Today’s Courant leads with Rell’s health care plan which focuses on insuring the 400,000 or so uninsured residents of Connecticut. From the Courant:
Rell presented in a press release what she is calling the Charter Oak Health Plan, which would lean heavily on private insurers. Any uninsured adult would have the option of paying no more than $250 a month for basic health care, prescription drugs, laboratory services and pre- and post-natal care. Rell said her plan would cost the state nothing more than nominal administrative and marketing support, and would be the product of collaboration with the managed-care industry.“Good health care cannot be a privilege available only to those with the ability to pay,” Rell said. “The key to keeping the premiums low is keeping the number of enrollees as high as possible and that is why there are no income requirements.”
Yet Anthem basically offers up a similar plan already, at least in a casual review of premiums for single people. But those are the details to be hashed out. Jim Aman takes aim in the same article:
“There’s no way in hell that this plan the governor is putting on the table is going to resolve the problem at no cost,” state House Speaker James Amann, D-Milford, said. “Look at Massachusetts. It’s costing millions of dollars and they have no way of containing costs.”
The truth about the health debate is that healthcare costs are beyond the control of government as long as the present system of private insurance is used to pay for basic health care. There is no debate that serious health issues require the common good of shared costs distributed through some form of insurance. But basic care that includes things like broken bones, colds and flus, sprains and allergies should be delivered in more cost effective formats. To start with, we need only look to the fast food industry to see how it could be done. Immediate medical care facilities that offer fixed price care for a menu of services. Fast, no waiting service and 24 hour service would fill the need to support people who have difficulty fitting in a visit to the doctor. The ability to refer more complicated cases that would invariably come in to other care givers whether hospital or private practice. Sure, there are more details to be sorted through, but the framework exists in other industries and once did for healthcare too. Manufacturing plants were once well aware that providing low cost on premise healthcare to its workers kept the plant productive.
But this scenario will not work as long as the payment for services trickles through the insurance middlemen. There is no incentive for health care providers to reduce costs when they have to play the game of filing paperwork in order to get paid. The insurance industry should be required to pay bills submitted by these facilities immediately. Let them figure out how to account for the usage and payment caps per health plan, but eliminate the administrative costs. Those that are uninsured would still receive care, but that should be subsidized by the employers who don’t provide affordable healthcare insurance to their employees. Much as the state requires companies to pay unemployment insurance, the state should require corporations to pay healthcare insurance taxes based on payroll and claims. This would incent those companies that employ thousands but in shifts that never offer enough hours to qualify for the benefits of full time employment.
To point of my scenario is not to offer a full scale health care solution, typed in the early morning after reading a few news articles, but rather make the point that new thinking and specific problem solving is sorely needed. The vague and ambitious terms of universal health care lead to debates that fail to address the real world issues that affect all of us in Connecticut. Affordable basic care should be available to everyone, and under our health care insurance system its not.
