Living In A Health Care Laboratory

Eric H. Schultz, president and CEO of Fallon Community Health Plan, recalls that Democrats and Republicans were able to work together in Massachusetts to pass health insurance reform, something that seems to elude lawmakers in Washington:

Scott Brown’s election to the U.S. Senate last week has obviously created uncertainty around the future of health care reform. And as all of Washington considers what to do next, it’s worth looking anew at Massachusetts health care reform because we’re as much a laboratory as a national model. Some things have worked well; others, not so.

By coincidence, the Senate election ended just days before a conference was convened in Boston by the Commonwealth Health Insurance Connector Authority and the Robert Wood Johnson Foundation titled “A National Conference on Health Care Reform in Massachusetts – How to Organize Exchanges and Other Lessons Learned,” which I had the privilege to address.

In looking at Massachusetts as a laboratory, the first thing we need to acknowledge is that our reform law was about increasing access – which it did brilliantly – and not about cost-control, which remains the single biggest challenge facing health care both here and nationally. Health care is too expensive, and there is no end in sight to the upward trend in cost. We also need to acknowledge that without addressing costs, any reform, including our own, will be undermined over time.

We’ve learned other lessons:

-- Success requires pretty close to unanimity among all major stakeholders. Despite some differences, we maintained an effective, collaborative process. We found common ground in the belief that, at the end of the day, we needed to develop a process that was sustainable, equitable and effective for everyone.

--Communication and compromise are also critical. In Massachusetts, we wouldn’t have been able to draft the legislation or implement the law without it. Commonwealth Care was implemented in literally 90 days and Commonwealth Choice was implemented in less than six months. This was a monumental task.

--Openness to modifications and fine-tuning is essential. Since we began working with the Health Connector in 2007, improvements have been made in a number of areas including streamlining the bidding process and refining coverage levels and benefit designs. But we’re not done. No matter how bipartisan or well-intentioned, legislation always results in unintended consequences. Seeing those for what they are — real opportunities for continuous improvement — helps ensure the long-term viability of our historic experiment.

I am reminded every time I look at the picture I have from the April 2006 Faneuil Hall signing of the health care bill that our collective success was driven by strong leadership with a common vision. It was striking to see then-Gov. Romney and the late Sen. Kennedy side-by-side, after having worked tirelessly with so many of us to get to that day. It can be done when all parties work together. Unlike the national health care reform debate, there were no villains in Massachusetts. We’ve shown that it can only be done when all parties work together.

This program aired on January 27, 2010. The audio for this program is not available.

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Rachel Zimmerman Reporter
Rachel Zimmerman previously reported on health and the intersection of health and business for WBUR. She is working on a memoir about rebuilding her family after her husband’s suicide. 



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