Healthcare, Malloy Healthcare, Malloy, SustiNet
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
Democratic Legislators, Healthcare, Malloy, State Employees Democratic Legislature, Malloy, State Employees, SustiNet
(Cross-posted from Pelto’s Point at the New Haven Advocate)
CTNewsjunkie posted another must-read story last night about the Democratic efforts to ease concerns that the Malloy/SEBAC agreement is somehow related to Connecticut’s comprehensive healthcare reform law. (see Wyman Seeks to Clarify SustiNet Rumors)
Rumors have been circulating that SustiNet (Connecticut healthcare reform) and the union agreement are related. State employees even received an email from a fake state employee making that statement.
As has been noted on this blog and in many other places, people can come up with reasons to vote against SustiNet or against the SEBAC agreement; but saying they are connected is not one of them.
In any case, the Malloy Administration and the Legislative Democrats joined the effort yesterday to persuade state employees that, in fact, the truth is the truth and SustiNet does not pave the way for the concession agreement and the concession agreement does not pave the way for SustiNet.
Part I of their effort came in the form of an email from Nancy Wyman to all state employees re-stating the fact that the two issues are not connected.
Part II was quite a bit more bizarre.
Think of the child who says to his or her parents “If you don’t buy me that IPod I will hold my breath until I turn blue.”
Or the bank robber who walks into the bank, puts the gun to his or her own head and says “If anybody moves I will pull the trigger.”
As CTNewsjunkie reports, “In what is a rare move the General Assembly recommitted the SustiNet bill in order to send a message to those trying to use it to defeat the $1.6 billion union concession package…” Recommitting a bill sends it back to committee and prevents that particular bill from being considered again during the legislative session.
According to the story, Democratic leaders “didn’t want anything they were doing to interfere with the decision 45,000 union members will be asked to make about their health care and pension benefits.”
The irony being that SustiNet was and is a very important piece of legislation. Advocates for healthcare reform have been working for years to ensure Connecticut is at the forefront of the effort to reform our of control health care insurance system. However, rather than trust state employees to understand that the state employee agreement is not related to SustiNet, they just voted to kill SustiNet, throwing away the opportunity to actually do something about the rising costs of healthcare insurance. (Go figure.)
Meanwhile, in a more direct effort to explain the situation to state employees, Lt. Gov. Nancy Wyman sent an email to the employees explaining the facts.
Wyman wrote, “the proposed changes to our healthcare coverage are not in any way related to SustiNet, or to the federal healthcare reform that became law last year…Our benefits will continue to be provided by Anthem or Oxford under the plan we selected during open enrollment.”
So when all is said and done, the truth is the truth…SustiNet and the SEBAC agreement are not related.
In case people missed the point – SustiNet and the SEBAC agreement ARE NOT related!
Oh, and meanwhile, for those who are shocked to see the SustiNet legislation go up in smoke, it is important to note that (1) as a result of Governor Malloy’s surprising opposition to the very concepts he had previously supported during the campaign, the present SustiNet bill has been so watered-down that it is but a shadow of its once impressive initiative and (2) the Malloy Administration already developed an Executive Order on
SustiNet back in the first week of April. The order, which only covers the minimal items that Malloy will support can then be issued once the Malloy/SEBAC agreement is resolved. In that way, Malloy is not only able to subvert the SustiNet healthcare legislation, but can come out on top claiming that he and he alone has been able to keep the healthcare reform process going. It is what is called a “win/win” move.
Finally, the piece de résistance of the last day of maneuvering is how Lt. Governor Wyman ended her email to state employees. Wyman’s final line to Connecticut’s state employees reads “thank you for the good work you do every day. Governor Malloy and I are grateful for your service.”
This, coming less than 24 hours after Malloy once again threatened Connecticut’s state employees, saying, “We will lay people off on a large scale for which I will not feel responsible,” and noted that the layoffs will include employees with far greater than 10 years of state service.
It reminds me of the school bully who beats up a kid every day for their lunch money and then says “by the way, I’m grateful that you come to school every day.”
