Massachusetts Medical Society: Testimony before the Health Equity Task Force

Testimony before the Health Equity Task Force

The Massachusetts Medical Society is a professional association of over 25,000 physicians, medical residents, and medical students across all clinical disciplines, organizations, and practice settings. The Medical Society is committed to advocating on behalf of patients, for a better health care system, and on behalf of physicians, to help them provide the best care possible. The Medical Society acknowledges that racial inequities create impediments to reaching those ends. Although we have advocated to eliminate injustice and inequity in health care, the COVID-19 pandemic has brought further, and deeper, issues to the fore that simply cannot be allowed to persist any longer. We would like to thank the Massachusetts legislature’s Health Equity Task Force for this opportunity to be heard on these issues of health inequity that impact people in our Commonwealth and beyond.

The COVID-19 outbreak has posed many novel and difficult challenges to the Massachusetts health care system, not least of which is how to respond to a highly transmissible disease that has disparate impact on various populations while working with limited resources. The Baker Administration acted quickly to quell the tide of coronavirus, and many of the measures taken have proven to be quite effective. One of the most critical orders was expanded coverage and reimbursement for telehealth services, which was key to maintaining and improving access to health care services. These policy changes promoted access to critical healthcare services while also providing necessary precautions to limit patient and health care worker exposure to COVID-19. Continuing these policies enacted to combat COVID-19 will further promote equity by improving safety for populations at increased risk for COVID-19 and removing barriers to quality health care services by helping to reduce the burden of traveling to appointments, to aid social distancing in the health care environment, and to limit the necessary use of personal protective equipment. We further commend the administration and MassHealth for supporting audio-only telehealth, which is critical to offsetting disparities based upon having a smart phone or computer and internet access. Telehealth has demonstrated its promise to increase access to care for all patients and uphold the values of equity in the health care realm, and we strongly encourage the Task Force to recommend legislative codification of these policies, which are mostly captured in Senate bill 2796 and House bill 4916, which is currently being reconciled in conference committee.

While a continuation of proven COVID-19 policies will certainly aid in the pursuit of health care justice, we must ensure equity is front and center looking ahead. This pandemic has repeatedly shown the necessity of proactive resource planning and, with the promise of a vaccine on the horizon, policymakers must develop a forthright plan for equitable distribution. This plan should contemplate all suggestions for distribution from the Centers for Disease Control and Prevention (CDC) and be largely based on recommendations from the National Academy of Sciences. Throughout each step of developing this plan for distribution, issues of equity must be considered in order to ensure adequate supply is allocated to, and prioritized for, identified populations who are most at-risk or who have been most impacted by COVID-19.

To ensure equitable distribution and encourage trust and willingness to take any forthcoming vaccine, work must be done now to foster trust with the public, specifically within communities of color who have a long-justified history of mistrust in medicine and who have been most negatively impacted by the coronavirus outbreak. The CDC recently reported that COVID-19 infection rates at the national level are 2.8 times higher in the Hispanic or Latino and American Indian or Alaska Native populations when compared to the rate for non-Hispanic white people and, for Black people, the case rate is 2.6 times higher while the death rate is 2.1 times higher. Similar trends occur in Massachusetts, where non-Hispanic Black individuals represent 7.2 percent of the population but 14.2 percent of cases and Hispanic individuals represent 12.2 percent of the population but 29.3 percent of cases. A recent Pew study shows that only 54 percent of Black adults say they would definitely or probably get a coronavirus vaccine if one were available today, while 44 percent say they would not, compared to 74 percent of White and Hispanic adults who say they would. The ability to build trust in health care within our communities of color is greatly influenced by the equitable delivery of health care. It is, therefore, necessary to focus on how to improve health of, and health care for, historically marginalized populations by working to address issues of treatment disparities, social determinants of health, and other health inequities. The health and wellbeing of our most vulnerable patients must be prioritized throughout each step of crafting policy to improve health care in Massachusetts. Prioritizing the health of these communities will help to guide distribution of vaccines, which further enhance the health care to those communities.

Efforts to build public trust in health care and vaccines among communities of color will be well aligned with the community engagement recommendations from the Massachusetts Department of Public Health’s Health Equity Advisory Group, which discuss planning and implementing a strategy for active engagement and representation of, and partnership with, existing anchor organizations in the communities in decision-making processes related to COVID-19 response and recovery. Critically, all community-centered efforts must consider the language and health literacy barriers that may impede ample understanding of the materials and information presented. These ends require the creation of strategic guidance aimed at intentionally recruiting a diverse, culturally sensitive workforce, that works on all aspects of contact tracing, case tracking, and other workforce needs.

Additionally, challenges with testing that have persisted throughout this pandemic must be addressed. The inequities in access to testing have continued despite the admirable efforts of important programs like the Stop the Spread initiative. It will be critical to build upon these programs while also developing more permanent and reliable infrastructure to ensure equitable access to testing. The communities that have been most impacted by COVID-19 would benefit from increased proactive testing that could help suppress the spread of this disease. For that reason, the Medical Society supports section 34(b) in House bill 4916, which requires carriers to cover certain asymptomatic COVID-19 testing, and encourages the Task Force to similarly support such measures.

Thank you for this opportunity to address health disparities for underserved or underrepresented populations during the COVID-19 pandemic. The Medical Society looks forward to continuing this discussion and working with the Task Force to advance health equity.

Share on Facebook

Find Your Legislator

Click here to enter your address and get a list of your federal representatives, state legislators, and your local polling place.

Find Your Legislator »

State and Federal Agencies

State House - Mass. State AgenciesRapid access to relevant resources from State and Federal health care agencies for Massachusetts physicians.

Massachusetts State Agencies
Federal Agencies

Advocacy Videos

See our advocacy in action through videos and testimonials of physician-advocates! Advocacy video preview

Facebook logoTwitter logoLinkedInYouTube logoInstagram

Copyright © 2020. Massachusetts Medical Society, 860 Winter Street, Waltham Woods Corporate Center, Waltham, MA 02451-1411

(781) 893-4610 | (781) 893-3800 | Member Information Hotline: (800) 322-2303 x7311