
the
Affordable
make
health
care
affordable
coalition.
I
want
to
start
by
thanking
the
Boston
City
Council,
our
of
is
particularly
councillor
McCarthy
in
Fling
for
calling
the
petition
to
for
this
hearing
today,
which
is
very
critical
for
our
communities.
N
So
I
want
to
start
by
saying
that
in
emphasizing
that
I
am
NOT,
a
health
care
specialist
I
am
here
representing
the
over
60
diverse
community
members,
leaders
and
representatives
of
the
communities
I
serve,
which
is
across
eastern
Massachusetts,
who
have
grave
concerns
about
the
13
Hospital
mega
murder,
led
by
Beth,
Israel
and
Leahy
health.
Many
of
our
members
are
here
today
behind
me
and
are
sitting
in
white
teachers
and
others
which
are
not
this
mega
merger
represents
the
biggest
change
in
our
healthcare
system
in
a
generation.
N
According
to
the
Massachusetts
health
policy
Commission,
it
will
impact
more
than
1
million
patients
across
eastern
Massachusetts,
including
those
who
rely
on
community
hospitals
in
Boston,
cyperus
neighborhoods.
The
track
record
shows
that
these
hospitals
do
not
serve
our
poorest
communities
by
joining
together.
They
are
forming
a
second
Goliath
in
the
market.
It
is
clear
that
it
will
leave
the
remaining
hospice.
N
The
server
comports
communities
further
behind
so
I
want
to
ask.
Why
would
we
do
this
now?
When
are
these
parties
in
the
healthcare
system
are
already
so
great?
If
approved,
the
merger
will
lead
to
higher
costs
and
reduced
access
for
working
class
and
especially
the
communities
of
color,
eventually,
community
hospitals
that
cannot
complete
will
be
will
have
to
close.
This
is
based
on
a
research
conducted
by
dr.
James
Jennings
of
Tufts
University
and
published
at
the
Boston
Globe.
Here
are
some
figures
to
keep
in
mind.
The
mega
merger
will
control
one
in
three
hospitals.
N
It
will
control
one
out
of
three
primary
care
visits
in
eastern
Massachusetts.
Every
study
has
shown
that,
as
providers
game,
market
power
costs
have
increased.
The
merger
will
target
affluent
households
of
income
of
over
100
$12,000
a
year,
while
low-income
and
MassHealth
patients
will
be
left
behind
to
further
demonstrate
this.
In
2016,
only
10%
of
lay
his
patients
were
on
MassHealth
and
18%
for
Beth
Israel.
N
This
compares
to
the
31%
of
Tufts
patient
in
51%
of
Boston
Medical
Center
patients,
which
are
on
MassHealth
Boston
community
hospitals
outside
the
mega
merger,
like
tops
B
and
C
in
Carling,
will
not
be
able
to
compete
and
will
ultimately
be
forced
to
reduce
their
services,
and
close
people
of
color
in
the
working
class
could
lose
their
doctors,
be
forced
to
travel,
long
distances
for
services
and
pay
more
for
health
care
premiums.
If
the
merger
is
approved,
we
believe
the
state's
Department
of
Public
Health
are
to
prematurely
in
issuing
its
approval
of
the
murder.
N
Last
week
before
the
HP
C's
cost
impact
review
was
completed
and
reported
again
I
thank
the
City
Hall
for
bringing
this
merger
process
out
of
the
darkness
and
into
the
light
and
I
urge
you
to
take
the
next
step
in
actual
attorney
general
Maura
Healey
to
in
the
HPC
to
fully
investigate
the
impacts
of
this
merger
before
it
is
too
late.
Thank
you
and
I'll
be
happy
to
take
any
questions.
O
Good
morning
Boston
City
Council
members,
my
name
is
Bonnie
Gilbert
and
thank
you
for
allowing
me
to
address
you
on
this
issue.
I
am
a
strategy
team
member
of
the
Greater
Boston
interfaith
organization,
gpio,
which
has
over
40
member
congregations,
many
of
which
you
probably
know
are
right
here
in
Boston,
I
am
chair
of
the
gpio
health
care
team
and
I'm.
