Wyman Says: SustiNet is dead… Dead I tell you… DEAD!

Cross-posted from Pelto’s Point at the New Haven Advocate)

Think Charles Dickens’ The Christmas Carol;

“Marley was dead: to begin with. There is no doubt whatever about that. The register of his burial was signed by the clergyman, the clerk, the undertaker, and the chief mourner…You will therefore permit me to repeat, emphatically, that Marley was as dead as a door-nail…This must be distinctly understood…”

When Governor Malloy’s new Health Care Cabinet met earlier this week, Lt. Gov. Nancy Wyman, who had helped to lead the SustiNet effort and was once one of its greatest champions, took great pains to ensure that no one – no one – thought that SustiNet was anything but dead.

Wyman proclaimed that “SustiNets not around anymore, there is no SustiNet.”

In fact, Wyman and State Comptroller Kevin Lembo, who served as Connecticut’s Health Care Advocate at the time, were the co-chairs of the SustiNet Health Partnership Board of Directors that created SustiNet.

Their board worked for more than a year and a half developing what was recognized as a profound step forward in the battle to provide greater access to affordable, high quality health care in Connecticut.

When the SustiNet Plan was finalized last December, Lembo said that “this report provides the General Assembly with a roadmap for reform – and propels Connecticut to the forefront in addressing a nationwide health care and financial crisis.”

This extraordinary victory did not come easily.

The legislation creating the SustiNet Board of Directors and laying out the process for developing Connecticut’s healthcare reform plan was vetoed by Gov. M. Jodi Rell in 2009.

The Democratic Legislature took the unprecedented action of overriding that veto and setting in to motion the steps that would eventual lead to the SustiNet plan.

Last December, on the day the SustiNet Board was adopting its final report, a rally was held in Hartford.

Dan Malloy, then the Governor-Elect, spoke at the rally.  As he did during his campaign for Governor he credited his mother for his lasting commitment to universal health care.

Speaking to the crowd, Malloy said that “it was through her eyes and her advocacy that I think much of my commitment to making sure that all of our neighbors have access to quality health care really arouse.”

Surrounded by health care reform proponents and religious leaders, Malloy pointed out that SustiNet represented Connecticut’s move toward universal health care.  The Governor to be added “I’m not sure we’re at the top of the mountain, where we see the promise land but we know the promise land exists or at least a substantial portion of that which is necessary to provide the promise land is just around the corner,”

Speaker of the House Chris Donovan, another leading voice in the battle for SustiNet also spoke at the rally calling it “an impressive sight” and pointing out how much had changed over the last few years.

Pointing to the next governor, the next lieutenant governor and all the clergy and said “I remember a couple years ago when the clergy wanted to meet with the governor and the governor then refused,”

Now, 10 months later, SustiNet is dead….

Dead as a doornail.

At this week’s Health Care Cabinet Meeting, Dan Malloy’s special advisor on health reform, Jeannette DeJesús worked to put all that in the past saying “There’s a lot of new things happening that we need to consider, there are lots of new opportunities, and there are lots of people who want to play that have not participated in the past. Our goal is to really be inclusive at every turn.”

New things, new opportunities, lots of people who want to play a role?

But despite the thousands of hours spent developing the SustiNet plan, there was no discussion about what elements of the old plan were so terrible that the SustiNet plan needed to be trashed.

Was it the effort to leverage Connecticut’s tremendous buying power to lower healthcare premiums for people whose healthcare is funded by taxpayers?

Was it the effort to create a system in which municipalities, non-profit organizations and small businesses could buy healthcare at a lower cost?

Was it the focus on lowering costs for everyone by making greater use of electronic medical records, preventative treatment initiatives or promoting cutting edge care in patient homes?

Or was it the creation of a “public option”, which was scheduled to begin in 2014 and would have provided health care insurance for the tens of thousands of Connecticut’s uninsured residents- an option that would have be financed by premium payments and federal tax credits and would not have required significant state subsidies.

Everyone in the room knew, but few would say, that part of the problem was that the SustiNet plan had gotten caught up in the recent Malloy/SEBAC agreement when, as a result of poor communication by both the state unions and the Malloy Administration, opponents of the concession deal interpreted the proposed health care changes as part of a secret plan to use SustiNet to undermine the state employee’s
health care plan.

