Unpacking Health Care Policy

Simply Civics

The Honorable Michael Dukakis

The third floor of the Brookline Senior Center was packed last Wednesday night. Brookliners gathered for the 20th Annual Public Health Policy Forum, presented by the Friends of Brookline Public Health and Brookline Adult & Community Education. The theme was: “Celebrating 20 Years of Advocating for Health Care Reform: Looking Back, Looking Forward.”

I barely found a seat!

The event began with welcoming remarks from the co-founders of Friends of Brookline Public Health: Alan Balsam, PhD, MPH, the Director of Brookline Public Health & Human Services; and J. Jacques Carter, MD.

Dr. Carter introduced the night’s moderator, the Honorable Michael Dukakis.

You may not know that former Governor Dukakis is a Brookline native. He started his public service career as a Brookline Town Meeting Member and was elected to the Massachusetts Legislature in 1962. He served three terms as Governor of Massachusetts, first from 1975-1979 and then again from 1983-1991. During that time, he was the Democratic Party nominee for President of the United States in the 1988 elections. And he’s from Brookline!

The panelists

I sat in awe as former Governor Dukakis introduced the panelists.  Each of the panelists has contributed so much to the field of public health through their respective careers.

  • Dr. Judy Ann Bigby served as the Commonwealth’s Secretary of Health and Human Services from 2007 to 2013. She was responsible for implementing many aspects of the 2006 health care reform law. She is currently a Senior Fellow with Mathematica Policy Research, located in Cambridge.
  • Amy Whitcomb Slemmer is the Executive Director of Health Care for All in Massachusetts. Health Care for All is a “nonprofit advocacy organization working to create a health care system that provides comprehensive, affordable, accessible, and culturally competent care to everyone, especially the most vulnerable among us.” (HCFA website).
  • Dolores Mitchell recently retired as Executive Director of the Group Insurance Commission after 29 years of service! The GIC provides health-related services to the Commonwealth’s employees, retirees and their dependents, municipalities, and other entities. Congratulations to Ms. Mitchell on her 29 years of service to the Commonwealth!
  • John McDonough is the Professor of Public Health Practice, Department of Health Policy & Management, at the Harvard T.H. Chan School of Public Health. He served as the Senior Advisor on National Health Reform to the U.S. Senate Committee on Health, Education, Labor and Pensions. He worked on both the writing and passage of the Affordable Care Act.

As Governor Dukakis pointed out, three of the four panelists were women!

A brief health policy primer

Throughout the forum, the panelists discussed the dimensions of public health policy in recent years and the challenges that lie ahead.

In 2006, Massachusetts passed a health care reform bill guaranteeing coverage to most residents of the Commonwealth. As Dr. Bigby explained, 500,000 people gained insurance in 2006, many of whom had previously struggled the most to get health care.

Four years later, in 2010, President Obama and Congress passed the Patient Protection and Affordable Care Act (ACA). Among other statutes, it mandated health insurance coverage for all Americans.

Where we are now

Today, many more Americans are insured. Consequently, fewer individuals find themselves financially bankrupted by medical crises. Plus, more Americans are receiving preventative medical care. Since 2010, Massachusetts has had the smallest increase in health care costs yet.

It’s not as simple as that, though. Mandated health insurance isn’t a one and done deal, and not everyone is in agreement about whether it’s the right solution.

The best way for us to develop informed opinions is through learning more about it. I’ll be the first to say my knowledge of the Affordable Care Act is just about a drop in the bucket of what the law entails. However, that’s one of the great aspects of attending an event like this. It exposed me to many aspects of health care reform, and then prompted me to do some more research on my own.

To learn more about the Affordable Care Act, check out the U.S. Department of Health and Human Services website. It has the full text and a guide with key features of the law.

Costs

One of the pressing issues right now, the panelists explained, is figuring out how to reign in the costs of our complex health care system. Medication prices are going up, which means the cost of care is also increasing.

Rising health care costs affect everyone: consumers, families, health insurance companies, medical practices, and hospitals.

Leaders have proposed reform in this area, particularly at the state level. Massachusetts State Senator Mark Montigny (D) sponsored Senate Bill 1048, An Act to promote transparency and cost control of pharmaceutical drug prices. You can follow the bill’s progress here.

Participating in policy

Because we live in a democracy, we each have a say in the future of our health care system. In fact, we can participate in our national policy discussions.

It’s important for each of us to be informed and to communicate our views and ideas to our elected officials, both at the state and national level.

If you’re interested in following cost control initiatives at the state level, the legislature has a Joint Committee on Health Care Financing. You can track bills and attend hearings.

Lastly, be in touch with your elected officials! They want to hear from their constituents about where they stand. Massachusetts residents, you can find your state legislators here.

Looking ahead

We know that the health care system is complex. The participants, speakers, and panelists at the forum brought up issues that impact all of us, wherever we live across the city, country, or world.

However, that doesn’t mean there aren’t sustainable and high-quality solutions out there. If we think boldly, we can both support the world-class medical system in America and bring down costs.

I wonder what updates the panelists will share this time next year at the 21st Annual Public Health Policy Forum.

Zoning for All

Simply Civics

I went to my first community meeting last night! It was the fourth installment out of four Housing Production Plan Community Workshops in Brookline Town Hall.

Because I had missed the first three, I had a lot of catching up to do. I’ll summarize the situation briefly. Brookline is working with RKG Associates, JM Goldson, and the Metropolitan Area Planning Council to create a housing plan. The Commonwealth requires that at least 10% of each town or city’s housing is affordable. Affordable means that residents don’t spend more than 30% of their income on housing.