A
member
of
the
ten
taxpayer
group
go
teach
I'm
involved
in
this
issue
and
I'm
here
today,
because
I
am
NOT.
O
Also
a
member
of
the
healthcare
industry
but
I
like
many
other
Massachusetts
citizens
have
had
our
family's
health
care
costs
escalated
to
outrageous
levels.
We
are
a
family
of
five
and
although
there
are
no
life-threatening
issues,
health
issues
in
my
family,
we
have
a
number
of
Chronicle
chronic
health
care
issues.
O
So
we
are
paying
now
close
to
twenty
five
thousand
dollars
a
year
between
co-pays
deductibles
premiums
and
other
non
covered
expenses,
and,
frankly,
I
would
challenge
everyone
here
to
go
home
and
tell
tally
up
your
medical
expenses
and
see
where
they
have
gotten
to
and
how
much
they've
grown
in
these
last
few
years.
So
gpio
s
position
is
that
we're
not
necessarily
opposed
to
the
merger,
but
we
are
deeply
concerned
with
the
same
two
issues
that
are
being
presented
here:
one
of
the
impact
on
other
community
providers
and
the
impact
on
Haas.
O
We
oppose
any
merger
that
does
not
include
strict
conditions,
preventing
higher
costs
and
prices
and
which
does
not
include
substantial
consequences
for
a
failure
to
do
so.
We
testified
last
week
in
front
of
the
Public
Health
Council
that
we
were
distressed
to
see
that
the
determination
of
needs
apartment
had
removed
the
only
condition
in
their
staff
report
that
directly
addressed
cost
increases.
The
additional
the
original
condition
was
removed
at
the
last
moment,
prior
to
any
operator
or
after
any
opportunity
for
any
public
comment.
O
That
condition
had
required
new
Coe
to
ensure
that
the
health
status,
adjusted
total
medical
expense
of
the
new
Coe
system
did
not
exceed
the
healthcare
cost
growth
benchmark
of
any
calendar
year,
which
is
currently
now
3.1
percent.
Now
this
condition
was
not
the
sole
solution
to
the
problem.
To
the
contrary,
we
considered
this
condition
to
be
the
bare
minimum
first
step,
but
it
was
removed
and
replaced
by
a
condition
that
one
will
only
be
triggered
at
the
discretion
of
the
health
policy
Commission.
O
That
T
does
not
have
any
significant,
enforceable
consequences
and
three
is
more
of
a
reporting
condition,
rather
than
a
specific
limit
on
costs
and
prices.
So
what
is
our
bottom
line?
We
recognize
that
new
codes
assertions
throughout
its
applications
and
in
its
testimony
today
that
its
intention
is
to
provide
high
quality
care
at
a
lower
societal
cost,
and
we
applaud
these
intentions,
and
this,
as
I
said,
is
exactly
what
dr.
niece
Backman
spoke
of
and
if
they're
right,
it's
a
win-win
for
everyone,
but
if
they're
wrong,
they
win
and
we
the
Massachusetts
citizens
lose.
O
A
P
You
good
morning
councillors,
my
name
is
Elizabeth
L,
Daley
and
I'm,
a
lui
lead
researcher
for
1199,
SEIU,
united
healthcare
workers
east.
Thank
you
for
this
opportunity
to
offer
testimony
today
on
behalf
of
1199
SEIU
and
at
the
1199
SEIU
10th
at
Speyer
group
that
was
established
to
offer
public
comment
on
the
proposed
13
hospital
merger.
That
is
the
subject
of
today's
hearing.
As
you
may
know,
1199
SEIU
represents
more
than
56,000
individuals
employed
in
Massachusetts
hospitals
in
nursing
homes
and
who
provide
home
care
workers
at
what
is
now
beth.
P
Israel,
deaconess
plymouth
hospital
have
been
part
of
our
union
for
more
than
45
years.
We
are
for
this
testimony
today
on
behalf
of
those
b.I.g
plymouth
members
and
on
behalf
of
all
our
members,
as
both
frontline
caregivers
and
as
Massachusetts
consumers
of
health
care.
1199
SEIU
formed
our
ttg
in
September
of
2017.
