"What a Difference a Day Makes" by Dolores Mitchell

This article is more than 14 years old.

This morning we all heard--and read--the very good news that a real breakthrough has occurred in the drive for affordable health care for all, achieved by the collective efforts of the governor, the Connector staff and Massachusetts" health plans themselves.

They seem to have succeeded in getting their premiums down to more affordable levels than their first offerings, and without gutting the benefit packages. We Connector Authority members will take a look at the details before our meeting on Thursday, but it looks as though we have at least, and at last, reached a base camp on our way to the top of the mountain. Now, on to the next level.

And a second entry from Dolores Mitchell about serving on the board of the Health Insurance Connector Authority...

There’s a lot being written about the decisions the new Connector Authority is struggling with, but not much about the process itself. It may seem a bit self-serving to say so, since I am a board member, but I think the enterprise and its success to date merits at least a small pat on the back. A small group of people, most of whom had never even met one another before they began to put together a comprehensive health plan and to put it into operation in less than a year, had to start from the very basics — understanding the law they were supposed to implement, adopting By-Laws, putting together a staff, writing and adopting regulations, putting together bid documents, figuring out how to reach the people who were eligible for the first, subsidized set of plans, choosing those plans, signing up the enrollees, discovering where each of us board members stood on the controversial issues, and how we might resolve them. Add to that, the fact that with an election smack dab in the middle of the start up we knew that some of the players would be replaced in January. It’s been something like trying to sprint up Mt. Kilimanjaro in 20 minutes.
Most new governmental enterprises at least begin with a history. There are new players all the time, but the basic structures, procedures, rules and traditions are already in place. The new people may plan or decide once they’re there, how they want to change things, but they usually don’t have to build from scratch. That’s what the Connector Authority had to do — and is doing. In my day job, I select health plans, try to communicate with about the same number of people the Connector is trying to reach, but at least I know who they are and how to reach them. Most of them are used to having health insurance. They already know the lingo, and how the system works. I am also making changes — trying to keep ahead of a rapidly changing health care environment, but at least it’s on a structure that’s already in place. Even so, it’s a tall order — one that keeps me hopping. The Connector’s staff has a much harder environment and a much tougher challenge — and the eyes of the nation are on them, watching to see if Massachusetts can pull it off. The most frequently asked question I get from colleagues is — “are you going to succeed?” I always say, “of course”, but I also always keep my fingers crossed as I say it.
The open meeting laws of the Commonwealth make the whole endeavor even more complex. Open government is a very good thing, but the process of having a group of relative strangers get to know one another, develop a group culture, learn one another’s points of view, style as well as substance, in front of an audience, is sometimes inhibiting to full and frank discussion. We’ll probably loosen up over time, but time is the one thing we don’t have much of right now, so saying what we mean and meaning what we say doesn’t always come easily.
So, before any further commentary from this new blogger on more substantive matters, I thought it was worthwhile to comment on the process itself, and maybe even compliment my fellow board members and the staff for the hours and hours and hours and hours they have devoted to this exciting, exhilarating and exhausting enterprise. Being present at the creation is pretty exciting, but actually being part of it is even more so.
So to you blog readers, I’ll just say — hang in there with us, give us your ideas, your criticisms, and maybe just a little support. We’d appreciate it.

Dolores L. Mitchell, Executive Director of the Group Insurance Commission of the Commonwealth of Massachusetts, the agency that provides life, health, disability and dental and vision services to 265,000 State employees, retirees and their dependents.

This program aired on March 4, 2007. The audio for this program is not available.