But of course, that problem could have easily been resolved.

What could not be easily resolved was the strong opposition from Connecticut’s health care industry.

And since that opposition was very real and politically significant, the Governor’s new Health Care Cabinet did what it had to do and simply skipped over the true reason SustiNet was killed.

In the end the real problem was that here, in what was once the “Insurance Capital of the World”, if the SustiNet System worked as it was designed to do then health care premiums would drop and if health care premiums dropped, insurance company profits might drop as well.

In a year when Dan Malloy gave Cigna Insurance company almost $50 million in public funds to “move” its corporate headquarters back to Connecticut and create at least 250 jobs, whacking the insurance industry’s bottom line was hardly the message some wanted to send.

And equally important was the fact that SustiNet would allow a variety of entities to buy their health insurance through one of the state’s pools or plans.  Many chambers of commerce, especially the Connecticut Business and Industry Association, make their money by selling insurance to their members.

Giving small businesses another option for getting insurance, even if it mean cheaper insurance for businesses and their employees would have had a devastating impact on the ability of business groups to fund their activities.

So yes, SustiNet is Dead.  It was killed by some of the very people who helped create it in the first place.

Go to CTNewsJunkie’s archives for a great set of stories describing the rise and fall of SustiNet:   http://www.ctnewsjunkie.com/ctnj.php/archives/taglist/SustiNet

  • Jeff Klaus

    So Jon, you think that the issue with Sustinet and SEBAC could have been “easily resolved”? And that the real villain is the private insurance industry?

    That theory fits nicely into your ongoing anti-capitalist narrative. But if you are honest with yourself, you would accept that no matter how much communication and explaining you do, the rank and file state UNION members (that you support so strongly) detest the idea of socialized healthcare. And not only that, but they are pretty conservative in their politics and would change a lot about the social safety net in CT. if the politicians would let them.

    These rank and file are old-school democrat union folks who come from a hard-working blue collar background. They do not consider themselves to be liberals or “progressives” in the political sense of the words – and they most assuredly are not members of the ultra-left. Malloy gets this, as does Obama. Why don’t you?

    • jonpelto

      And here i was thinking Malloy and Obama are wrong and I’m correct. Did you see Bank of America, after taking our tax money is laying off 30,000 people. All i want it my IRA value back and my kids college fund and the value of my house and … the tens of thousands i’ve paid to underwrite the success of Bank of America and other other corporate giants that don’t pay their fair share in taxes. No… I’ll stick to my views until I see something that convinces me that malloy is right and I’m wrong.

    • jonpelto

      By the way Jeff I’m not anti- capitalism. I am very pro-middle class and I think modern capitalism has swung to far. We are losing the middle class and without us – american capitalism will fail. The choice we face is to have a capitalism that is fairer or no system at all.

  • CT Dad

    JP: This is a great piece and puts it all in the correct perspective. Well done!

    (PS. Please ignore the radical anti-healthcare rants that may very well follow…)

  • Jeff Klaus

    In order to survive BofA is doing lay-offs. If they didn’t, they wouldn’t be around at all. Would that be the right outcome? And I, too would like to see the value of my home return as well as my retirement funds.

    But I don’t blame anyone else for the decisions that I make. I knew what the risks were in owning risk-based assets like real estate and stock. I could have invested only in cash and rented an apartment instead buying a home. So why is anyone, Wall street, BofA to blame for my own decisions? They didn’t tell me I had to make the choices that I did.

    • jonpelto

      Not to be flippant but I thought Bank of America was doing the layoffs so it could continue to meet wall street expectations with historically high profits.

  • Jeff Klaus

    We don’t have a middle “class”. We don’t have “classes” in America -at least not in the permament, immovable tradition of Europe,India, China etc.. That is the big difference between the U.S> and others. Those who promote the idea of fixed classes are foisting the notion that our citizenry are somehow chained to their current economic status. And by doing that you defy the reality that in this country hard work and education can make all the difference in one’s life.

    We have middle income earners all of whom will rise, fall, or stay the same. But not because of a class structure – but because of their own abilities and ambitions.

  • Jeff Klaus

    Historically high profits at BofA? What do you know that the shareholders and the rest of the market doesn’t seem to know about their health, Jon?

  • Richard

    I would feign surprise.to be polite. But I can’t.