After
the
merger
application
was
filed
with
the
determination
of
need
program
of
the
Department
of
Public
Health,
we
attended
all
three
of
the
DPH
public
hearings
on
the
and
submitted
written
comments.
P
1199
SEIU
acting
executive
vice
president
Tim
Foley
is
also
privileged
to
hold
a
seat
on
the
health
policy
Commission,
which
is
conducting
a
full
constant
market
impact
review
of
the
proposed
merger,
and
we
will
continue
to
weigh
in
on
this
issue
through
that
process,
like
others
here
today,
we're
very
concerned
about
rapidly
increasing
healthcare
costs.
Just
about
all
research
indicates
that
hospital
mergers
result
in
higher
prices
and
costs
for
consumers,
insurers,
the
state,
municipalities
and
other
payers.
P
We
remain
very
skeptical
that
the
conditions
imposed
on
this
merger
by
the
state
DPH
will
provide
adequate
protection
for
consumers.
Secondly,
we're
concerned
that
the
merged
entity
currently
being
referred
to
as
new
Co
will
result
in
a
loss
of
transparency
and
accountability
due
to
the
consolidated
filing
of
financial
documents.
Accordingly,
we
seek
a
requirement
that
the
merging
entity
file
provider
level
as
opposed
to
system
level
financial
reports
next
we're
very
concerned
about
the
health
of
community
hospitals.
That
will
be
impacted
by
that.
P
This
merger,
particularly
those
hospitals
on
the
Northshore
and
in
the
Merrimack
Valley
and
Boston's
disproportionate,
share
hospitals.
The
new
Co
entity
has
the
potential
to
draw
commercial
payments
away
from
competing
hospitals,
potentially
harming
these
competitors
enough
that
it
may
result
in
loss
of
services
and
lots
of
healthcare
access
for
their
patients
and
their
communities.
At
the
same
time,
we're
also
concerned
about
the
smallest
community
hospitals
involved
in
this
transaction.
We
know
from
experience
that
it's
often
the
smallest
and
weakest
hospitals
in
an
integrated
health
system
that
bear
the
brunt
of
service
cuts.
P
Finally,
we
remain
very
concerned
that
almost
no
structures
aren't
to
adequately
engage
the
thousands
of
staff
at
the
merging
hospitals
in
the
merger
transit
position
and
the
company
restructuring
at
b.I.g
Plymouth,
where
1199
SEIU
represents
more
than
1,000
workers
and
departments
across
the
hospital
and
the
mass
Nurses
Association
represents
our
ends.
The
Union
difference
is
clear
when
business
decisions
are
made
that
might
result
in
a
reorganization
or
reduction
in
staff,
workers
are
involved
in
seeking
appropriate
solutions
that
minimize
disruptions
in
care
when
workers
must
be
laid
off.
P
It
is
essential
that
workers
at
all
levels
of
an
organization
can
voice
concerns
about
best
practices,
for
patient
care
and
for
workplace
safety.
Workers
should
be
assured
of
an
orderly
and
fair
process
for
training
opportunities,
overtime,
pay
increases
promotions
and
or
for
any
reductions
and
staff.
New
job
descriptions,
staffing
allocations
or
work
expectations
should
be
developed
in
close
collaboration
with
the
entire
frontline
workforce.
Over
the
years
we
have
seen
too
many
instances
of
management
and
Hospital
human
resource
departments
protecting
the
company
and
not
the
workers
who
bring
the
problems
to
light.
P
1199
SEIU
cannot
support
the
proposed
without
some
formal
structures
and
processes
in
place
throughout
the
nico
nico
facilities
that
will
foster
a
true
culture
of
employee
engagement
and
support.
We
commend
the
Boston
City
Council
for
your
interest
in
the
proposed
merger
and
for
holding
this
important
public
hearing
today
to
hear
from
a
range
of
stakeholders
about
the
potential
impact
on
healthcare
in
the
city
of
Boston.
Thank
you
for
hearing
our
concerns
and
I'm
happy
to
answer
any
questions
you
might
have.
A
B
Thank
you
very
much.