The more things change, the more they stay the same.
Healthcare, Malloy Malloy, SustiNet
(cross-posted from Pelto’s Point at the New Haven Advocate)
Like a scene out of a Monty Python skit we hear that SustiNet is not dead after all. Perhaps it is only sleeping.
But last week Governor Malloy and Democratic Legislative Leaders agreed to a “compromise” on the SustiNet bill that gutted its major provisions.
Gone was the large purchasing pool to drive down insurance premiums, gone was the ability for small business to buy into the state insurance pool thereby having an additional option in the never-ending quest to find affordable insurance and gone was the “public option”, the technique for making sure those without health insurance can get coverage.
Governor Malloy’s senior advisor made it very clear where Malloy stood. Gone were the pledges, promises and observations from Candidate Malloy and in their place, Roy Occhiogrosso said the governor “does not believe that [a public option] is a viable option at this point. He thinks it might not ever be.”
Alas, it was only last August when Malloy, then the Democratic nominee for Governor and fresh from his primary win over Ned Lamont said ”I want to be perfectly clear. I support a public option. I don’t think we have health care reform without a public option,”
In any case, yesterday, as supporters of SustiNet rallied and marched in Hartford, advocates and proponents optimistically declared that Sustinet was not dead – in fact – total victory was insight.
You can read the excellent coverage in the CTMirror and CTNewsjunkie
At Wednesday’s pro-SustiNet rally, House Speaker Chris Donovan said “We’re going to open up the [state employee health insurance] pool to cities and towns and eventually, small businesses…We’re going to create that public option in Connecticut so that everybody can afford health care.”
Juan A. Figueroa, president of the Universal Health Care Foundation of Connecticut, one of the initial supporters of SustiNet said, “Don’t believe the obituary that has been written by some members of the press…Don’t believe those obituaries”
As in what? It was the media that killed SustiNet?
So the question now is – what gives?
Governor Malloy is against all the major provisions of Connecticut’s comprehensive healthcare reform bill.
The Malloy Administration has even gone so far as to say the federal health care reform law is the way to go rather than state action – despite the
fact that Congressional Republicans continue their unending effort to derail, destroy and decimate the federal law. Let alone the additional fact that even if the Republican’s efforts aren’t successful, the federal healthcare reform law will fall far short of providing universal coverage for health care insurance.
So again, the question remains, what gives?
The proponents say the fight is not over even though they have agreed to a compromise that undermines the program.
To borrow from a World War I analogy of sorts, it confuses the troops when the generals command “Charge, over the trench!” while word continues to circulate that have already signed the proclamation of surrender.
(cross-posted from Pelto’s Point at the New Haven Advocate)
The Connecticut Business and Industry Association, the group that deserves much of the credit for helping the Malloy Administration derail Connecticut’s landmark comprehensive healthcare reform law known as SustiNet, has also been the state’s loudest voice against health care mandates. Mandates being state laws that require health care policies sold in Connecticut to cover certain types of services.
In a recent release, CBIA wrote “According to the Small Business and Entrepreneurship Council, Connecticut’s healthcare mandates have made our state among the costliest in terms of healthcare costs in the nation. We rank eighth. It’s not a distinction of which we should be proud.”
And the CBIA goes on to say “CBIA has been saying this for years — our words often falling on deaf ears in the legislature considering that the General Assembly doesn’t appear to be able to control itself from passing these cost drivers.”
8th most expensive state in the nation for healthcare due to healthcare mandates!
Yup, 8th most expensive and according to the Council for Affordable Health Insurance, it’s Connecticut 54 health care mandates that are a key factor in our high healthcare costs and corresponding sky-high insurance premiums.
Seems like a clear cut need for action, except what CBIA doesn’t report is the fact that Texas and New Mexico, two very pro-business states have 57 health care mandates each while Virginia, another state held out as a pro-business environment, has 60 healthcare mandates. At the other end, Montana, one of the ten best states according to the report CBIA has “only” 40 mandates (14 less than Connecticut).
So what exactly are these mandates that CBIA wants repealed?
