Boston College Expert: Affordable Care Act
Professor Dean Hashimoto
BOSTON COLLEGE LAW SCHOOL
(617) 552-4617 (office)
(617) 519 4129 (cell)
Professor Dean Hashimoto’s specialty is healthcare law, particularly the interface of law, science and medicine, especially in the areas of health care policy and the role of scientific evidence in the courtroom. Educated as both an attorney and physician, he teaches torts, environmental litigation, health care law, and evidence. Hashimoto was a law clerk to the former Supreme Court Justice William Brennan and is a board-certified specialist in occupational and environmental medicine; he serves as the chief of this specialty at the Massachusetts General Hospital and the Brigham and Women's Hospital.
A day after reversing himself on cancelled health insurance policies, President Obama will meet with health insurance CEOs who now have to figure out how to minimize disruptions in a marketplace with new rules and an uncertain price structure.
“It’s really hard to make significant changes once open enrollment begins,” says Boston College Law Professor Dean Hashimoto, MD. “It’s very awkward to make changes like this and it sort of adds to the confusion. Clearly the White House wants this issue to go away. It is a weaker response and a very defensive stance to make.”
Hashimoto says the confusion, outrage, and contempt for the law could be avoided if the federal government would take a page out of the corporate HR playbook.
“I think the success of Obamacare is predicated on the federal government and state exchanges to become like the human resource departments that exist in large employers,” says Dr. Hashimoto, who is also a board-certified specialist in occupational and environmental medicine at both Massachusetts General Hospital and the Brigham and Women's Hospital. “These departments are underappreciated. What human resources does is very carefully decide what health insurance to make available, the scheduling in the open enrollment period, making sure the websites are working, having the packets of information – all the things we take for granted. The challenge is whether states and federal governments can function in the same way.”
From the technical issues on the healthcare website to the presidential apology and reversal on customers being able to keep, for another year, policies the administration deems substandard, the “fumbled” rollout has only added to the angst and anger millions of Americans now feel.
“This is exactly the kind of thing human resources departments know they need to avoid because it creates communications problems and employee relations problems,” says Professor Hashimoto. “When we think of Obamacare, our discussions tend to focus on large policy issues when what may be just as important is the need for a smooth and acceptable implementation. I worry that there has been an underestimation in the importance of having a very smooth operation and excellent communication in order to achieve acceptance. The logistical and communication issues raise challenges to the legitimacy of the whole process.”
Hashimoto says this process is in sharp contrast to what we see in the private sector, where polls show 90% of Americans enjoy receiving health insurance from their human resource departments.
“People overwhelmingly trust their human resources department to represent their interests,” says Hashimoto. “People have strong beliefs that their human resources department is able to secure health insurance that is appropriate for them. We like the fact we are getting the same insurance as our co-workers. We haven’t developed that same deep trust yet with the federal government. The question is can the federal government, being distant and providing what feels like a more generic approach, take the place of what human resources departments are doing for employees on a more discrete level?”
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