Brookline is under the 10% benchmark, and it has work to do. In Brookline:

  • 1/5 of households spend more than 50% of their income on housing;
  • 1/2 of households with low/moderate-income spend more than 50% of their income on housing; and
  • For renters, 3/4 of households with low/moderate-income spend more than 50% of their income.

Those numbers are truly staggering. The housing market is actually pushing individuals and families out of Brookline.

What’s exciting, though, is that there was a big turnout last night of concerned members of the community. For the most part, they want to see more affordable housing units. They want the people who are currently living in affordable housing to be able to keep their housing, and they want people who do not have affordable options to find them in Brookline. The question is: how?

The Brookline Planning Board, Housing Advisory Board, RKG Associates, and JM Goldson proposed draft strategies. There were four buckets of strategies: Regulatory, Resource Allocation, Education & Advocacy (my favorite), and Local Policy & Planning. I’m not familiar with Brookline zoning laws, but from what I gathered, they are complicated and are probably in need of some serious updating.

I tried my best to keep up with the presentation. What is Chapter 40B? What’s a Zoning Overlay District? What are all these buildings the presenters are referring to? I felt clueless and uninformed. At least I’m only here to gather information and learn, I thought.

Wrong.

We broke out into groups and rotated through four tables, one for each topic. Each person had to speak once before anyone could speak twice. I couldn’t hide. I had no option but to participate.

Facilitators asked us for our feedback on each strategy. Should we promote the use of 40B on appropriate sites for development or redevelopment? That sounds right, I thought. Do we want to prioritize building more affordable housing units or renovating the ones we already have? Can’t we do both? Should we raise taxes, divert funding from social programs, or provide incentives for developers to build renewable units in Brookline? Should we take land away from parks and open spaces to build new housing? Definitely not (Channeling my inner Leslie Knope from Parks and Rec.) The parks contribute a lot to Brookline’s character.

We spent 80 minutes debating, proposing, considering, refuting, inferring….

My head was spinning.

I felt like I was back in college, only this time, the stakes were a lot higher. My thoughts were actually being recorded and I was contributing to the Housing Production Plan for my town. This plan is going to impact housing development, financing, and sustainability for years to come. I was reminded that not only do we have to plan for Brookline today, but we must consider the future, too. We need to think critically about how to promote smart and sustainable housing policy for generations to come. As a millennial at the meeting, I represented the future generations of Brookliners.

As the meeting came to an end, the facilitators stood up and presented on the themes that had come up during the discussions. There seemed to be consensus around a lot of strategies, but also some disagreement about others. Some participants even had suggestions for potential community partnerships to expand affordable housing options.

The revised plan will be submitted to the Board of Selectmen in July. Updates should be posted on the HPP site.

We adjourned at 9:15, but the discussion is far from over. To provide input in the production plan process, submit your thoughts and/or questions here. It’s a tangible step we each can take to ensure Brookline’s affordability for years to come.

If you’re interested in participating in future community meetings, visit the Brookline calendar. There’s something going on almost everyday!

 

Freakonomics & Why We Follow the News

I listen to NPR One regularly…probably daily. If you haven’t checked it out already, download it from your App store. It’s an audio app that streams NPR news and programs based on your interests. I hear newscast clips from the Boston area and programs from across the country. If you hear one you don’t like, you can skip it. It’s similar to Pandora in that way. To be honest though, I don’t think I’ve skipped anything before. It’s that good.

I stumbled upon an interesting Freakonomics Radio rebroadcast the other day, called  Why Do We Really Follow the News?

Do we follow the news because we find it entertaining? We enjoy following sports, music, arts, fashion, etc, in the news. I personally find the Today Show entertaining. That’s not really what the podcast is getting at though.

I would argue that following the news, particularly when it comes to politics and the community, is not about entertainment. We grow through connecting with others. We feel compassion for others. We want to be informed of what’s going on down the street from us, and across the world from us, because it matters to us. When we’re more informed, and when we can relate to others through news, we thrive together in our local, national, and global communities.

Listen to the episode and let me know what you think!

 

Ben & Jerry’s

Ben and Jerrys

I was listening to one of my favorite podcasts the other day, Wait Wait Don’t Tell Me. As it never fails to do, it got me thinking. I started wondering about how much politics and the news industry have changed with social media and technology. Has community life changed too? Do we engage civically in 2016 the same ways we did in 2006? 1996? 1986?

I’m willing to bet ten pints of Ben & Jerry’s Americone Dream that today in 2016, we can find new ways to build connectedness in our communities, nationwide, and globally.

And so, I’ve started this blog.

I’m writing about my civic adventures in Brookline and Boston, and I’m inviting you to join me wherever you are.

There are so many opportunities for civic engagement.

We can vote, support candidates, and run for office. We can read, watch, and follow the news. We can listen to podcasts.

We can attend town or city events, or meet our neighbors at block parties. We can read about our local history. We can serve fellow community members through soup kitchens and clothing drives. We can explore and clean our parks and public spaces.

We can debate and dream boldly with our friends, family, and strangers.

That’s just the beginning.

I’m going on a journey to discover the virtues and vulnerabilities of living fully in our democratic society. I’ll share my path, and I hope that together we’ll find limitless possibilities. Wherever you are in your career, schooling, or life, there is a way to exercise your role as a citizen.

Civic engagement is more than just voting. It’s being present and active in our communities.

I’m excited to begin. Will you join me?

I’d love any ideas so please feel free to leave comments or email me. We’ll see where this goes!