TheDay.Com -- 3/18/2007 in Home »Editorial »Perspective

By Donald E. Williams Jr., president pro tempore of the state Senate.

Real Universal Health Care For Connecticut

Our existing health-care system is on life support. It's too complicated and too expensive even for those who have health insurance. For the more than 350,000 men, women and children who have no health insurance, and for the under-insured, it's a system that discourages early intervention and encourages expensive emergency room treatment.

This legislative session we must improve the quality and affordability of health care for everyone, and expand access to care for those without health insurance. As Martin Luther King, Jr. said: “Of all the inequalities, injustice in health care is the most shocking and inhumane.”

Half of all the bankruptcies in the United States are caused by medical debt. What is surprising is that in the majority of those medical-related bankruptcies, the individuals actually had health insurance. The problem was that their insurance didn't cover critical needs.

Many folks with health insurance have high deductibles and policy exclusions. This discourages them from getting the preventative care they need. The incentive is not to get care early on, but only when there's an emergency and the cost is the greatest.

Too many families — both with and without health insurance – are one medical crisis away from personal and financial disaster. It's another reason why our existing health-care system isn't working, even for those who have insurance.

That's why I've joined with my colleagues to propose the HealthFirst Connecticut Plan. HealthFirst Connecticut will provide universal coverage, and improve quality and affordability.

There is a model for this. It's called Medicare. It's one of the most effective and efficient government programs—one that covers our seniors. It produces savings by spreading risk through a large pool and streamlining administration. We need this type of system in Connecticut, but one that covers people regardless of age. We need “Medicare for All.”

Special interests will oppose this plan, just as they fought against Medicare. But when Medicare was approved in 1965, inflation in health care was rising faster than the cost of living. Costs were outpacing growth in the incomes of older Americans, and they had difficulty finding affordable insurance. In short, seniors faced many of the same problems of access and affordability that we all face today. A single-payer, Medicare for All system would bring better quality and affordability in health care for everyone. This is best accomplished on the national level, but in the absence of national leadership we must move forward at the state level. There are some logistical obstacles, but we are working to put together all of the necessary components of a Medicare for All program.

At the same time, HealthFirst Connecticut can immediately insure up to 40 percent of those without health insurance by expanding our HUSKY and Medicaid programs that provide coverage for children and adults in need by getting everyone who is eligible enrolled and by letting parents cover their children longer. That would cover nearly 140,000 people currently without insurance.

We also must fix our existing HUSKY program. According to a recent survey, new patients enrolled in HUSKY and Medicaid were unable to receive appointments for care 75 percent of the time. That's shocking and unacceptable. The main problem is that reimbursement for Medicaid has lagged far behind costs. Doctors and hospitals lose money every time they see a patient insured through HUSKY. Hospitals then attempt to make up this loss by cost-shifting — charging more for those who have insurance. The effect is higher costs for everyone. It's one of the reasons why health-insurance premiums have increased 87 percent in the last six years.

It makes sense to raise Medicaid reimbursement rates to the same level as Medicare because it will increase access for the children and adults on HUSKY, and will hold down insurance costs for everyone else. And one-half of the expense of raising Medicaid rates and improving HUSKY coverage would be paid for by the federal government.

Real health-care reform must also increase efficiency without sacrificing quality. HealthFirst Connecticut would provide chronic disease management for those with asthma, diabetes, heart disease and other chronic diseases. When treated on a regular basis instead of waiting for a crisis, patients are healthier and there is significant cost savings. Preventative care must be a top priority, and HealthFirst provides more capacity for school-based health clinics and community health centers. New technology such as digital medical records and electronic prescriptions reduce errors, eliminate unnecessary duplication in testing, and improve care while reducing waste. Providing greater transparency and information about quality and outcomes will help consumers to make informed choices. These reforms will produce long-term savings while increasing the quality of care.

The Connecticut Health Insurance Policy Council has estimated that we spend $22 billion on health care each year in Connecticut. That's more than $6,400 for every person in the state. The Council concluded that there are more than enough wasted dollars spent on health to cover the costs of the uninsured. With the real reform proposed in HealthFirst Connecticut, we can redirect these dollars away from waste and high administrative costs and back into health care.

HealthFirst Connecticut is the only plan that addresses the fact that our current system is too expensive, too complicated, and leaves too many people behind. It's time to put aside the special interests and make Connecticut a leader in quality, accessibility and affordability in health care for all residents. It's time to put health first.

Donald E. Williams Jr. is president pro tempore of the state Senate.

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