Thank
you
very
much
for
taking
your
time
being
here
today,
quick
question,
I'm,
not
sure
who
can
answer
I'm,
guessing
Bonnie,
maybe
I'm
not
sure.
As
far
as
the
restrictions,
when
you
go
for
the
public
health
committee,
who
can
who
puts
those
restrictions
on,
can
they
add
that
of
subtract
that
to
the
merger
or
is
the
merger,
as
is
so.
O
The
department,
the
determination
of
need
determination
of
needs,
apartment
staff
reviews
the
application,
creates
the
report
that
includes
the
conditions
that
they
recommend
to
be
put
upon
the
merger
they
put
that
report
out
to
the
general
public
for
comments,
and
then
that
report
is
accepted
or
not
by
the
public
health
Council.
In
this
case,
it
was
amended
three
days
prior
to
the
vote
after
the
period
for
public
commentary
was
closed,
so
that
one
of
the
conditions
that
was
in
the
original
report
was
removed
and
a
different
condition
put
in
its
place.
O
O
O
C
Mine
workers
1199
the
mass
Nurses
Association
as
well
and
I,
know
you
both
do
tremendous
work
and
interacting
with
the
patients
you
were.
Are
you
afraid,
if
you
know
a
merger
takes
place,
that
some
of
that
hands-on
personal
contact
we
have
between
our
nurses
and
in
other
healthcare
people
will
lose
some
of
that
compassion.
We'll
lose
some
of
that
interaction
because
now
we're
dealing
with
the
bigger
company
and
that
may
not
be
focused
on
the
day-to-day
or
interaction
between
the
patient
and
the
provider.
C
P
I
think
there's
there's
tremendous
pressure
throughout
the
market
to
keep
costs
under
control
and
I.
Think
too
often
when
workers
don't
have
adequate
representation
or
a
voice
on
the
job
too
often
the
brunt
of
those
cost
controls
are
borne
by
the
frontline
caregivers
and
and
so
that
can
create
instances
where
patient
care
is
less
than
ideal.
C
N
So
sorry,
we
have
participated
and
we
were
part
of
the
whole
process
with
the
public
hearings
which
were
in
the
through
public
hearings
were
in
cluster
in
Cape
Anne
and
one
in
Roxbury,
both
health
up
by
5
p.m.
where
many
of
our
grassroot
members,
where
we're
coming
out
of
work
and
working
and
picking
up
their
kids.
So
that's
why
they're
here
today,
because
they
wanted
to
make
a
statement
that
you
know
they
want
to
be
part
of
the
conversation
you
may
have.
You
know
they
are
obviously
collaborating
with
other
organizations,
but
the
roots
themselves.
N
A
A
Gonna
call
if
there
are
folks
here
that
are
wishing
to
offer
public
testimony.
There
are
sign-up
sheets
over
there
and
to
my
left
to
everyone's
right,
but
we'll
start
with
Isabel
o
Connors
Santa
Rosa,
Auto
yeah.
It
looks
like
Antonia
all
right,
fireteam,
STS,
yeah,
standing
in
and
there's
there's
a
public
testimony
microphone
just
behind
the
woman
there
with
the
camera
and
again
in
order
of
how
you
arrived,
Isabella,
Connors,
Santa,
Rosa,
Rosado,
Artemis,
TS,.
Q
R
Q
Q
Q
Q
Q
Q
A
N
A
S
S
We
are
here
today
in
opposition
of
the
13
Hospital
merger
mega
merger.
As
a
student
as
in
health
in
a
healthcare
institution,
we
have
learned
a
lot
about
the
medical
field
and
how
hospitals
function,
and
we
believe
that
is
vital
to
stop
this
merger,
since
it
will
have
detrimental
effects
in
various
groups
in
the
community.
In
the
13
Hospital
Beth
Israel,
Leahy
merger.
It
would
have
numerous
adverse
effect
on
low-income
communities,
which
include,
but
are
not
limited
to
reduced
access
to
health
care,
lack
of
health
care
service,
an
increase
in
premium
for
medical
services.
S
S
Consequently,
people
would
be
forced
to
move
to
go
to
more
expensive
hospitals
in
the
in
Boston,
which
they
cannot
afford
to
the
rise
of
cost
and
lack
of
resources.
