From the Editor: In the Eye of the Storm

Dan Maffei is the first Democrat to represent upstate New York’s 25th Congressional District in two generations.

That makes him a cautious, middle-of-the-roader from a swing district as he approaches the most contentious political decision of his young congressional career—whether or how to reform the nation’s broken health care system.

And he’s swamped. Before a vote has been cast, he has received 1,700 letters, phone calls and e-mails full of advice. Like all of his Capitol Hill colleagues, Maffei has been cajoled, lectured and feted by special interests: Drug companies, doctors, hospitals, labor unions and other stakeholders, including AARP, have already spent $126 million on lobbying this year.

For Maffei, who turns 41 on July 4, making his way through this maze starts at home.

His district includes Syracuse and a portion of Rochester, with rolling farmland in between. In his words, “It’s a hospital district”—four regional hospitals, a rural hospital and a Veterans Affairs hospital. That makes the health industry a major employer, and it has given Maffei firsthand accounts—from physicians, hospital officials and their employees.

Since he took office, the message from constituents has been consistent: “Costs are out of control,” Maffei said. “Patients can’t afford this. Our hospitals are just reeling. We’re having a heck of a time recruiting primary care physicians.”

His constituents’ advice, he says, emphasizes the two extremes—either implement a single-payer, government-run system or leave the best health care system in the world alone (and don’t raise taxes!). “The truth is,” Maffei said, “that it’s not the best health care system in the world. We are paying more for less care, for less healthy people, and with lower life expectancy.”

Maffei is part of a group of moderate Democrats generally sympathetic to business. But he said he is influenced more by what he knows best. His wife had to battle her insurance company over treatment for a kidney infection three years ago. The issue was not whether the treatment was covered. It was. But she had not called the company’s 800 number for preapproval. The company denied her claim, then hired a private investigator during an extended appeals process. Eventually, she won her appeal, but not before Maffei became convinced that there were layers of administrative waste in the system. “That crystallized the whole thing,” he said.

Sometime in the next few months, he and his House colleagues likely will vote on a comprehensive overhaul of the nation’s health care system. His preoccupation at the moment is the cost of the overhaul, especially plans to trim Medicare—“that would be a problem in my district”—and financing the fixes by ending longtime tax benefits.

“We need a bipartisan, lasting health care reform,” Maffei said. “Otherwise, if it’s not bipartisan, it’ll just be ripped up in a few years, and we’ll have to do it again.”

Indeed. A “bipartisan, lasting health care reform” is in the national interest. “Otherwise” is not. 

Jim Toedtman is editor and vice president of AARP Bulletin.