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"What the Public Needs to Know About Health Care Reform" by James Roosevelt, Jr.

Today is the first day that an individual in Massachusetts can purchase a new Connector approved health plan. It is a date that came quickly. The bottom line to the successful implementation of health care reform is education. An understanding of health care reform and its implications needs to be fostered as there are individual consequences.

Educating the public about a major change in public policy is not an easy feat. While Nancy Turnbull made me laugh with her suggestions for “seals of approval,” she is on to something. Many reports and my own conversations confirm that many are unaware of the individual mandate to purchase insurance. While the issue of affordability has prevented some from accessing coverage, persuading those that make a deliberate choice not to purchase coverage presents an additional challenge beyond simple education. We – meaning all of us in health care – need to engage the public and ensure that the individuals and families who will now be able to purchase health insurance understand their coverage options, the benefits and the costs of that coverage.

Our history in the United States of providing social safety nets, which dates from colonial times, has shown that these programs evolve as times change and start with a massive need for information. In 1938, the Woolworth Company used a sample social security card to demonstrate how a card would fit in one of their wallets.

More than 40,000 people reported that sample number as their personal number with 12 people reporting the sample number as their number as late as 1977. The public had to learn that Social Security numbers are individual.

What do residents of the Commonwealth need to know right now?

 They must be enrolled in a health insurance plan by July 1, 2007 or face financial consequences.

 Their health coverage, whether provided by an employer or purchased individually, must meet requirements for a minimum level of coverage as established by the Commonwealth’s Connector agency.

 This massive and welcome expansion of public policy to provide health care coverage for all has a price tag that is financed by all purchasers and taxpayers.

The first point is easy to understand and should be the groundswell message that spreads across this state. Every resident must be enrolled in a health care coverage plan by July 1 or lose a tax deduction in 2007. In 2008, they will pay a greater penalty for not being enrolled. By my estimation, that could amount to an annual payment of $1500 or more.

The goal of health care reform is to ensure that all residents of the Commonwealth have protection in the form of health insurance. They have a wide variety of options and should investigate the benefits, cost and quality of their health care. I am hopeful that the state will adopt standard measures of health care quality so that individuals can more easily evaluate their health care options.

Health care reform legislation does not address the fundamental issue of increasing health care costs. Therefore, providers as well as health plans must be creative in delivering solutions. Doctors and health plans must use evidence-based medicine, the latest science available, to standardize care. This will help improve quality and eliminate unexplained variations in who receives which treatment and when. Individuals must know their medical history, their treatment options and where they can receive high quality care with the greatest efficiency. The art and science of medicine must be called upon in full measure so that the habit of using the most expensive treatments as the first line of care does not cripple this grand, historic effort.

This week, the Commonwealth’s Connector will begin a campaign to inform the public about the options and obligation for health care coverage. I challenge us all to learn, and to communicate throughout this process. The success of this reform depends on it.

James Roosevelt, Jr. is President and CEO of Tufts Health Plan

This program aired on May 1, 2007. The audio for this program is not available.

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