Connecticut law requires that, among other things, health insurance policies sold in Connecticut must cover ambulance services, autism screening, lead poisoning screening, mammography, mastectomy and breast reconstruction, cervical cancer screening, diabetic supplies, emergency services, prostate cancer screening rehabilitation services and well child care.
Hard to imagine those are the things CBIA doesn’t think are important.
They must mean other health care mandates. How about Montana, at only 40 mandates they must have it down to only the bare minimum. So what DOESN’T MONTANA require? Try ambulance services, autism screening, lead poisoning screening, cervical cancer screening, hearing ads for minors, prostate cancer screening and rehabilitation services for starters.
Meanwhile, while CBIA provides legislators and the media with “facts” about the negative side of health care mandates, they don’t reveal that The Small Business & Entrepreneurship Council, a very conservative “think-tank” is actually using information from the Council for Affordable Health Insurance, which is another very conservative “think-tank’ that serves as the a voice for the insurance industry.
And we’re not talking about those run-of-the-mill conservatives. The Small Business Council includes Grover Norquist, the founder of Americans for Tax Reform, a group that “opposes all tax increases as a matter of principle.”. Not only is Americans for Tax Reform a leader in the anti-government movement, but they are also playing a pivotal role, along with the Koch Brothers in opposing climate change legislation. Another key player at the Small Business Council is a conservative operative named Sydney Hoff-Hay, whose claim to fame is being called the “the Iron Lady of Arizona’s right wing.”
By the way, this is the same Small Business & Enterprise Council that rates members of Congress, recently giving right-wing nuts like Boehner, Cantor, Paul Ryan and “not intended to be a factual statement” Republican Senator Jon Kyl 100% ratings while bestowing on Connecticut’s Rosa DeLauro, Joe Courtney and John Larson a pawltry 0% ratings.
And the Council for Affordable Health Insurance? they have their own roster of top line conservatives including the former head of the American Conservative Network Merrill Matthews as well as others who have been out flacking for America’s Insurance Industry.
Talk about not revealing your sources.
Finally, back on SustiNet, CBIA recently wrote “Gov. Malloy should be congratulated for bravely defending the fiscal viability of the state while holding true to his goal of real healthcare reform – which he rightly sees federal reform as addressing.”
An interesting approach from a group that makes a significant amount of money from selling health insurance policies to small businesses in Connecticut, a major revenue stream that might be negatively impacted if SustiNet became law and employers could benefit from the state’s buying power.
Hey CBIA…So much for telling the public the truth and nothing but the truth!
Malloy Malloy, SustiNet
Thanks to a deal between the Malloy Administration and the Legislature’s Democratic leaders, a “SustiNet” bill will move forward – but in a form that is but a shadow of what it was and what it was meant to be.
The deal will allow municipalities and a sub-set of nonprofit organizations to buy into the state employee healthcare plan but the public will be left out.
Furthermore, the “deal” will not combine Medicaid and state employee and retiree health plans into a large purchasing pool so the insurance industry need not fear that a new major force will be created that could push down healthcare premiums.
Also, since small business will not be able to buy into the plan, it’s a huge win for the Connecticut Business and Industry Association who maintain a very lucrative health insurance sales business they offer to their business members.
The “piece de résistance” is that the “deal” will create a “SustiNet Advisory Panel” that will be housed within Lieutenant Governor Nancy’s Wyman’s office. The new committee will be responsible for overseeingConnecticut’s health reform efforts. The net effect will be that Wyman, who played such an important role in developing the comprehensive SustiNet legislation, will now be responsible for overseeing the water-downed version of the plan.
Ellen Andrews, the Executive Director of the Connecticut Health Policy Project, and a key proponent of the real SustiNet plan gets the award for the quote of the week when, in response to the news that the deal does not include a plan for covering the uninsured, said “That was kind of the whole point of this from the beginning.”
Andrews, who was quoted in a CTmirror story, added “If all they’ve accomplished is putting different groups of people who have really good insurance together but not expanding to the uninsured, they haven’t helped [those who don’t have coverage now].
