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.