    Susitnet, like the death penalty and the anti-war coalitions, are the types of issue groups and issue items that a mature Democrat politican appropriates and calls their own to get elected.

    Joe Lieberman’s only crime? He didn’t lie to the Progressives. and use them like tools to get elected.

    Where are Wyman and Malloy today? Celebrating at Sikorsly? Attending the Petit trial? At a doctor’s appointment? Perfomring a land swap to build a casino on some waterfront land?

  • Sharewhut

    A major concern of the unions wasn’t the undermining of the health benefits, it was the inclusion in the ‘pool’. Being the only paying ‘swimmers’ in the pool to start. ‘Guaranteed’ to be kept separate from the rest of those in the pool. But the fact is, and the OFA analysis brought it up (though not in these exact terms ; ) ) that no matter where someone pees in the pool it’s gonna reach the guy in the roped off lap section. Changes in any of the groups could have an effect on all groups. Overall costs go up, if there’s no fed $ to cover, the choices are charge those paying in more or raise taxes to cover.
    And I don’t want to get into the potential for a horror show presented in the subcommittee appendices to the Sustinet report presented to leg.in January. Especially the one dealing with equal access regardless of income, race, etc.
    Stuff written by lawyers setting up class action lawyers for a field (pay) day!

  • Richard
  • CT Dad

    JP,

    I recommend a *strong* disinfectant — with at least 95% DEET – to clear these comments of the Radical Right-Wing Troll (Let’s call him “Richard”) and his hater sock-puppets who live to trash “Susitnet,” workers, the middle class, Democrats, fairness, facts, logic, the rules of grammar, reform… and you.

    • jonpelto

      yeah… maybe I need to stop hitting “approve” so quickly……

  • perturbed

    Jon, very interesting piece, but could you help me out with something?

    You wrote: “Everyone in the room knew, but few would say, that part of the problem was that the SustiNet plan had gotten caught up in the recent Malloy/SEBAC agreement when, as a result of poor communication by both the state unions and the Malloy Administration, opponents of the concession deal interpreted the proposed health care changes as part of a secret plan to use SustiNet to undermine the state employee’s health care plan.”

    Could you possibly be mistaken on the chronology? As I understand things, the SustiNet legislation reverted to what it is now **before the air-tight top-secret SEBAC/Malloy agreement ever saw its first light of day.** In fact, the deal with Malloy on SustiNet and the deal with Malloy on SEBAC 2011 coincided exactly. (To be sure, my assertion all along has been that they were two halves of the very same negotiation process, and my pension was the major bargaining chip played by SEBAC to preserve the shards of SustiNet.) So how could the adverse reaction by state employees have possibly influenced the legislation, after the fact?

    Going further, and though it doesn’t seem connected to the killing of an already dead SustiNet, I also find myself largely agreeing with Jeff Klaus on state workers’ politics. His assessment is a gross generalization, but he does have a point. As in the state as a whole, there is a significant contingent of deeply conservative state employees. That shouldn’t be news, state workers are a subset of state residents, many of whom are also deeply conservative. In fact, for many of my most conservative friends/co-workers, it almost seemed, at times, as if the actual effects on the state health care plan were secondary to the perception of an orchestrated plot to further the national Patient Protection and Affordable Care Act. Believe me, no Yankee Institute involvement was necessary. (What a BS claim that was.)

    Later in your analysis, you do outline some truly plausible reasons for Malloy pulling his support for SustiNet. But that all predated state workers’ first glimpse of the agreement. (Didn’t it?)

    –perturbed

    • jonpelto

      Good questions perturbed – I am on the run – so to speak – at the moment but I will definately respond in detail.

  • Richard

    Hitting the approve button so quickly?

    It depends on whether you want a blog of vanilla ditto heads who identify abortion, gay rights, Rube Goldberg-esque solutions, and the public sector employee/pension teat.as the Democratic Party

    I am fiercely independent and never voted for the GOP FWIW (maybe some town council here and there but that’s a different thing entirely)

    That doesn’t mean I support the Democrats — as you can tell if think they’ve fallen far from their Truman and JFK- era roots. .I truly hate their fallen condition and would like to see them walk upright again.

