Category Archives: Sustinet

Sustinet: Universal Healthcare in CT by 2012

The CT State legislature’s override of the Sustinet veto will bring universal healthcare to CT by 2012.

Let me start by saying for the record that I believe that the effort to provide comprehensive, affordable health insurance for all is a very important economic and social public policy. I have worked in the health insurance industry for more than 24 years, and I know how important it is to have solid health insurance, and how scary it can be when you don’t.  I truly believe that virtually all Americans share my opinion and believe that it is a noble initiative.

The challenge, of course, is how to implement and pay for universal coverage. How do we fix what is broken without compromising what is working well in the current system? And how do we do so in the most economically efficient manner for taxpayers and businesses? In an earlier post I summarized what I believe the prevailing attitude is among most Americans:

I do care about other people-I swear.  I want them to have good insurance, I want them to have good healthcare.  But I have pretty decent coverage myself (85% of us) and I have a good job (90% of us), and I don’t want to lose either.  I am willing to help out, but I’m really tapped out financially and I can’t pick up the insurance tab for everyone.  So I am all for health reform as long as it costs me less-not more-and as long as I get to keep what’s working in the system today.

I think this is true in CT, with respect to Sustinet, and I think it is true across the country.

Our job, then, is to try to influence the debate in a positive way to ensure that we preserve what is working, fix what is not, and deliver care and coverage in the highest quality, cost efficient manner possible.

So what exactly does the Sustinet bill give us?  Essentially, the bill provides a framework for a nine-member Board of Directors to make recommendations to legislature by 1/1/2011 on how to implement universal coverage by 1/1/2012.  The Board will be co-chaired by the State Comptroller and the Healthcare Advocate and include 1 position appointed by the Governor and 6 positions appointed by legislative leaders representing the Majority and Minority parties equally.

The full analysis of the bill is here, but here is the bill summary also from the General Assembly website:

This bill establishes a nine-member SustiNet Health Partnership Board of Directors that must make legislative recommendations, by January 1, 2011, on the details and implementation of the “SustiNet Plan,” a self-insured health care delivery plan. The bill specifies that these recommendations must address:

  1. establishment of a public authority or other entity with the power to contract with insurers and health care providers, develop health care infrastructure (“medical homes”), set reimbursement rates, create advisory committees, and encourage the use of health information technology;
  2. provisions for the phased-in offering of the SustiNet Plan to state employees and retirees, HUSKY A and B beneficiaries, people without employer sponsored insurance (ESI), people with unaffordable ESI, small and large employers, and others ;
  3. guidelines for development of a model benefits package; and
  4. public outreach and methods of identifying uninsured citizens.

The board must establish a number of separate committees to address and make recommendations concerning health information technology, medical homes, clinical care and safety guidelines, and preventive care and improved health outcomes. The bill also establishes an independent information clearinghouse to provide employers, consumers, and the general public with information about SustiNet and private health care plans.

Finally, the bill creates task forces addressing obesity, tobacco usage, and the health care workforce.

Exciting times and noble intentions, to be sure.  But we all know the devil is in the details, and the successful implementation of the Sustinet plan will be a highly complicated and political process, and will hinge in no small part on the reform initiatives that ultimately emerge from Washington.  Stay tuned.

One thing is for sure:  as the great Bob Dylan once said a long, long time ago, The Times They Are a Changing.