This article is more than 13 years old.

Frequent visitors to this space have read all of the gloomy predictions recently about health reform. Both the media and health care pundits in Massachusetts (and even around the nation) have started to ring the death knell on reform and are crying that the sky is falling.

But wait a minute.

Now is not the time to lose focus of what it is we that we set out to accomplish nearly two years ago. Did anyone really think that there would be no challenges along the way? No obstacles to success? Of course not.

For those who have started to lose hope that reform can succeed, there is some very encouraging news. Today, for the first time, Massachusetts hospitals are releasing a report analyzing the impact that reform, the virtual gateway, and other coverage initiatives have had on free care demand. The report, and the data included within the report, offer a startling glimpse at how well reform is working. Consider this: during the past three years, we have witnessed a 28 percent increase in coverage through Medicaid and Connector products. What has happened to free care demand during the exact same three-year period? An identical 28 percent decrease. Yes, one of the central tenets of reform, that we can move people out of the pool and into insurance, appears to be very sound.

Now, no one is suggesting that this report alleviates all of the concerns about reform or indicates that we do not have many issues to address. Are there more uninsured than we initially thought? Perhaps. Does much more need to be done to address health care cost? Absolutely.

And there are inconsistencies across the state. Our report indicates that some regions have experienced slight increases in free care, while other regions have experienced dramatic drop-offs. Experience also varies widely by hospital type. But when a global, long-term view is applied, we are succeeding. To know that, as a Commonwealth, we are moving people out of last-ditch, safety net programs and into comprehensive health plans at an even and consistent rate is cause for optimism.

Finally, let’s talk about value. Many are quick to point the finger at cost overruns and declare reform dead. What about the value we are receiving for our money? What about the lives we are changing as we provide families with comprehensive health plans, who have never had the type of security and comfort that comes with knowing that their children are covered? What about the long-term cost savings that could come with a new generation of Massachusetts residents managing their chronic disease and getting the preventive care and screenings they need?

I can’t take credit as one of the founding architects of this historic law, having arrived in Massachusetts just this past summer. But I can tell you that in my 30 years in health care – both at a state and national level – I have never witnessed an initiative that has commanded such a strong commitment from such a broad range of constituencies and interest groups – advocates, providers, business, and government.

Let’s not lose sight of why we started this thing in the first place.

Lynn Nicholas, FACHE is the President & CEO of the Massachusetts Hospital Association. To download a copy of the report in its entirety, visit

This program aired on February 13, 2008. The audio for this program is not available.