Dan joins activists, elected officials, and hundreds of working people from all over the state at the Capitol steps to call upon the Governor to sign the Sustinet Healthcare bill.
The availability of affordable, quality health care is one of the most important issues facing Connecticut's children and families. As the son of a nurse, one of my proudest achievements as the Mayor of Stamford was extending health insurance coverage to more than 2,200 low-income children in the city – an accomplishment that no other candidate for Governor can claim.
I believe health care is something everyone should have. In fact, I view it as a moral issue. If a state can't work with the private sector to put in place a system to care for its people when they're sick, especially children, the frail, and the elderly, what does it say about the kind of society we are? Not something good. And not something I will allow it to say when I'm Governor.
It's time to recommit ourselves to this mission.
Connecticut's Uninsured
While I am proud to have instituted a successful Every Child Matters program that extended insurance coverage to children in Stamford, there are still nearly 335,000 Connecticut residents who do not have health insurance.
1 Most are children and working families. Why? The skyrocketing cost of insurance has made it too costly for families, small businesses and the self-employed to purchase coverage.
And those who do have coverage are paying among the highest insurance premiums in the nation - premiums that are driven up by the costs of providing care to the uninsured.
2 Just last year, Connecticut health insurance companies sought rate increases ranging from 12% - 24%.
3 Increases like the ones sought by insurance companies are simply not sustainable for most of Connecticut's working families.
U.S. Census Bureau data has shown that the number of Connecticut residents age 65 and younger with employer-provided health insurance is declining. And, more than half of all small firms in Connecticut employing fewer than 10 people do not offer coverage at all.
4 One in ten CT residents lives without health coverage, and it is estimated that 310 CT residents have lost coverage every week since the current recession started in January 2008.
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Meanwhile, the increasing cost of health insurance continue to far outpace increases in wages, leaving more and more families without access to health insurance and quality, affordable healthcare. From 2000‐2007, families in Connecticut saw an 80.7 percent increase of healthcare premiums, yet average median income only increased 9.9 percent.
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These increasing costs associated with obtaining healthcare as well as the increasing costs associated with treating those who cannot afford healthcare ultimately impact state and municipal budgets leading to cuts in services and increases in taxes.
Access to quality, affordable healthcare and meaningful health insurance has long been a concern and one that has reached crisis proportions. To be clear: I am thrilled that Democrats in Washington, D.C. passed a healthcare bill, and that President Obama signed it into law. It wasn't perfect, but it was historic, and long overdue. But it doesn't solve all of our problems, and for the problems it does address, it doesn't do so overnight. There's more we can and should do here at home.
A Basic Right
I hold a fundamental belief that quality medical care shouldn't be a luxury affordable only to some. That's why four years ago I was the first candidate for Governor to propose a comprehensive plan to extend health insurance coverage to every child in the state. And today I am the only leader in the state to have implemented such a plan at any level – all while maintaining balanced budgets and holding down taxes.
In 2006, I also proposed a comprehensive health insurance plan to extend affordable coverage to uninsured residents, while maintaining competition and choice. My plan also provided strategies for reducing health care costs and providing greater access to prevention and wellness services.
People First
State government is the largest purchaser of healthcare services in the state. I've been a vocal supporter of state legislation to use this purchasing power and large number of covered lives to help drive down costs for municipalities and boards of education – as well as other employers. The new law that allows the State Comptroller to pool prescription drug purchasing is a step in the right direction, but it's not enough.
As Governor, I would use the purchasing power and influence of state government to convene all parties -- insurance companies, employers, unions, medical practices, hospitals and others -- to improve the quality of healthcare delivery and lower costs for everyone. The current system is broken. We need to connect all providers with electronic medical records, reduce duplicate testing and procedures, and change the way we pay for healthcare services in the State. My running mate, Nancy Wyman, deserves to be recognized for her advocacy on this issue; she's been a vocal proponent of a comprehensive pooling law for a long time.
In fact, Nancy knows more about the health care system and how to reform it than just about any elected official in Connecticut. As just one example, in 2009 her office commissioned an actuarial analysis which found that the Department of Social Services had been overpaying HUSKY HMO's by more than $50 million per year. Despite attempts by lawmakers to lower those payments, the problem continues today. Our administration will change that.
I was also an early supporter of legislation that would have established a health insurance option for Connecticut residents called SustiNet. In the end, the final legislation did not go as far as I had hoped. It did not create the SustiNet Health Insurance option, but did set the wheels in motion toward developing a plan that could become law. This was a step in the right direction that was inexplicably vetoed by the Governor. Thankfully, the State Legislature showed great leadership in overriding that veto and moving us one important step closer to achieving quality, affordable healthcare for every Connecticut resident.
Again, Nancy Wyman has played an active leadership role on this issue, serving as co-chair of the SustiNet Health Partnership. Under Nancy's leadership, 160 volunteer experts are working hard as we speak to develop a strategy for implementing the SustiNet plan.
The Big Picture: Mental Illness and Health Care
No discussion of health care is complete without a discussion of mental illness. Mental illness is not discriminating. It can happen to our co-workers and neighbors, our men and women returning from extended combat, our friends and our families.
As many as 1 in 5 adults and more than 1 in 5 children experience mental illness. Most adults and children with mental illnesses do not get effective treatment and many get none at all. Without treatment, mental illness and its cost on society won't go away. With treatment, recovery lasts.