    • jonpelto

      My response was a bit tongue in cheek. I value and appreciate the time and energy you put into your responses.

      oh – and I too beleive the Democrats have fallen from their roots 🙂

  • perturbed

    This is way OT, but both Jon and Jeff lament the loss of value in your retirement and/or college savings accounts. It’s not clear how aggressively you’re invested, but an allocation to a simple index fund portfolio with any reasonable fixed income allocation, say ~30%, held throughout the Great Recession, could currently be within a few percent of its value at the peak of the market in October, 2007, including the dividends the investments would have generated. With dollar cost averaging into the allocation throughout (when “hamburgers” were on sale), there’s a good chance of a small gain by now.

    For example, $10,000 in a target retirement fund consisting of roughly 50% total US stock market index, 20% total international stock market index, and 30% total bond market index (or any similar custom index fund blend), bought at the peak of the market and held throughout, would be worth about $9,728 today. That’s only a 2.7% loss as of today, and it would have been in positive territory for most of this year. By comparison, the 100% equity broad US market index alone would still be down nearly 15%. (Sold anytime during the period of deep fear, not good.)

    See growth chart here: http://i55.tinypic.com/1z1a1rs.jpg

    Just one example of simple, low-cost, passive, diversified, buy-and-hold investing brought to you as a public service…

    –perturbed

    PS: On the SustiNet/SEBAC 2011 chronology, see a selected list of dated headlines in my comment here:

    http://www.ctnewsjunkie.com/ctnj.php/archives/entry/stakes_continue_to_climb/

  • Richard

    SustiNet was dead when Malloy realized bringing CT up to where Massachussetts is will be expensive enough .as a first cut.

    Not to mention CT will take years to do what Mass did in one year. CT’ policy wonks pride themselves on their self-importance and white papers and assume after 4 years of wonkiness the implementation happens with a wave of the wand and its.ony then aggressive timelines must be met. Of course it’s the project is then under-budgeted and under-staffed and wasn’t as well thought out as the wonks claimed but they’ve moved on after stuffing their resumes full of praises and accolades from the peers in wonkiness. .

    In CT we have the whole medical home definition which was scaring some as the non-profits were looking to become homes and small agencies that service SNAP beneficiaires were looking to become PCMHs.

    The Slippery Slope argument against medical homes is muddying the waters by the growing number and influence of nonphysicians with doctoral degrees, whose legitimate use of the Doctor title might lead patients to make incorrect assumptions about their levels of training and scope of practice.

    Advanced practice nurses, nurse practitioners, and physicians’ assistants all now have curricula leading to the doctorate, and it may not be too far in the future when practitioners without the doctorate are grandfathered into licensing and PCMH administrative status..

    There needs to be strong legislation that only physician practices with X number of F/T active physicians can be PCMH homes and delegate to individual practioners and avoid the non-practicing PCMH, the over reaching non-profit administrative agency, from the label PCMH. The non-profit is the agency that is contracted for a specific service not the other way around where medical vendors. are selected by a non-profit to be Primary Care while the agency collects the coordination fees.

  • perturbed

    Jon,

    I’d be curious to hear your thoughts on the timing of the SustiNet/SEBAC 2011 agreements, and how they were hammered out with Malloy simultaneously. If you’ve scanned the headlines (linked above), you must admit the timing is eye-opening.

    Something else I’ve often wondered is whether Malloy pulled his support for SustiNet when he did, in part, to strengthen his bargaining position with SEBAC. He knew how important the legislation was to the SEBAC negotiating team, and he does seem to like to position himself into no-lose situations. (The unreasonable budget savings goal from state worker concessions is another example.) By opposing key SustiNet provisions, he gains the upper hand with SEBAC and any concessions on his part would need to be matched (secretly, of course) with state pension/benefits concessions. Or he simply avoids making waves in the insurance industry, just as good. Is this giving too much credit to Malloy and/or his administration?

    But if it were only a negotiation strategy, he would be free to soften his position on SustiNet now. Why would a state worker uproar worry anybody? SEBAC has the authority to implement state health plan changes on their own (well, with OPM), without a rank-and-file vote. State worker sentiment means nothing to Malloy now — or to SEBAC, either. We sure as hell won’t support Malloy now, or the union elite that run SEBAC, and they all must know it.

    Thus, your theory on protecting the insurance industry seems plausible.

    –perturbed