December 8, 2009

The Honorable Mark Begich The Honorable Jeff Merkley

The Honorable Michael Bennet
The Honorable Roland Burris
The Honorable Kay Hagan
The Honorable Ted Kaufman
The Honorable Paul Kirk
The Honorable Jeanne Shaheen
The Honorable Mark Udall
The Honorable Tom Udall
The Honorable Mark Warner

United States Senate

Washington, DC 20510

Dear Senators,

Health care reform must not only ensure quality, affordable health insurance for
all, it also must tackle our system’s ever-rising costs. In addition, legislation must
make clear that poor-quality, unorganized, and inefficient care will no longer be
rewarded. Make no mistake: business as usual in our health system must change.

For these reasons, we extend our support today for your package of amendments.
The Patient Protection and Affordable Care Act takes many significant steps
toward a more sustainable health system. We believe your proposals improve
that legislation by:

• Strengthening payment reforms in the Medicare and Medicaid programs

• Expanding the scope of reforms to focus on both the public and private
sectors
• Reducing legal and administrative barriers to high-quality, coordinated
care

Indeed, your package of amendments reflects closely many proposals included in

our recent whitepaper, “Realigning U.S. Health Care Incentives to Better Serve
Patients and Taxpayers.”

To be successful and sustainable, health care reform must begin to slow the rate
of health care cost growth. This package of amendments brings us closer to that
goal by enhancing the Patient Protection and Affordable Care Act’s ability to
incentivize higher-quality, lower-cost care.

A higher-quality, more efficient health system is eminently feasible. We have to

look no further than our own backyards to prove it is possible. As health care
leaders, it is our duty and responsibility to ensure the promise of affordable
health insurance comes with a guarantee that care will be high-quality,
coordinated, and safe. We applaud your leadership, share your goals, and offer
our support. We urge our colleagues to do the same.

Sincerely,

Scott Armstrong, President and CEO, Group Health Cooperative

Bruce Bodaken, President, Chairman, and CEO, Blue Shield of California
Lloyd Dean, President and CEO, Catholic Healthcare West
Kenneth C. Frazier, President, Global Human Health, Merck & Co., Inc.
Dr. Patricia A. Gabow, CEO, Denver Health
Dr. Gary Kaplan, Chairman and CEO, Virginia Mason Medical Center
Donna Katen-Bahensky, President and CEO, University of Wisconsin Hospital and Clinics
Anthony R. Tersigni, President and CEO, Ascension Health
Dr. Nicholas Wolter, CEO, Billings Clinic

Cc: Senator Harry Reid

Senator Max Baucus
Senator Chris Dodd
Senator Tom Harkin

Health CEOs for Health Reform (HC4HR) is a diverse coalition of health care leaders who share a unique willingness to
transform their business models to create a more sustainable health system. HC4HR members are facilitated by the
New America Foundation. There is no fee for HC4HR membership.