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A Cure For The Crisis?

Universal Health Care The Answer To State's Complex Coverage Mess

May 20, 2007
Commentary By JUAN A. FIGUEROA

When more than 5,000 residents flocked to a rally in Hartford for universal health care earlier this month, the crowd broke into a rousing chant that should serve as marching orders for Connecticut's legislature: "Get it done!"

The rally call reflected a hunger spreading across the state for meaty health care reform. At the start of the legislative session, an overwhelming majority of Connecticut voters - 84 percent - had indicated in a statewide survey that they favor quality affordable health care for all residents.

Employers, consumer and business groups, health care providers and other stakeholders have jumped on the health care reform bandwagon. Political leaders in both parties as well as the governor have pronounced the status quo unacceptable. The cause of the outcry? The state's bloated and fragmented health care system.

A tour of the complicated and costly maze is in order.

Most residents get their health insurance through their employers. Some of that insurance is regulated by the federal government and some by the state. Some other employers insure themselves, some buy insurance and others offer coverage through either a state-run or private health insurance purchasing pool.

Some low-income residents receive coverage through the state's Husky A managed-care plan, plus coverage of mental health services.

Other residents get Husky B managed care; others get Medicaid fee-for-service care; and others get SAGA (state-administered general assistance) physical and mental health care from two different plans run by two different state agencies.

Some people buy individual insurance regulated by the state, others buy individual coverage through the state's high-risk pool and still others transition from group to individual insurance under federal rules. Meanwhile, more than 407,000 residents, most of whom work, lack any health coverage. Thousands more are poorly covered.

Health care experts have estimated that the lack of health coverage costs taxpayers as much as an eye-popping $1.3 billion a year. This is outrageous. We can do better.

Near-universal health care proposals from states such as California and Massachusetts have filled the headlines of newspapers. If this state's leaders grab the opportunity to fix Connecticut's system, history just may record us as the first state to give all its residents high-quality, affordable health care through a simple, sensible, sustainable health care system.

Lest anyone think this vision is pie in the sky, consider the economic and other benefits of universal coverage. Health care experts maintain that - aside from residents not having to worry about losing health care coverage - Connecticut's economy and households would benefit under universal health care.

It's been estimated that Connecticut would gain between 6,000 and 11,000 new jobs and pump $600 million to $800 million into the economy.

Contrary to simplistic and exaggerated claims, the actual cost of universal health care would be spread among employers and employees as well as the state and federal government. And if the state went after untapped federal funds - estimated in the hundreds of millions of dollars - they could be used to offset the costs of covering all residents.

Universal health care would add more dollars in annual-household bottom lines through lower premiums, reduced out-of-pocket health care expenses and other benefits. It can be achieved through a variety of approaches, including a single-payer system. Unfortunately, this concept has been badly misconstrued by opponents and used for fear-mongering.

To equate universal health care with socialized medicine shows breathtaking naiveté. Connecticut needs a universal solution that fits its needs and financial realities. Several separate health-related proposals in the legislature - such as bills to expand Husky and increase Medicaid reimbursements - are steps in the right direction.

Unfortunately, in the absence of a comprehensive universal health care plan, these measures amount to little more than tinkering around the margins of the costly and inefficient mess. In the long run, universal health care is the only viable solution. Connecticut needs a good plan to lead the way.

Juan A. Figueroa is president of the Universal Health Care Foundation of Connecticut, based in Meriden.