If
this
merger
goes
through,
Beth,
Israel
and
Leahy
would
control
more
than
30
percent
of
hospitals,
primary
care,
physician
visits
and
the
emergency
rooms
in
Massachusetts.
The
substitute
this
substantial
control
over
the
healthcare
industry
in
eastern
Massachusetts
will
reduce
will
result
in
a
reduction
of
competition
which
will
result
in
surges
and
prices.
S
This
is
proven
by
a
study
conducted
in
March
in
2016
by
researchers
in
Northeastern
University.
This
rise
in
price
could
be
due
to
monopolistic
behavior,
which
could
also
be
which
could
also
deteriorate
the
quality
of
the
hair
of
the
care
due
to
diseconomies
of
scale
a
large
number
of
low
income
families
would
be
forced
to
travel,
long
distance
and
pay
higher
prices
for
basic
ask
axe
access
to
health
care.
Additionally,
this
merger
would
eventually
drive
the
remaining
competitors
to
either
reduce
their
service
or
shut
down
completely.
S
If
this
merger
goes
through,
insurance
premiums
would
rise
through
the
due
to
the
consolidation
of
these
13
hospitals.
According
to
a
study
conducted
in
2015
by
the
America's
health
insurance
plans,
the
rise
of
consolidations
in
Ohio,
Missouri
and
Georgia
have
been
strongly
correlated
in
increased
monthly
premiums.
The
aftermath
of
the
merge
would
quite
possibly
until
this
dilemma
from
Massachusetts
as
well.
S
We
have
dedicated
our
future
to
help
save
and
improve
lives
of
others,
and
in
order
to
do
so,
everyone
should
have
equal
and
act
equal
access
to
affordable
and
efficient
health
care
instead
of
progressing
towards
this
fundamental
goal.
This
merge.
This
merger
would
take
health
care
several
steps
backwards
and
we
wouldn't
need
to
stand
against
this
together,
not
only
to
keep
a
balance
in
the
economy,
but
also
to
maintain
equality
and
healthcare
for
everyone's
benefit
and
equality
in
Massachusetts.
S
S
T
N
T
N
T
Mega
Fazio
Mesa
privada
los
hospital
attend
an
opportune
tendrán
el
poder,
a
saluto
demo
ver
a
nuestros
medicos
de
cabeza
de
loja
potala
comunitario,
para
centro,
Mesrine,
tabla,
esto,
sólo,
no
es
un
problema
logistic
o
enter
Meno
de
tranportation,
a
nuestros
nvj
siente
sino
también
para
los
las
personas
des
necesidades,
especi
ally,
sino,
también,
para
las
personas
y
y
tambien
para.
Lo,
lo
que
se
hace
humanitary
Ament
a
con
nuestro
doctores
que
son
tambien
otro
pro-v
doors.
T
N
Des
mega-mergers
moved
this
house
pros
who
t
absolute
power
of
market,
and
they
will
have
the
power
to
canalize
and
move
our
primary
care
providers
from
our
local
hospitals
to
centers
that
are
more
right.
The
higher
price
centers.
This
will
not
only
create
a
logistically
a
logistic
problem
in
terms
of
transportation
for
elderly
and
for
special
needs
individuals,
but
it
will
also
create
a.
N
N
N
N
U
U
As
you
know,
there's
over
60
members,
diverse
members
from
throughout
the
communities
and
I
just
wanted
to
talk
a
little
bit
more
about
our
efforts.
Unfortunately,
there
wasn't
enough
attention,
especially
media
attention
regarding
the
issue,
so
we
actually
held
our
own
mini
roundtable
discussions
throughout
Jamaica
Plain.
It's
a
kind
of
inform
because
we're
all
community
activists
like
within
our
own
communities,
so
we
informed
our
own
community
because,
unfortunately,
there
wasn't
enough
attention
around
it.
U
So
most
of
our
the
narratives
that
we've
heard
the
folks
had
expressed
that
the
impact
regarding
the
merger
and
how
much
basically
how
much
it
would
have
impact
their
daily
lives
and
eventually
take
control
of
their
finances.
