ALISTER MARTIN MPP/MD 2015 is an emergency room physician in Boston with a front-row seat to the broken U.S. health care system.
He attends to patients experiencing acute episodes like heart attacks, strokes, and gunshot wounds—but, more often than not, he witnesses the “everyday violence of poverty,” as he said in a 2023 interview at the Aspen Ideas Festival. He went on, “I see patients who come to the ER with abdominal pain not because they have appendicitis but because they haven’t eaten in three days. I see people who come to the ER because it’s two degrees outside in Boston and they need a place to sleep, or a young mom of two who needs me to write her a note so she can get back to work and provide for her family.”
When Martin sees a problem, he creates solutions. Ranging from civic engagement to overcoming bureaucratic hurdles, the answers he devises—and implements—are all focused on improving the lives of vulnerable populations.
Take Vot-ER. This initiative was born after Martin saw a desperate single mom in the ER. She had moved from another state to stay with relatives in Massachusetts after fleeing an abusive relationship, but in time she and her children found themselves homeless. A state law guarantees a right to shelter, which Massachusetts provides to unhoused individuals at hotels and motels—but to access this service, people had to show proof of residency, something the woman was unable to do without documentation such as a utility bill or state driver’s license. There was, though, one thing she could do: register to vote. This would give her the proof she needed.
A 1993 federal law—the National Voter Registration Act (often called the “Motor Voter Act”)—expanded locations for voter registration. Martin realized that the health care setting could be leveraged to connect people with this opportunity. As he told HKS Magazine in 2021, it is a logical continuation of what doctors had been doing. “We ask everyone about smoking. We ask about domestic violence. We should be asking folks if they’re registered to vote in the next election.” Today, more than 50,000 health care workers in all 50 states and Washington, D.C., participate in this program, which includes wearing lanyards with QR codes that direct patients to their state’s voter registration website. Vot-ER also created a network of health care providers and others that helps patients vote from their hospital beds via emergency absentee ballots.
Another administrative obstacle Martin addressed was the inability of many doctors to prescribe buprenorphine to treat patients suffering from opioid use disorder. This difficulty—the result of complex requirements set by the U.S. Drug Enforcement Administration—meant that patients did not receive appropriate treatment. So, Martin started the “Get Waivered” program, which increased certification for over 5,000 doctors nationwide. In 2023, Congress eliminated the need for doctors to receive a waiver to prescribe this lifesaving treatment. Because of his efforts, Martin was invited to the White House to speak at the event celebrating this new legislative change.
Navigating governmental systems is difficult for doctors and patients alike. Martin found that many of his ER patients were thwarted by administrative mazes or even a basic lack of awareness of programs to which they were entitled—so he started Link Health, which facilitates enrollment in the Supplemental Nutrition Assistance Program, Low-Income Home Energy Assistance Program, and other federal initiatives. So far, Link Health has connected over 1,500 families to funding that otherwise would have been left on the table.
Vot-ER, Get Waivered, Link Health, and other programs—including GOTVax, which worked to ensure that marginalized communities were able to access vaccines during the pandemic—are all under the umbrella of Martin’s nonpartisan health care organizing incubator, A Healthier Democracy. Its overall goal is to maximize impact on pressing social challenges by using health care settings to facilitate civic engagement. Says Martin, “Health care alone cannot create a healthier democracy, but without health care it cannot be done. I’m grateful to the Kennedy School for giving me the training and community to be able to play a small role in helping to do just that.”
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Photography by Bethany Versoy and Raychel Casey.