As a husband and father, Tom knows the importance of health care. When asked by friends how he’s doing, he invariably remarks upon the health of his daughters and wife. Many Americans do the same, and it’s a demonstration of how much value we place on maintaining good health, and having access to good, affordable health care. For most families, few other things in life are as important.
The late Senator Edward M. Kennedy understood this, and health care became his cause and passion while he served in the Senate. Kennedy advocated for a “Medicare for All” approach to health care access. While neither Massachusetts nor the United States as a whole has been able to implement such a single-payer system, Senator Kennedy did express his strong support for achieving what is possible through the Massachusetts model. He saw the broad coalition of stakeholders who came together to enact the Massachusetts reform as a vital accomplishment that would serve as the basis for even more significant reforms going forward. Kennedy also strongly supported President Obama in the historic enactment of the Accountable Care Act, for exactly the same reasons.
Massachusetts can and must continue to be an incubator of health care innovation. In addition to exploring all avenues possible to make our new Massachusetts model even better, we need to more robustly explore the feasibility of implementing the single-payer approach to health care funding. This would take significant administrative costs out of the health care system and make those funds available to provide more universal coverage. However, we also know that a single payer system per se does not solve the intractable problems that our perverse payment system causes, or many of the other factors that are driving up the cost of health care. Medicare, like most other payers, operates mostly on a fee-for-service basis. Therefore, even though it is a single payer model, Medicare has all of the same quality, cost and patient safety problems that conventional insurance coverage has.
Tom believes that advocacy of a single payer system is not enough to solve our Commonwealth’s or our nation’s health care challenges. It could help, but does not solve the health care cost problem. It does not address the health care quality issue.
Our Goal: Access to Good, Affordable Health Care for All
The Massachusetts model has been especially successful in achieving near universal insurance coverage. Still missing are robust approaches to cost containment and quality assurance that can translate universal access into the kind of health care access and outcomes that the people of Massachusetts deserve. What we need is a universal system of patient-centered care, where the payments are made not for services rendered (volume) but for outcomes achieved (value).
Regardless of the payment mechanism, we need a health care system designed to provide the right care at the right time in the right place and for the right people. This means a system of cost-effective, highest quality care based around the patient, their family, and the community.
Massachusetts is blessed with an extraordinarily talented and knowledgeable health care community, with leaders who will continue to innovate our way toward the goal of affordable, high quality health care. They have been blazing a trail for the rest of the nation, and have been working with leaders in government who understand how health systems operate and how they can be reformed and optimized. As the Vice Chair of the Joint Committee on Health Care Financing at the State House, Tom is and will be one of those leaders.
How Tom will make a Difference: Patient Centered Care
Tom understands the complexities of health system financing, organization, and delivery, and he will take that understanding to Washington as an advocate for a patient-centered health care system. Tom believes that Medicare and Medicaid are essential elements of our national health system and must be protected, improved, and guided toward patient-centered high quality care.
Tom has become one of the most knowledgeable and clear thinkers on health care by meeting and talking with the people all over Massachusetts who are involved in the health care system. One the many insights gained has been to see first-hand the vital importance of community-based health care. Community physicians and other critical health care workers, health clinics and hospitals form an absolutely essential resource throughout the Commonwealth, without which many residents could not receive proper care. Tom will advocate strongly for the resources that can strengthen community care centers, medical home models, and care-giver support that is so vital to healthy outcomes.
Even with our nation-wide health care reform in process, America faces daunting challenges in meeting the health care needs of our people in the critical areas of access, cost, quality and outcomes, patient safety and service. While the ACA remains the object of much political point-scoring, states and their Secretaries of Health across the nation see the many positive features in the freeform and are forging ahead to implement key provisions. Most of the law’s implementation has been put into the hands of the individual states, which will roll out its provisions over 10 years. This means that every aspect of the law and its implementation will be carefully vetted and refined by the 50 different states and their stakeholders who will run it and use it, including physicians, hospital, and patients. Tom will fight hard to ensure that the states have the resources and support envisioned by the ACA to implement and continuously improve the ACA and healthcare overall for all Americans.