Looking to the Future

Hartford Advocate, October 21, 1999

By Jayne Keedle

If leadership on the issue of universal health coverage is going to emerge first on the state level, then what can we expect from a legislature located in the Insurance Capitol of the World?

The answer, predictably, is not much -- at least for the next couple of years.

It's not because we don't need to expand coverage, either. Although we pay $6,000 per capita on health care -- that's $2000 more than the national average -- in 1998, over 12 percent of Connecticut residents were without health insurance. That's a 74 percent increase from 1990. Even people who do have health insurance are having a hard time as rates increase and coverage options diminish.

"The cost of health care is a matter of conversation everywhere," says Stephen Glick, president of Coordinated Financial Resources, whose company consolidates members of local chambers of commerce to allow small businesses to get group insurance rates.

"We have an employee shortage, and what keeps a person working more than ever is having adequate benefits," says Glick. "In order to keep people somehow [small businesses] have to restructure their benefits. On the other hand there's less competition because we're losing carriers that were part of the mix of choices."

Some managed care companies themselves are struggling as well. Kaiser Permanente dropped out of the market in the Northeast because the company found it couldn't turn sufficient profit here, and WellCare of Connecticut has decided to hold off on any new business for the moment. HMOs started by hospitals that thought it would be cheaper to get into the business themselves are discovering that isn't the case.

Suburban Health Plan, created by Griffin Hospital in Naugatuck, went out of business earlier this year. And HealthChoice, a managed care company that absorbed Yale Preferred and includes St. Francis Hospital, has frozen underwriting new business and is looking for a buyer.

What's the solution, then? Dr. John Battista, a member of Physicians for a National Health Program, believes it's a single-payer plan. Last legislative session, he helped write an Act Concerning Health Care Access for Working Families, a publicly financed health care system that would replace the patchwork quilt of government and private insurance programs in Connecticut.

The plan, says Battista, was "to bring a single payer comprehensive health insurance plan to all residents paid for by personal income taxes on a sliding scale, a payroll tax and taxes on health detrimental activities, smoking, pollution and the like." The money would be placed in a public trust, to be managed by a board that included medical professionals.

Amazingly, this bill actually made it out of committee. Not the Public Health Committee, however, which is co-chaired by Rep. Mary Eberle (D-Bloomfield), former general counsel for CIGNA, who wouldn't even bring it to a public hearing. (To be fair, the Health Committee also had its hands full dealing with a managed care reform package.) The Labor Committee took the lead on the radical issue of moving to a single payer plan.

"I think it got a lot of good attention, because the issue has not surfaced at that level for some time," says Suzanne Haviland, director of Health Care for All, a coalition of nearly 40 organizations, including community groups, activist organizations such as Connecticut Citizens Action Group, and labor unions.

"Every couple of years we have seen a very serious attempt to moving people around the single payer issue. It stopped around the time Clinton's proposal came out," says Haviland, adding that this upcoming session a study bill might be raised that would enable the legislature to study the options. "I think we now have an opportunity to do some public education."

Sen. Edith Prague (D-Columbia) says she plans to reintroduce the single payer bill again next session. "I know we have over 300,000 people in this state alone that don't have health insurance," says Prague. "It's a critical problem and we have to figure out a way to deal with it and not keep pushing it under the rug, because health care is a right for everyone, not just for everyone who has an employer to pay for it."

Although no one testified against the bill at the hearing, Prague says the lobbying against it behind the scenes was ferocious. It was all the usual arguments -- that government has no business getting into health care, that private insurers can do the job better.

What people fail to recognize, says Haviland, is that we already have a vast system of popular national health programs, such as Medicare and Medicaid, both of which are cost effective and provide universal coverage for the elderly and the poor. Still, with next year designated a budget year in the legislature -- i.e. only issues related to the budget are supposed to be raised -- none of the bill's supporters expect much headway will be made on the issue until 2001. Then, says Prague, "I believe there will be a big fight."