When Connecticut made the right choice years ago to stop warehousing adults and children with mental illnesses in large institutions, the state promised to invest in a safety net of effective and accessible mental health care. Connecticut did not keep that promise.
- More broken families, dependency, unemployment and lost productivity in our workforce.
- Higher public and private insurance costs for other health care consequences.
- More addictive self-medication though smoking, gambling, drug and alcohol abuse.
- More special education in our schools.
- Increased homelessness and homeless shelters.
- More expensive, ineffective and high cost hospitalization and nursing home placements.
- Higher rates of juvenile and adult crime resulting in costly incarceration.
Connecticut needs to invest smartly, save money and save lives:
- Assuring access to effective mental health care for all in need
- Ending stigma and increasing awareness
- Emphasizing prevention and early intervention
- Adequately funding and staffing state facilities
- Investing more in community-based treatment and support that sustains long term recovery through mental health care, housing, employment and peer support.
We can also work to improve care by caring for concurrent addiction and mental health issues. We treat alcohol addiction in one place and mental health issues in another. We need collocation of services and concurrent programming because each one feeds on the other. There are ways to incentivize this type of programming and we should be moving in that direction. When they are separated out, the care doesn't work.
Finally, we need to have insurance parity. In other words, we need to recognize that mental illness is an illness just like any other and should be covered at the same rates and levels as any other illnesses, not stigmatized and shunted aside with lower reimbursement rates that limit access to care.
A Healthier Connecticut, A More Cost-Effective System
In the end, if we are to succeed in providing the kind of access to health care that citizens and employers in every other industrialized country enjoy, we need leadership at the State level to do its part in the equation.
Inaction has left those in need of care without the medical attention they ought to receive. It has placed greater financial burdens on the State and local budgets. It has driven up costs to those who purchase health insurance and share in paying for uncompensated care. And, it has made our employers less competitive in a global market filled with international competitors that have universal health care coverage as a right.
With regard to healthcare, Connecticut has been penny-wise and pound foolish. We continue to pay the exorbitant costs of down the line treatments for illnesses that could have been prevented or treated before they became catastrophic. I recognize clearly that investment in prevention and early treatment will give Connecticut a phenomenal return, significantly lowering the resources we will need for more serious preventable disease.
As Governor, I will:
- 1. Change our fiscal focus from paying exorbitant costs of advanced preventable illness to prevention, early detection and treatment, thus saving lives as well as resources.
- 2. Push for a comprehensive pooling bill to allow municipalities, small businesses and the self-employed access to better coverage at a lower cost. In addition to providing more health care coverage, this will make Connecticut a more business friendly state – i.e., it's a job-creator.
- 3. Form strategic partnerships with Connecticut's community health centers, which play a vital role in our health care system by treating those who have been denied or cannot afford health insurance, or who don't live in close proximity to a hospital.
- 4. Properly fund our nursing homes to cover the actual costs of providing care. In urban areas, I will ensure the homes are kept open so local residents can remain near family.
- 5. Properly fund privately-operated (non-profit) group homes and day programs to maintain and improve care services and job standards. These services have been severely under-funded for years, leading to high staff turnover rates.
- 6. Establish a ‘Workforce Council' for the growing home care industry so that our caregivers have a voice in the development of care requirements and job standards, including wages, benefits, training, and more. This Council could also maintain a statewide list of caregivers to assist consumers in finding referrals.
- 7. Expand Connecticut's Primary Care Case Management (PCCM) system, HUSKY Primary Care, to 400,000 low income children and parents in the HUSKY program. Participants in PCCM receive comprehensive care that is coordinated by a primary care physician to optimize and integrate all of their healthcare needs. PCCM is key to prevention, early treatment and maintaining health. Like the pooling bill, this will deliver better health care at a lower cost.
- 8. Work with our congressional delegation to get our fair share of Medicaid and Medicare dollars.
- 9. Make mental health care the priority it should be, but still isn't.
- 10. Provide leadership to create all-payer Patient Center Medical Home primary care practices throughout the state to improve quality and lower medical costs for everyone.
- 11. Work with the federal government and medical schools in the state to train more primary care physicians, nurses, and other providers who will remain in the state to meet the needs of our residents.
Conclusion
We've made some progress on healthcare in Connecticut in the past year, and Congress and the President made history in Washington, DC. But the fact is that too many people in Connecticut still don't have access to quality, affordable healthcare. That will change when I'm Governor. So too will the incredible, job-killing burden the cost of healthcare places on employers. I am completely convinced that, with Nancy Wyman's as my partner in this effort, we can expand access and bring costs down. We can improve people's lives, and make Connecticut a more business friendly state. That's a promise we have a moral responsibility to keep.
References:
1"Census data show decline in employer-sponsored health insurance coverage in Connecticut over decade" Connecticut Voices for Children (September, 2009).
2Business Council of Fairfield County, Connecticut Health Scorecard, p. 72 (December, 2007)
3OLR 2009-R-0442 (December, 2009)
4Business Council of Fairfield County, Connecticut Health Scorecard, p. 68 (March, 2006)
5The Clock is Ticking, Families USA, July 2009.
6Families USA, “Premiums vs. Paychecks: A Growing Burden for Connecticut’s Workers,” Sept, 2008.
"Census data show decline in employer-sponsored health insurance coverage in Connecticut over decade" Connecticut Voices for Children (September, 2009).
DAN MALLOY FOR GOVERNOR OF CONNECTICUT