In reference to your article “Municipal Meltdown” (CW, Fall ’07), I would like to set the record straight. You stated that the Professional Firefighters of Massachusetts “opposed” the GIC law [allowing municipalities to join the state’s Group Insurance Commission as an alternative to negotiating health insurance coverage with local public-employee unions]. I take exception to your statement, and you certainly did not research your claim. The Professional Firefighters of Massachusetts was an active participant with the Municipal Finance Task Force, and for over 18 months we worked diligently to reach consensus.

Last June 25, I sent a communication to the House Chairman of the Joint Committee on Public Service stating that “firefighters do not oppose the concept of municipalities purchasing health insurance plans through the GIC. Our final concern was to add an amendment to establish a safety net and safeguard to protect the future quality of proposed health insurance plans.” If that amendment had been accepted by the Legislature, the bill would have had our full support.

Municipal employees and retirees are not responsible for a “municipal meltdown,” nor are they responsible for the increases in the cost of health insurance, and they should not be expected to bear the full brunt of increases in premiums, co-payments, and deductibles. It should be noted that employees and participants negotiated with municipal management in good faith over many years and have received [minimal] salary increases in order to retain affordable, quality health insurance. Municipal employees, retirees, and survivors of participants should not be punished for actions not under their control.

It is time for all the stakeholders to address the annual double-digit increases for health insurance and not just offer inferior plans with higher premiums, co-pays, and deductibles. Nobody wins with that solution.

Bob McCarthy
Professional Firefighters of Massachusetts


Dan Kennedy does an excellent job explaining how the relationship between young people and the news media today is damaged (“Plugged In, Tuned Out”). I wholeheartedly agree that increasing participation among young people in the creation, consumption, and distribution of news is a key to the survival of the industry, as well as our democracy. And I share his belief that a dramatic shift in how the news industry operates has the potential to spawn larger changes in our society. As he writes, “the ongoing reinvention of the media that’s being driven by the Internet could lead to a better, more democratic, more decentralized way of staying informed.”

At the same time, I am concerned about how folks in the news media are responding to this trend, and this is reflected in the practices that Kennedy highlights in his article. Organizations—and the news media in particular—too often look at technology as the solution to their problems. But when it comes to communicating with an ever-evolving audience, today’s news organizations have more than enough tools to get the job done: blogs, podcasts, social networks, and much more. Yet they are still struggling to stay focused and execute their ideas, find a connection, and stem the decline in news consumption.

Consumer-generated content is the newest, hottest trend, but the media’s obsession with it is just another symptom of “Shiny Object Syndrome” —a terrible affliction that results in a marketing path based on whatever is generating the most buzz of the moment, instead of what will truly be effective. Consumer-generated content has been seriously compartmentalized and has become simply a novelty addition to existing [news] operations, not an accepted component of the business model. I believe that as long as organizations focus on the distribution mechanism (as the news industry seems to always do), they’re missing a core element: the information and experience that audiences value. If, or when, the news media focus on creating more thoughtful, engaging, relevant information and experiences, young people will re-engage.

Brian Reich
Director of new media
Cone Inc.


I’ve long thought that the newspaper industry has a responsibility to get involved in schools. If every publisher would sponsor one or two classes in their community, it would open the eyes of so many young people to what newspapers have to offer. Information is addictive, compelling and enriches our lives. We need to pass this passion on to our children.

My mother is in her 70s. She reads the paper daily. Her father, who had very little formal education, also read the paper daily and that left an impression on her.

Putting a passionate journalist in every school would turn this industry around in five years!

Karen Everett Watson
Galt, California


Thank you for highlighting some of the factors contributing to the rising cost of health care in Massachusetts (“Cost Unconscious,” Summer ’07). For health care reform to truly work, it is imperative that we identify areas where we can control escalating costs —and then take action so that premiums do not continue to take bigger and bigger chunks out of employees’ paychecks and employers’ budgets. To that end, I have introduced legislation that is quite simple: It requires the use of standard, nationally recognized procedural and diagnostic codes. Although this idea was not mentioned in the article, acute care hospitals in Massachusetts have estimated it would save $20 million in the first year of its implementation alone. Add doctors and other health care providers, and even greater savings will be realized.

How many of us have undergone a medical procedure we know is covered by our insurance plan, only to get a bill in the mail telling us that coverage was rejected? You make calls, more bills are sent, and finally the bill gets paid by the insurance company or you pay it yourself to avoid further frustration. This scenario is often the result of each insurance company requiring hospitals, doctors and other health care providers to follow their own customized version of coding and billing, which routinely results in miscoding. This is precisely the type of situation Senate Bill 697 seeks to ameliorate, without infringing on any rate of payment or contract.

Currently, nearly one-third of all dollars spent on health care go toward administrative costs, as hospitals and providers must hire additional staff to puzzle out which combination of codes to use to describe a given medical procedure, depending on the patient’s insurance plan. Without this layer of bureaucratic expense, hospitals, doctors and health care providers can focus on what they do best: making people well.

Standardized and uniform coding procedures have perhaps an even more important benefit to the Commonwealth—the ability to collect accurate and consistent data on which diseases and chronic health problems are prevalent, where they may be concentrated, and when they occur. The Health Care Quality and Cost Council’s mandated goals of transparency and accurate reporting of health data across the state will continue to be hindered as long as hospitals and providers must track, bill, and report using the current system of inconsistent, customized procedural and diagnostic coding. Accurate and consistent reporting is not only a mandate. It is a necessity if we are to make the best use of scarce resources and have sound public health policies for our residents.

I was proud to be a part of the historic health care reform movement in Massachusetts. Like so many of the people you interviewed for your story, I too worry about its long-term success in the face of spiraling costs. As you noted, there are many reasons health care costs keep going up. However, implementing true standardized coding is one fix that would result in better health care policy and save all of us money. It is an idea that is long overdue.

Karen E. Spilka
State Senator
2nd Middlesex & Norfolk District