Bottom line; The business community and the insurance industry, with the help of the Malloy Administration, derailConnecticut’s healthcare reform effort.
Healthcare Malloy, SustiNet
From my commentary piece on today’s New Haven Advocate web-site
The former Lion of the Senate, Ted Kennedy, is rolling over in his grave.
Last week saw the one-year anniversary of the national healthcare reform legislation that Kennedy envisioned and Connecticut’s own Chris Dodd helped bring about. During that time, Connecticut has been moving forward with an even more impressive comprehensive health care reform package.
SustiNet, one of the most far-reaching health care initiatives in the country, was designed to fit into the new national reform structure but go even further in ensuring that Connecticut’s citizens have access to high-quality and affordable healthcare.
But Connecticut’s healthcare reform effort is flat-lining as Democratic Gov. Dannel Malloy abandoned the SustiNet health care legislation that his own Lieutenant Governor helped craft. Instead of working through the concerns he had, Malloy stunned the bill’s supporters this week by announcing in a statement that he “does not think this piece of legislation is the right vehicle” for achieving health reform.
One of the most important elements of the SustiNet system would have been to place state healthcare programs (including those for state employees, retirees and Medicaid recipients) under a quasi-public authority made up of people appointed by public officials. In this way, the state could leverage its $7 billion in purchasing power to save money, expand coverage and slow the growth of healthcare costs.
Malloy recently blasted the concept, despite the ironic fact that it is a system utilized by American businesses every day. If the state is buying health coverage in bulk, it will get a better price. Walmart and Target are two examples of how bulk-buying power can be leveraged to increase quantity while reducing cost.
Once Connecticut’s new bulk purchasing system is in place, municipalities, small businesses and nonprofits would then be allowed to buy healthcare coverage through SustiNet.
Finally, there would be a “public option” that would be used to cover all uninsured Connecticut citizens, while allowing any individual or employer in the state to buy the SustiNet coverage if appropriate and cost-effective.
To ensure that Connecticut’s “public option” succeeds, the law even requires that before the public option can be created, the new SustiNet Authority must determine that coverage will be financially viable and would not require any subsidy from Connecticut’s General Fund. In this way, the public option could not be used to undercut Connecticut’s private health insurance sector.
Despite these protections, opponents have consistently raised concerns that SustiNet would end up competing against Connecticut’s famous insurance industry and would cost more taxpayer funds than has been projected.
Democrats have been strong supporters, even going so far as to override Gov. Jodi Rell’s veto of the legislation putting the SustiNet planning process in place.
During the gubernatorial campaign, Malloy made reform one of his core issues.
“I hold a fundamental belief that quality medical care shouldn’t be a luxury affordable to some,” he said, and touted his record of support for “a comprehensive health insurance plan to extend affordable coverage to uninsured residents.”
When Malloy chose State Comptroller Nancy Wyman, a leader in the SustiNet planning effort, to be his running mate, he wrote: “I am completely convinced that, with Nancy Wyman as my partner in this effort, we can expand access and bring down costs down … That’s a promise we have a moral responsibility to keep.”
But just a few weeks later, when the landmark legislation came up for its first legislative public hearing, Malloy blasted the proposal.
Last week, as noted by the CT Mirror: “Malloy expressed his strongest reservations to date about the proposed SustiNet program.” Speaking in front of one of his townhall meetings, Malloy questioned both the cost of SustiNet and the appropriateness of even setting up the SustiNet Authority.
Then on April 1, Roy Occhiogrosso, the governor’ senior advisor, announced that Malloy did not support a public option at all: “He is hard pressed to see how something that has not been tried and proven effective anywhere else could be done here.”
What may prove to be the “nail in the coffin” occurred on April 5 when Malloy completed his march toward opposing the legislation.
There is no question the news comes as a stunning blow to many of Malloy’s strongest supporters who believed that it was Malloy’s very public support of comprehensive healthcare reform that proved to be the galvanizing force behind his successful campaign to beat Tom Foley, a staunch opponent of healthcare reform efforts.