Their
personal,
like
daily
lives
such
as
lions,
add
a
little
bit
about
that,
because
I
know
that
had
noise
spoke
about
it
because,
unfortunately
they
were
folks
in
the
community
couldn't
attend
the
public
hearings
because
there
were
a
five
o'clock
also
they
didn't
have
the
language
capacities.
So
I
just
wanted
to
add
that
as
well.
Okay,.
U
Unfortunately,
one
of
our
coalition
members-
he
couldn't
make
it
today,
so
he
did
for
us
to
submit
a
testimony
on
his
behalf.
His
name
is
Christopher,
noble,
he's,
also
a
student
and
so
I'm,
just
gonna
read
it
I'm
gonna
try
to
go
as
quickly
as
I
can
the
Massachusetts
state
legislature
legislature
approved
the
budget
last
summer
that
included
16
billion
a
year
to
cover
the
1.9
million
MassHealth
recipients
will
depend
on
this
program
to
live.
U
Massachusetts
does
not
need
another
partners,
health
care.
What
Massachusetts
needs
is
a
single-payer
health
system.
Last
December
the
Massachusetts
Tate
Senate,
approved
the
healthcare
cost
containment
bill
that
included
a
benchmarking
bill.
That
would
lay
the
groundwork
for
enacting
a
single-payer
health
system
and
for
this
new
system,
if
it
proves
it,
would
prove
more
cost-effective
and
that
what
the
state
the
state
would
be
paying
it
currently.
A
B
You
very
much
I
mr.
chair
and
thank
you
everybody
for
being
here
for
both
panels,
as
well
as
people
who
spoke
after
I
think
the
goal
as
I
stated
at
the
beginning
of
this
hearing
was
to
be
educated,
and
this
certainly
was
a
forum
for
that.
I
want
to
thank
my
co-sponsor
at
Flint
for
helping
put
this
together
and
we'll
report
this
out
tomorrow
and
I.
B
Think
that
as
I
see
it
it's
great
for
every
city,
councillor
all
13
of
us
to
review
the
if
they
weren't
here,
they
had
an
opportunity
to
ask
questions
better,
educate
themselves
on
how
they
wish
to
proceed,
as
we
also
stayed
at
the
beginning.
This
isn't
a
city
council
matter,
but
this
was
an
educational
forum
and
I
appreciate
everybody
who
took
their
time
today
to
help
us
come
to
conclusion.
So
thank
you
very
much.
Kathy
all.
C
You,
council,
fire
T
and
thank
you,
council
McCarthy,
for
both
of
you
for
your
strong
leadership
on
this
issue.
Council
McCarthy.
This
was
a
great
opportunity
for
the
councillors
to
learn
more
about
how
this
merger
would
impact
residents
across
Boston.
So
we
want
to
say
thank
you
to
you
for
your
hard
work
and
bringing
us
together.
I,
don't
pretend
to
be
an
expert
on
this
issue,
but
it
was
very
informative
and
I
learned
a
lot
during
this
hearing.
C
I
want
to
thank
everybody
for
testifying
and
I
want
to
thank
the
experts
for
educating
us,
but,
more
importantly,
I
wanted
to
thank
the
the
people
here
from
South
Boston
accion
for
being
here
and
for
speaking
about
what
impact
this
really
would
have
on
the
poor.
The
needy,
low-income
families,
the
elderly,
the
disabled,
so
I
just
want
to
say
thank
you
for
being
here
today
and
we
have
great
respect
and
admiration
for
you.
Thank
you.
Thank.
A
There's
a
diverse
diversity
of
opinions
here
with
respect
to
this
merges
so
well,
well,
first,
obviously
from
multiple
sides
and
at
the
same
time
we'll
have
a
committee
report
and
move
this
out
of
committee
for
Wednesday,
so
without
further
adieu,
with
respect
to
docket
0
3a
to
order
free
hearing
regarding
the
proposed
13
Hospital
merger
of
care,
Group
Incorporated
parent
company
of
Beth
Israel
Deaconess,
Medical,
Center
and
Lahey
Health
Systems,
the
Committee
on
government
operations
is
adjourned.
Thank
you.