|Almunus David Cade '85 is the CEO of the American Health Lawyers Association|
David S. Cade, JD ‘85, didn’t expect to be a health lawyer. His plan when he entered Maryland Carey Law was a career in criminal law, as a prosecutor or a defense attorney.
Cade now is the CEO of the American Health Lawyers Association (AHLA), the largest nonpartisan educational organization devoted to health law issues in the U.S. He is a leader among health lawyers nationwide, with a nearly thirty-year career at the U.S. Department of Health and Human Services.
“Sometimes our journeys take us in unexpected directions,” Cade said. “You have to seriously evaluate the opportunities that come your way.”
Cade’s intention in law school was “to help people,” and he thought that would happen through the clinics that allowed him to have one-on-one contact with criminal law clients. “Maryland had a clinical program with actual application of the law,” he said. “The education was not just in the classroom. I was given the chance to interact with clients, to make a difference.”
He was a student attorney in one of the law school’s health law clinics at a time when deinstitutionalization of mental health treatment was taking place in the United States. Cade worked with “clients who had varying levels of diminished mental capacity,” he said. The state had rules, regulations and policies on its side, but “the citizens often were truly helpless, there was no voice for them. It was compelling to try to be the voice of those individuals.”
Upon graduation, Cade kept his options open by applying for positions in both criminal law and health care. A position at HHS presented itself, and so Cade began a 28-year tenure at the federal agency. He served as deputy general counsel for 14 years, supporting program policy and working on program expansions for both Medicare and Medicaid. Cade also served as acting general counsel, director of the Centers for Medicare and Medicaid Services’ Family and Children’s Health Programs Group, as well as acting deputy director of the Medicaid Bureau. He also served as a working group member of the Task Force on Health Care Reform during the Clinton administration.
Before accepting his current position at AHLA, Cade served on its board from 2009 to 2015. He also was a shareholder in the Health Care and Public Policy Practices at the national law firm Polsinelli, PC, in Washington.
Cade has made diversity and inclusion major focuses of his work throughout his career, including now at AHLA. He strives to make AHLA representative of the “mosaic of people involved in health law and health care.” Cade often speaks of the importance of diversity and inclusion in his addresses to high schools, colleges and business groups.
“Everyone in this society should have an equal opportunity to engage, and that doesn’t always happen,” he said. “There are barriers. We have to work very hard to overcome our own unconscious bias and prejudice and allow the way for people to fulfill their promise.”
Diversity and inclusion should inform the discussions surrounding health care reform, Cade said. “This country continues to struggle to find an economical way to provide health care to all our citizens,” he explained. “Despite all the rhetoric and however we get there, the goal is health care for everyone in an efficient and affordable way. We are not efficient and cost-effective yet, but we strive to get there.”
Key issues in the future of U.S. health policy include, as always, coverage, and affordability of that coverage, Cade said. Another hot topic in the coming years is care coordination, where all members of the health care team work together to “follow the patient, understand the patient, and understand how the patient navigates through the system,” Cade said. “Successful providers understand the arc of patient care and how the patient manages his or herself outside of the provider’s experience.”
Technological innovation, Cade added, can make possible advances in care, enable coordination of care and pave the way for more preventive medicine. Precision or personalized medicine will allow treatments and prevention tailored to each patient’s needs. Innovation and compliance are the cornerstone of the future,” Cade said. That’s compliance with regard to rules and regulations, and keeping finances in order, as well as patient compliance with treatment protocols.
His time at Maryland Carey Law prepared him for the dynamic field of health care law, Cade explained. “It gave me experience and exposure to of all the elements associated with the legal profession and health law,” he said. He was able to work with clients in the clinic, work on writing and advocating for health legislation, train in arbitration and mediation in class and more.
“It was the invaluable experience that I received at Maryland that helped me succeed at the Department [of Health and Human Services] and even now in my career at AHLA,” Cade said.