[Cross-posted from Pelto's Point - http://www.newhavenadvocate.com/peltos-point/default]
The Connecticut legislature will be holding a major public hearing today on the legislative proposal to further implement Connecticut’s landmark healthcare reform program called SustiNet.
SustiNet was adopted in 2009 by the Connecticut General Assembly. The law put in place a process to ensure that Connecticut was ready to implement the Federal healthcare reforms that were making their way through Congress. With a major implementation plan developed, phase I of the law is now complete and it is now up to the legislature to authorize or reject moving forward with the full plan.
Healthcare reform has become the issue of our time, both in Washington and here in Connecticut. In our politically polarized country few if any issues generate as much rhetoric and political debate. As observers across the political spectrum have come to know, it is the duty of Republicans, conservatives and tea-baggers to refer to national health care reform as Obamacare and socialism. Meanwhile, Democrats, liberals and those on the left are quick to point out that opponents of healthcare reform refuse to recognize that Americans have a fundamental right to health care and that like Scrooge, these right- wing nuts will not satisfied until the so called surplus population (aka the poor and uninsured) are dying in the streets.
Interestingly, both sides have managed to put God and country on their side while openly suggesting that the other side is following in the footsteps of Hitler and the Nazis. Meanwhile, the laws that require hospitals to treat anyone who walks in the door remain intact and virtually all economists recognize America’s existing healthcare system is bankrupting the country, our economy and countless hard-working Americans.
So with that as a backdrop, Connecticut s state government will spend a good deal of time and energy in the coming months debating whether to move forward with the SustiNet, a law that is designed to make sure that Connecticut is at the forefront of the effort to create a higher quality, more affordable healthcare system that will also provide healthcare coverage to the state’s uninsured residents.
One of the most important elements of the SustiNet law was the requirement that, regardless of what eventually happens with the Federal reform effort, insurers in Connecticut will be prohibited from discriminating against people with preexisting conditions. In addition, the SustiNet law includes a series of steps to improve quality while slowing the increasing costs of healthcare in Connecticut.
By bringing together state employees and retirees as well as state funded Medicaid and HUSKY beneficiaries, the law begins by using the state’s buying power to force health insurers to enhance coverage while charging more reasonable premiums.
Second, this new SustiNet health coverage option will give Connecticut cities and towns the opportunity to buy into what will be better, more affordable health insurance policies thereby reducing the pressure on local property taxes.
Third, SustiNet will then offer commercial-style insurance to small employers and non-profits, allowing employers and non-profit organizations to provide their employees with more, and hopefully less expensive, healthcare coverage.
When fully implemented, municipalities, employers and consumers will all be able to buy into the larger, more efficient SustiNet health insurance pool if they determine that is their best course of action for getting high quality, affordable coverage.
The SustiNet system will also maximize the amount of federal funds Connecticut receives. By getting its full share of federal funds, these enhancements and improvements will be much more affordable.
Further, the SustiNet law raises the required level of patient care including state-of-the-art programs like patient-centered medical homes, emphasis on preventative care and evidence-based medicine. It also creates fairer, more accurate reimbursement methods and encourages investment in technology such as electronic medical records that reduce medical errors and duplication of services.
Finally, rather than leave the development and management of this program in the hands of various state departments and agencies, the law seeks to improve coordination and oversight through a quasi-public SustiNet Authority.
Are there major costs associated with implementing this piece of legislation – yes of course – but there are even greater costs by not implementing it. People who need care and don’t get it end up seeking treatment in far more expensive places like emergency rooms. Meanwhile without affordable health insurance more and more companies will find themselves unable to maintain their present work force let alone expand it. And cities, town and nonprofit companies all need to find ways to provide quality benefits at more affordable rates.
Opponents miss the key point – SustiNet is a piece of legislation that will lead to a better Connecticut – economically and healthwise.
(The full implementation recommendations of the SustiNet Board can be found at: www.ct.gov/SustiNet)
For an excellent opposing view on this story, check out Heath Fahle’s new blog http://www.heathwfahle.com/blog/.