Governor Deval L. Patrick
American Health Lawyers Association Annual Meeting
Marriot Copley Place, Boston
Monday, June 27, 2011

Good morning and thank you for inviting me. Let me first take the opportunity to welcome you to Massachusetts for those of you who are joining us from out of town. I hope you will make the most of our Commonwealth while you're here and I warmly invite you to stay as long as you like and spend as much as you can.

I hope to spend most of our time this morning in conversation. I'd like to begin with a few remarks about the reforms we have been working on in Massachusetts and that have since been scaled up to the national level, as well as some of our new initiatives on cost control.

Perspective on governing: most of my career in the private sector…

So together, we chose to invest in education, in health care, and in job creation, because we all know that educating our kids, securing our good health care, and having a job is the best path to a better future.

That's why today our economy is growing twice as fast as the Nation's, our unemployment rate is well below the national average and declining and CNBC rated us the fifth best state to do business in. Our bond rating has not only remained strong, but gotten stronger -- we are one of only three states in America whose fiscal outlook is currently positive.

We are also first in the nation in providing health care coverage to our residents. That didn't happen by accident either.

In 2006 a Republican Governor, a Democratic legislature and a Democratic United States Senator worked together with organized labor, business groups and advocates to develop and pass a landmark health care reform law. It was, in fact, more than just a law. It was a statement of values, of who we are as a Commonwealth. What we codified was the fundamental belief that health care is a public good and that everyone in Massachusetts deserves access to it.

People may quarrel, and they do, about whether an exclusively private sector solution or an exclusively government one is better than the hybrid version we chose. But the bigger achievement is that we put a marker down as to the kind of state we wanted to live in - and then we worked towards it. That's important to remember. A broad range of interests came together to get a good bill, and then stuck together as we worked to implement and refine it - even in the face of an economic collapse.

And where are we today? More than 98 percent of our residents have health care coverage today, including 99.8 percent of our children. No state in America can touch that. More people are getting preventive care instead of waiting until they have to go to the emergency room. You no longer have to worry about a catastrophic illness forcing you into bankruptcy or being denied coverage because you are already sick. And more private companies are offering health insurance to their employees now than were before the bill.

We paid for expanded coverage as we said we would, by delivering more care in primary care settings than in emergency rooms. With 98% of our residents covered, universal coverage has required about 1% more of our state budget in state spending. Universal health care coverage in Massachusetts has been a resounding success and rightly served as the model for President Obama's federal health care reform law last year.

So, for Massachusetts, the Affordable Care Act is familiar. Like our law, it improves health security for all citizens. It takes a hybrid approach that leverages the best of government, non-profits and private industry. And with President Obama's leadership, it was developed and supported by a broad coalition of stakeholders and advocates who understood that our public health and economic competitiveness demanded action. Based on our experience, national health reform is good for job growth, an important step toward controlling our national budget deficit and a boon to public health.

So, thanks to the gains made by our health reform law that were extended by the Affordable Care Act, health insurance is universally accessible in Massachusetts. But it still costs too much. My state is home to some of the world's best hospitals and health care providers, but our costs are far too high and they are growing at an unsustainable rate. The challenge of high health care costs is not unique to Massachusetts and has nothing to do with our health care reform. Escalating premiums, rising over 130% in America in the last decade, far outpacing the rate of economic growth or general inflation, are a challenge for businesses, governments and working families all over the country.

And just as we in Massachusetts have provided the national model for universal access, I believe we can crack the code on cost control.

In February, we launched the second phase of health care reform in Massachusetts, aimed at finally controlling costs and making health care as universally affordable as it is accessible. Right now, the current system rewards providers for the quantity of care they deliver, not the quality. For costs to come down, this has to change. We are working with that same broad coalition of leaders who devised health care reform in our state to accelerate the transition to innovative, improved models for delivering health care.

It's about doing more to encourage integrated, whole person care: paying providers for the quality of health care they deliver, not just the quantity.

There are many good models for that being tried in the market today. We are working on scaling them up and making sure the savings are passed along to businesses, families and government in the form of lower premiums. That means encouraging new models of payment and delivery but also putting in place a set of common expectations and standards that will hold the industry accountable to its stated mission of cost containment. Our goal is for integrated, cost-efficient caregivers to predominate in Massachusetts by 2015.

At the same time we have taken the somewhat aggressive step of empowering our Insurance Commissioner to disprove excessive health care premium increases as a way of putting pressure on the private market. We are enhancing and refining that power with this new legislation.

Taken as a whole, these measures make up the next phase for health care reform in Massachusetts. The details may be complicated, but our goals and our values are simple - even universal. Better, more affordable health care for us all. By most accounts, higher quality care -- meaning well-integrated, whole person care -- equates to lower cost. From now on, we propose to pay for that rather than the fragmented system we have today.

Just like with that first round of health care reform, this undertaking is about what kind of Commonwealth we want to live in. We led the Nation to the most successful model for universal coverage ever. If anyone's going to crack the code on cost containment, it will be we here in the Commonwealth of Massachusetts.

So that's where we're going. And we need to get there soon. But why? Why are we on this path in the first place?

In some fundamental way, solving this challenge has everything to do with fulfilling our generational responsibility - that old-fashioned idea that each of us in our time must do all we can to leave things better for those that come behind us. It's about building a better, stronger Commonwealth - not just for ourselves, but for generations to come. This is their health care as well. We owe it to their future to get this right.

Thank you all for having me and I look forward to your questions.