‘Tonight We Have A Plan’
by Christine Stuart | January 13, 2009 10:03 PM
Posted to Health Care
“Two years ago we didn’t have a plan we had an ideal—tonight we have a plan,” Rabbi Stephen Fuchs told hundreds gathered at Union Station in Hartford Tuesday.
Two years ago the Universal Health Care Foundation’s proposal to solve the crisis of the uninsured in the state fell flat when the Office of Fiscal Analysis put a price tag on it.
Juan Figueroa, president of the Universal Health Care Foundation, said earlier Tuesday afternoon during a conference call with the media that the Sustinet proposal is different in that it addresses the delivery of health care by making it more efficient, instead of simply dealing with the financing of the plan.
It creates “medical homes,” which is the modern version of a family doctor. In addition, it requires participating doctors to upgrade to an electronic medical records system and measures patient outcomes.
The plan which was put together over the past two years was also a collaboration. Figueroa said the proposal incorporates the ideas and suggestions of individuals, businesses, clergy, doctors, labor, and national experts.
Dr. Michael Deren, council chairman of the Connecticut State Medical Society, said many times these health care proposals are written in a vacuum without the input from medical physicians. He said that’s not the case with Sustinet, where the input of the medical society’s 7,000 members was welcomed and incorporated as part of the plan.
“If the concepts in the plan are passed things will change,” he said.
But Tuesday night was not about facts and figures or details about the plan it was a rally and a celebration.
The rally call Tuesday night was a resounding “Yes we can!” followed by “Yes we will!”
Inspired by the many speakers before him, Sen. Jonathan Harris, co-chairman of the legislature’s Public Health Committee, asked the hundreds in attendance to stand up so he could know it wasn’t a dream.
“We don’t need to study this anymore. We need to act,” Harris said.
Last week Harris said he believed some kind of health care reform was possible this year despite the state’s more than $6 billion budget deficit. However, he said it was possible as long as it didn’t cost any money. “Any new spending this year is not likely,” Harris said.
That being said the new costs associated with Sustinet are not immediate, Harris said Tuesday. He said the proposal would be in the planning stages for 2009 and 2010 while the state attempts to tackle some of its deficit woes.
Enrollment in the plan would begin in 2011 and by 2014 it would be fully operational.
Figueroa estimates that by 2014 families and businesses could save an estimate $1.75 billion.
In closing Tuesday’s rally Rev. James Walker called it a “watershed” moment and said there should be “no delay, no hesitation, and no compromise” when it comes to advocating for Sustinet. “It’s time for us to get vociferous,” he said.
Click here to read our earlier report which includes more details about Sustinet.
Comments (3)
Posted by: City Hall Watch | January 14, 2009 10:04 AM
How do you launch a new program and not have it cost any money? I'm all for efficiency but I don't believe for a second there is no cost in 2009 or 2010. Even if there isn't, what's the cost in 2011, 12 and 13? Lots of discussion about saving dollars - what's the cost to the state taxpayer?
This type of fuzzy thinking where programs are started now and the long term funding of it is somehow paid for later is exactly what's gotten us into the financial problem we're in. New Haven does exactly the same thing and eventually, the program becomes part of the lineup in the budget and taxpayers are forced to squeeze their family budgets because of higher taxes to pay for that new program.
Posted by: hopeful | January 14, 2009 1:15 PM
Could some one tell us more about the "Medical Homes" and how this would differ from the role and tasks of a Primary Care Physician. Could be a good idea if it freed up doctors to have more time to treat patients, rather than dealing with paperwork. But the term "medical home" is problematic. It implies a residential facility - as if someone was trying to use a euphemism for "nursing home." The medical wold is full of difficult language; it's worth thinking through the concept to find a term that does not cause more confusion.
And also - the digitized medical records need to be open to patients, not just doctors. The most progressive insurance companies do this and some have even made it possible for patients to add corrections records, which is very important.
Posted by: Edward J.Volpintesta MD | January 18, 2009 7:01 PM
The medical home means placing primary care doctors in a central role whereby patients see them for all their primary care needs; it also means that primary care doctors will act a coordinators for their patients, making referrals to consultants, following up patients discharged from hospitals and nursing homes, following up on abnormal CT scans, X-ray and other laboratory tests, dealing with health insurers when conflicts arise over patients' coverage for lab tests, referrals, and medications, and other responsibilities.
In part this is like the "gate keeper" concept that insurers tried to impose a decade ago and failed. Many primary care doctors already act as medical home doctors. The concept is good but care must be taken that doctors are not over-burdened with paper work, something that many of them already complain of.
Primary care doctors who choose to formally act as medical home doctors must be paid fairly for their added responsibilities.
Not all these doctors can afford the electronic medical record systems which they will be required to install. Most will need financial aid and technical help if they are to have completely electronic offices.
The malpractice system must be reformed if the medical home is to succeed. Primary care doctors are amongst the most frequently sued doctors. They are sued for failure to diagnose and failure to refer in a timely manner. Living under the ever-present threat of malpractice suits most of which are frivolous, these doctors frequently practice defensive medicine. That is, they order unnecessary tests and consultations in order to have a good defense in case a suit is filed. This wastes innumerable millions of dollars and has all but destroyed doctor-patient relationship. Injured patients must be compensated fairly of course, but the current system is out of control and too many loopholes exist that allow for opportunism and exorbitant awards . This alone is a reason why many doctors are refusing new patients and not taking on seriously ill ones.
Finally, there are not enough primary care doctors to satisfy the primary care needs of our state. And when universal care is enacted chaos will ensue. This happened in Massachusetts where all are required to have health insurance but patients found that the primary care doctors were not taking new patients. Thus new training programs that are more practical than current ones must be sought to train primary care doctors quicker to fulfill future needs. Two or three years could be safely cut out of the usual eight years currently required before residency.
Finally serious thought must be given to using nurse practitioners and physician assistants in new ways. The new relationship must not compromise either's professionalism but be based in complementing each other.
Clearly a new paradigm is needed for providing primary care. The current system has not worked for over two decades. The time is right for a pragmatic and comprehensive response.