Model Patient

Harvard Business School Alumni Bulletin
March 16, 2009

...Policy experts seem guardedly optimistic as well. Valerie Fleishman (MBA ’97) is the executive director of the New England Healthcare Institute, known as NEHI, a nonprofit health policy group based in Cambridge, Massachusetts, that brings all sectors of health care together to work on some of the industry’s systemic challenges. “What we’ve done in Massachusetts is incredibly innovative in terms of testing health reform,” Fleishman says. “By the end of last year we had 440,000 newly insured in the state, leaving fewer than 3 percent still uninsured. That’s a tremendous success, as is the fact that employer-sponsored health insurance offerings continue to grow.

“The early political decision to tackle coverage and defer the cost issue is instructive,” Fleishman continues. “Controlling health-care costs remains unresolved. From the standpoint of lessons learned, the Massachusetts experience underscores the reality that providing access to health care is necessary but not sufficient. Health care must also be made affordable, and to do that we need to reform the way health care is delivered. By that we mean redesigning primary care to better prevent costly chronic diseases and to remove the waste and inefficiencies currently plaguing the system.”

Despite these shortcomings, the cold, hard facts of health care’s costs are forcing major concessions from employers and insurance companies on the one hand and labor on the other that were not the case even ten or fifteen years ago. A breakthrough appears possible, and Massachusetts may show the way. Recalls Fleishman, “Not so long ago, the idea of a state-subsidized plan was a complete nonstarter politically. Then, about two years ago, the state-by-state approach seemed the most viable in large part because there wasn’t the political or social will to do it nationally. All that’s suddenly changed; now the Massachusetts plan is part of the national dialogue.”...

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