As I often remind people, health care is not just a necessity of modern life and the most personal and emotional of all services; at 16 percent of GDP, it is also the single largest sector of our economy. In Massachusetts, it is $60 billion a year and growing. So, you do not want to reform the financing of health care on a 51-to-49 vote.
Fortunately, the leadership of an overwhelmingly Democratic legislature worked with Republican administrations (in Massachusetts and D.C.), using the good ideas generated by academics and leaders in the private sector, to fashion a consensus for reform. It took nearly three years from the initiation of public discussion of achieving universal coverage and building coalitions to the spring of 2006, when every Senator and nearly every Representative voted for Chapter 58.
That was time well spent, not only to develop broad support for enacting Reform, but to build a base for implementing it. From the outset, we’ve said it will take another three years and the support of a broad coalition to fully implement Reform. Halfway through, we are celebrating the enrollment of some 300,000 newly insured. This is a worthy achievement, and I want to talk about how we got this far.
Commercial health insurance is what’s called a “grudge buy.”
Nobody brags about their health policy, or even bothers to read it before they absolutely need to. Moreover, many of those without health insurance are hard to reach: they may be reasonably well-informed, but convinced that they do not need coverage; or more comfortable accessing a nearby health center or E. R. through the free care pool than signing onto a complicated insurance scheme; or they may swim outside the mainstream of media and community involvement. It has taken a sustained civic campaign to find the uninsured, to inform them, and to motivate them to enroll.
The credit for this campaign goes to so many people and organizations throughout Massachusetts, who have worked as part of a concerted outreach effort. Space will not accommodate a full listing, but it is important to recognize just how broad is the commitment.
Of course, advocacy organizations, such as Health Care for All and the Greater Boston Inter-Faith Organization, have led the way, informing their communities and putting on their own events. GBIO held over 65 outreach events this year. The participants in this outreach effort also include the major “players” in the health care world, who often find themselves on opposing sides on legislation and at the negotiating table – hospitals, health workers’ unions, physicians, health centers and health plans. And legions of lawyers, accountants, consultants & brokers have deciphered the laws and regulations, so that they can help the state’s 193,000 employers figure out what they need to do.
Organizations not normally steeped in health care jargon have “stepped to the plate” as well. Of course, the Red Sox leant their prestige and active support. Many employer groups have reached out as well: Associated Industries of Massachusetts, the Mass. Business Roundtable, Boston Chamber of Commerce, & the Mass. Retailers’ Assn., to name just a few. A half dozen other retail chains and businesses have donated promotional space and/or actual advertising, which not only extends the reach of the Connector’s own campaign, but conveys a sense that this is a communitywide civic campaign.
I discovered an interesting side-benefit of this campaign for health insurance, while attending a recent outreach event at the Pittsfield public library: an outreach worker from Berkshire Medical Center told me that, in the process of enrolling some 10,000 people in Commonwealth Care, they also found folks in need of fuel assistance and Women, Infants & Children (WIC) program benefits. As a result, applicants for these latter two programs were running 15-20 percent above normal for the season.
The extraordinary cooperation required to enact Reform has been matched by very broad participation in outreach. As we continue outreach, but now add the challenge of keeping health care affordable, that commitment of the health care community is all the more needed.
On behalf of the Board and the staff of the Health Connector, I want thank so many people who have led the way to Healthcare Reform in Massachusetts.
Commonwealth Health Insurance Connector Authority
This program aired on December 28, 2007. The audio for this program is not available.