HEALTH REFORM GIVES MEANING TO THE CONCEPT OF COMMONWEALTH by Richard T. Moore

Our state – this Commonwealth – is founded upon one of the great themes of religious faith – the responsibility to care for each other and for those less fortunate. The very meaning of the term “commonwealth” reflects a concern and caring for the public good – a covenant among members of the community for the welfare of the least among us.

In his noteworthy sermon aboard the Arbella entitled, “A Modell of Christian Charity,” our first Governor – John Winthrop – admonished the first citizens of the Province of Massachusetts Bay with a clear statement of our civic responsibility as a reflection of our actions as people of faith. No document better exemplifies the spirit behind the Puritan migration to the New World, effectively summarizing the goals of these first American Puritans.

Winthrop said that “to do justly, to love mercy, to walk humbly with our God,… we must be knit together in this work [of building a new society] as one man, we must entertain each other in brotherly affection, we must be willing to abridge ourselves of our superfluities for the supply of others' necessities, we must uphold a familiar commerce together in all meekness, gentleness, patience, and liberality, we must delight in each other, make others' conditions our own, rejoice together, mourn together, labor and suffer together, always having before our eyes our commission and community in the work, our community as members of the same body.”

A Modell of Christian Charity, 1630

In his sermon, Governor Winthrop laid out the fundamental principles of a community and of a commonwealth, explaining that others in succeeding generations would judge us by how well we made others’ conditions our own, and they will point to Massachusetts as an example of either success or failure in that regard. In an analogy loved by both President John F. Kennedy and President Ronald Reagan, Winthrop proclaimed: “For we must consider that we shall be as a city upon a hill, the eyes of all people are upon us.”

One hundred and fifty years after Winthrop’s sermon, in drafting the preamble of the Constitution for the new Commonwealth of Massachusetts, John Adams did not sit down and invent a covenant out of the depths of his mind. He built upon Winthrop’s concept of a covenant of community with these words:

“The body politic is formed by a voluntary association of individuals: it is a social compact, by which the whole people covenants with each citizen, and each citizen with the whole people, that all shall be governed by certain laws for the common good. It is the duty of the people, therefore, in framing a constitution of government, to provide for an equitable mode of making laws, as well as for an impartial interpretation, and a faithful execution of them; that every man may, at all times, find his security in them.

“We, therefore, the people of Massachusetts, acknowledging, with grateful hearts, the goodness of the great Legislator of the universe, in affording us, in the course of His providence, an opportunity, deliberately and peaceably, without fraud, violence or surprise, of entering into an original, explicit, and solemn compact with each other; and of forming a new constitution of civil government, for ourselves and posterity;…”

Preamble to the Constitution of the Commonwealth of Massachusetts, 1780.

In these two founding documents – Winthrop’s “City on a Hill” sermon, and Adams’ Massachusetts constitution, we are called to make the wants and needs of our fellow citizens our shared responsibility as Winthrop noted; and we are bound together by a solemn social compact for the common good on which Adams based our foundation as a Massachusetts commonwealth. We are, in essence, called to help all in our society through the caring of a supportive community. Furthermore, it should come as no great surprise that Massachusetts and its citizens have played a prominent role in the history of America, in the expansion of human liberty, human rights, civil rights, women’s rights and the alleviation of human suffering?

As President John F. Kennedy, addressing the Massachusetts Legislature in 1961 prior to his inauguration, said of Massachusetts: “Its leaders have shaped our destiny long before the great republic was born. Its principles have guided our footsteps in times of crisis as well as in times of calm. Its democratic institutions--have served as beacon lights for other nations as well as our sister states.”

One of those more recent beacon lights, in my opinion is our Commonwealth’s historic leadership in health care. In our time, the landmark Massachusetts Health Reform Law, enacted in 2006, establishes a framework to make health insurance accessible and affordable to every resident of the Commonwealth. Indeed, Massachusetts has already crossed a threshold that has eluded presidents, governors, and other political leaders in the United States for generations by becoming the first state to require and provide universal health care coverage.

There is growing anecdotal evidence that our health reform program is improving the lives of many of our fellow citizens and, in some cases, is even saving some lives. At the second anniversary of the passage of the health reform law, Reverend Hurmon Hamilton, a leader of the Greater Boston Interfaith Organization, told a story of a woman who came to him complaining about a chronic sore throat and the lack of money to see a doctor for treatment. He told her about the new health insurance program and helped her to sign up. When she went to a doctor about her sore throat, she learned that it was actually the early stages of throat cancer, for which she was later successfully treated. She said that “the new health insurance program saved her life.” We’ve heard similar stories among the 370,000 Massachusetts residents who now have health care who, only a year ago, were among the uninsured.

Every state is watching the ongoing efforts in Massachusetts to make this health reform program succeed. Will we have the will to continue? If we do, will we, as Winthrop wrote, “be willing to abridge ourselves of our superfluities for the supply of others' necessities?” In other words, are we willing to sacrifice our time and treasure to make health reform work so that everyone has access to care?

We understand, of course, that if health care is to be accessible to all, it must also be affordable to all. Furthermore, it must be of a quality and safety that makes it a goal worth the sacrifice, and there must be easy access to primary care providers.

Last month, the Massachusetts Senate endorsed a second phase of health reform in the form of a comprehensive Quality Improvement and Cost Containment bill, sponsored by Senate President Therese Murray and many of our Senate colleagues, which will, if passed by the House of Representatives and signed by Governor Patrick, go a long way to helping all of our Massachusetts residents find affordable, high quality health care.

Our plan is to:

· Improve Access to Primary Care Services;

· Enhance Transparency of Health Care Costs and Quality;

· Encourage the Modernization of the Health Care Delivery System;

· Promote the Efficient Use of Health Care Resources; and

· Empower Patients and their Families in Health Care Decision-making.

Our journey to ensure that everyone has access to safe, high quality, affordable health care is an evolving story, a work in progress. As we, sometimes, stumble in our personal lives, we will certainly stumble in the effort to offer health care to all. However, we will continue to pick ourselves up and keep working toward our ultimate goal.

Senator Richard T. Moore
Senate chair of the Joint Committee on Health Care Financing