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OP-ED | Why We Still Need SustiNet

by Ellen Andrews | Apr 26, 2011 1:28pm
(2) Comments | Commenting has expired
Posted to: Opinion

There is a common and troubling misconception among legislators and policymakers the Capitol – that with the passage of national health care reform, health insurance is fixed and SustiNet is no longer needed.

Nothing is further from the truth.  In fact, national health reform makes the need for SustiNet even more critical.

In 2014, under the Affordable Care Act, everyone will be required to secure coverage unless they qualify for a public program. People who don’t qualify for Medicaid and don’t have a decent benefit offer at work will be forced to buy it in the private market.

Historically, the insurance market has been hostile to consumers. The offerings available to my low income clients are so meager, that many are better off putting their money under their mattress. The most rational economic option for them is often to forgo insurance and to pay for doctor visits in cash; if the worst happens, they would then likely qualify for some public or private assistance.

While there are new rules to vastly improve the value of insurance, enforcement is left mainly to stats and our state insurance department has a checkered history of protecting consumers. Regulation, by its nature, is reactive – waiting for something bad to happen and changing rules to react. It is necessary, but not enough to protect people.

And so we get to why SustiNet is so critical. SustiNet will provide a good insurance option – one that covers what insurance should cover, at a reasonable cost. Most important it is a public option, answering to the public not to stockholders and highly paid executives.

SustiNet’s connection to the rest of state health care programs will for the first time allow individuals, usually at a severe disadvantage in the market, to share in the benefits of bulk purchasing and innovations such as patient-centered medical homes and payment reforms to drive down costs.

What makes SustiNet is so scary to its opponents? It is an option, purely voluntary. If it doesn’t work for my clients, they won’t sign up. Because SustiNet provides what people need, it will serve as a rational competitor, keeping the insurance companies honest and raising the bar—improving the system for everyone.

While national reform provides some subsidies and limits on costs to working families, those subsidies and limits will not be enough. . Some consumers will have to spend as much as 20 percent or more of their income on health care.  It is critical that we ensure consumers are not wasting money on insurance that won’t cover what they need when they need it. The private market will not protect consumers – if it did, we wouldn’t have needed health care reform in the first place.

National health care reform is a great start, but the provisions of SustiNet that help individuals and small businesses struggling to find affordable, quality health insurance are critical to making health care reform work for every Connecticut resident.

Ellen Andrews is executive director of the Connecticut Health Policy Project.

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(2) Comments

posted by: Noteworthy | April 26, 2011  5:30pm

Nobody ever addresses how to pay the massive costs. When S-net was being formulated nobody wanted to discuss cost. In fact many proponents said it wouldn’t cost taxpayers anything. Then the estimates began to arrive none of which were lower than hundreds of millions. Malloy launched a new welfare program in EITC which will cost taxpayers a quarter billion in this budget. Already we are stealing from the transportation fund to support a bulging welfare program which consumes more than a quarter of the budget. Is there ever a point where we say enough already or do we just continue to shrink the private sector middle class and turn CT into nothing but a welfare state?

posted by: hc4all | April 27, 2011  10:20am

YES! Thank you, Ellen! There are so many mixed -and negative- messages out there that even would-be supporters get confused or discouraged. Often I think the things that are *Good* for us, for working people, are the ones we most distrust and fear. Of course I understand why the insurance industry wants to kill the public option piece, but why are regular “joe” small business owners, working and middle class and even lower-income folks scared of this? MOstly because they don’t know enough about it and they’re hearing all these negative and conflicting messages from politicians and the media.
Thanks for being a voice of reason and a moral voice.
SustiNet is all about saving money and controlling costs. NO other plan is addressing this or the 400,000 people who have absolutely no coverage (they are linked to the skyrocketing costs, of course, because they end up in the emergency room with no way to pay and that costs gets put back on all of us). The insurance industry itself admits the current system is unsustainable. Folks want to complain about the poor and about welfare -but at this rate that will be 80% of us before long. Stop falling prey to the divide and conquer. We ALL need care. We ALL deserve good health and when we care for the “Least among us” it benefits us all by strengthening our communities, lowering the financial burden on tax payers, reducing crime rates, and creating a more stable, harmonious society.