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Steve Winter
State Representative District 3

March  6, 2012
"Specialty Hospitals "

Steven Winter represents the towns of Newbury and Sutton, Merrimack District 3, in the NH House of Representatives.

Representative Winter is a member of the House Executive Department & Administration  Committee, The Special Committee on Public Employee Pension Reform and the Joint Legislative Committee on Administrative Rules (JLCAR).


"…(I)t creates jobs and gives society another organization dedicated to treating cancer,"
 – from a message from the House Majority Leader.

On Saturday, February 18th, I received a message from the House Majority Leader, Rep, D.J. Bettencourt. The message was regarding House Bill 1642 and it was sent to all Republicans in the NH House.

HB 1642 is sponsored by Rep. Marilinda Garcia, a Republican from Salem. It has been co-sponsored by D.J. Bettencourt; the House Speaker, Bill O’Brien; the Chairman of Ways and Means Committee, Rep. Steve Stepanek and various other members of leadership.

The purpose of HB 1642 is a proposal to waive the requirement for a Certificate of Need for an out-of-state hospital corporation so that it could begin specialized hospital and clinical services in New Hampshire without going through that rigid Certificate of Need procedure. HB 1642 would allow this and perhaps other such "destination specialty hospitals and clinics", also called niche or boutique providers, to set up shop(s) in New Hampshire, thus providing jobs and additional tax revenue. It sounds like a win-win arrangement.

I am a member of a nearly unprecedented five committees (plus various subcommittees) in the NH House. I am not a member of leadership since I am technically a freshman. But I have seniority and my share of respect as a returning member. I have occasionally gone against the "official" leadership position in the past because I represent my constituents and my principles and I have some contrary thoughts about this bill. So I wrote this response to the Majority Leader:

D.J. – As much as I support increasing business enterprises, the growth of jobs, and an abundance of choices, I am not in favor of this bill.  I believe in competition but I feel that government regulation should present a level playing field to all entrepreneurs.  When we exempt businesses from regulations required of all other businesses, we create "winners" and "losers".  This is the very process for which we condemn the Obama administration.

Rep. Garcia’s statement says, "Locating these centers in our state will help develop the economy, create jobs and make our great state of New Hampshire a magnet for those seeking high-quality, specialized health care."  While that may be true, what does it do to the many fine hospitals, some with excellent specialty care, already in place?

I am not a great fan of the Certificate of Need process.  But it’s what we have.  Our current hospitals have certain obligations that emanate from the CON process.  A major responsibility is that they serve all who pass through their doors.  A waiver of the CON would tilt the playing field in favor of these "destination specialty hospitals and clinics" and allow niche providers to take private insurance patients and leave greater numbers of uninsured and Medicaid patients to be served at community hospitals.  A few other words for that are "skimming" and "cherry picking."

That does not appear to be a good tradeoff to me, D.J.  I cannot support HB 1642 bill as written.

Best regards, Steve Winter


Steve Winter, Representative, Merrimack District 3
Newbury and Sutton, New Hampshire 

Telephone:  603-271- 3125 and 271-3319


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