A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Thank You, Governor Patrick

Governor Patrick at HCFA's "For The People" Dinner, 2014

Thank You, Governor Patrick

January 7, 2015

It started long before he was even Governor, when he was just one of a number of long-shot candidates. In the fall of 2005, Deval Patrick endorsed our long-shot health reform proposal, calling it “a credible, achievable means to bring immediate progress.” Over and over, he declared that health care was a public good.

Our bill was merged with ideas from Governor Romney, Speaker DiMasi, and many others, but it was eventually became Chapter 58. The law passed in April 2006, just months before the November election. So implementation largely fell to Governor Patrick. Barely a week after being sworn in, he personally attended his administration’s first Connector Board meeting, pledging his commitment and concern for meaningful health reform.

Under Governor Patrick’s leadership, the Connector and MassHealth made health reform work, leading to the lowest uninsurance rate in the country, expanding employer coverage, improving access to care, and better overall health. His stewardship of health reform, focusing on affordability, strengthening the Connector’s role in assuring that people get meaningful coverage, and opening up the decision-making process to the public led to the confidence that national leaders could draw upon to fashion the Affordable Care Act.

The 2006 health reform law is sometimes called RomneyCare. Governor Patrick made it work, and set the stage for national reforms. Integrating the ACA into our framework took more work, and Governor Patrick excelled there, too.

Governor Baker inherits this challenge of continuing to keep Massachusetts at the vanguard of meaningful reform.

But there’s another law, equally historic, that rightfully should be called PatrickCare, though no one yet does.

In his first inaugural address, Governor Patrick set his sights beyond expanding coverage:

I know we can have more accessible and more affordable health care for ourselves and our families. But it will take transparency among clinicians and health insurers, a system of care that makes more use of community settings, simplified administrative systems, and government stewardship for the good of the whole. Let’s reach for that.

The process that led to 2012’s Chapter 224, our comprehensive cost control and delivery reform law, deserves a detailed study. It is only due Governor Patrick’s leadership and patience that we now have a real opening to improve care and control costs.

As hard as expanding coverage is, just about everyone is a winner, so only the details are at issue. But controlling costs means there must be losers as well as winners, and that’s much harder in politics.

We can’t forget his impassioned demand, repeated over and over, that we must “crack the code” on health care costs. Here’s how WBUR covered his “pounding the podium” in a 2011 speech:

There’s an emerging consensus on solutions: well integrated, whole-person care equates to lower costs — instead of fee-for-service, we should pay for integrated care.

“We have got to stop being defeated by the complexity of this.” (Here the governor starts pounding the podium and raises his voice.) There can be “no more talk about how complicated it us so we can’t solve it.” (Applause)

The goal is: better, more affordable health care for everyone

Chapter 224 is still a work in progress. The signs are positive. But the potential for a state, again, to lead the way on the toughest issue in health care, makes his achievement in this area historic. And for all of that, we thank him.

Governor Baker also inherits this challenge, of cracking the cost code, and further implementing Chapter 224. We look forward to his vigorous attention to the consumer concerns as cost and quality issues stay at the center of health policy.

And then there’s everything else. The first bill Governor Patrick signed, Chapter 1 of the Acts of 2007, was a reform of the Public Health Council, opening up its membership to the broader health community. A new coverage program for people with disabilities, real progress on behavioral health parity and children’s mental health, a unique program to invest in community public health prevention, and on and on. And for all of that, we thank him.

Governor Patrick’s legacy is broad, but health care will be at the center of the stage. For that, we thank him.

   - Brian Rosman