‘Marching Toward Coverage’ With Health Care Expert and Author Rosemarie Day

Flyer courtesy of Rosemarie Day.

The coronavirus pandemic has many scared—not only for their physical health, but for their financial health as well, especially if they are uninsured. 

What the country needs is someone who will fight for the public’s well being, while also providing them with the knowledge to later advocate for themselves. Somerville’s Rosemarie Day—a longtime health reform worker, CEO of Day Health Strategies, and author—may very well be that someone.

Day recently published a nonfiction book about public health titled “Marching Toward Coverage: How Women Can Lead the Fight for Universal Healthcare.” Her writing is dedicated to encouraging others, specifically women, to advocate for better healthcare. It is largely informed by her experience in leading statewide healthcare reform throughout her extensive career. 

A Mass Reform of Healthcare

From working at start-ups, all the way through major corporations and government positions, Day has seen and done it all. 

In 2006, she helped lead the launch of the Massachusetts healthcare reform law, which aimed to provide health insurance to nearly every resident of the state and later became the model for the Affordable Care Act. Day served as the founding deputy director and chief operating officer of Massachusetts Health Connector, the nation’s first state-run health-insurance exchange. 

“I was honored to be recruited to come in and help build this brand new health reform model that had never been done,” she says.

Her experience included her position as chief operating officer for MassHealth, the state’s Medicaid program, where she specialized in providing healthcare coverage to low-income people.

For Day, the decision to take part in the healthcare reform of 2006 was an easy one. 

“When I worked in Medicaid [at MassHealth,] we were doing a very necessary thing, but it left out a bunch of people who were working but didn’t make enough money to get health coverage,” she says. “It’s a great program, but just by law, it’s limited to the most low-income people. So, this chance to work on a program that I thought would fill that gap was too good to pass up. I just believed it was needed so badly, based on people I knew who were falling through those cracks.”

Her role at Health Connector differed in that she was able to completely rework how the government approaches public health coverage. Here, she was able to bring down the amount of residents who were uninsured to an all-time low of 2 percent. This later became a model for the Affordable Care Act on the national level.

In 2010, Day launched the Somerville-based company Day Health Strategies, with the goal of helping other states implement health reform using the Massachusetts model. 

Living in Somerville has shaped her perspective on public health, affecting both her book and the trajectory of her career, she says. Getting to know her neighbors and interacting with a diverse socioeconomic group helped her understand the vast disparities in healthcare. 

“I knew the folks who were falling between the cracks that are working really hard,” she says. “I’m very affected by that because it’s not just theoretical, it’s people that I know.”

For example, she references the Shape Up Somerville program in her book, which aims at helping reduce obesity by getting everyone to take part in exercising, eating right, and other overall improvements towards better health. 

Becoming Inspired to Speak Out

The spark of inspiration for “Marching Toward Coverage,” which came in 2016, was twofold, and the ideas brewed in her head for a while. On one hand, she was motivated to take action following the election of President Donald Trump—who sought to partially repeal the Affordable Care Act with the American Health Care Act. On the other, she had had a personal reckoning, as a patient and as a woman. 

During a routine screening that year, she found out that she had a very early stage of breast cancer and decided to have a mastectomy.

“I came out fine, but in going through that, I really saw how much I wanted to make a case for universal health care,” she says. 

While in the hospital seeking treatment, Day recalls asking the doctors about what happens to patients without comprehensive healthcare. She remembers hearing the answer that many “just defer their care. They don’t come in for treatment, and that increases their odds of death.”

Her experience also left her frustrated because it made her realize how many women had minimal resources and very little say in their own healthcare. Day wanted to share her story and help educate others on how to advocate for themselves. The increased beginning of the #MeToo movement around 2017 later added to the feminist lens of the book, as well. 

“That’s when I realized I’ve got to put this together,” she says. “Because women are the caregivers still, first and foremost, in most families. They make 80 percent of the healthcare decisions and yet, we do not have 80 percent of the power. Not even close.” 

“Marching Towards Coverage” During a Crisis

With the current state of the global pandemic and upcoming election, Day believes it is more important now than ever for people to acknowledge the need for universal health care. 

“My goal is for people to demand that health care be a right in this country,” she says. “Bernie Sanders has gotten a lot of good coverage on the idea of Medicare For All, but that is only one way to get universal health care.”

One of the goals of her book is to show that there is more than one path towards universal coverage, she says. In “Marching Towards Coverage,” Day uses other countries as examples and case studies in reaching universal health care for less cost. 

“Right now, obviously what’s on people’s minds is the coronavirus,” she says, and recognizing the ties between the virus and health care across countries is essential to managing its impact. 

“[Universal health care] doesn’t solve the coronavirus problem, but more people can get tested and not worry about copays if you’ve got universal health care,” she says. And at the end of the day, “that helps stop the spread of disease.” 

Day’s book tour, which was initially supposed to pass through Cambridge at the public library on March 16, was canceled due to the virus. However, her book is now available for purchase online at Porter Square Books. 

This article has been updated to more accurately reflect the Shape Up Somerville program.

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