story & photo
by Vito Leo
At the invitation of the League of Women Voters of SECT (LWVSECT), several members of Universal Health Care Foundation of CT, Meriden, explained a new concept in health insurance at the Groton Public Library on April 20th. The hour-long presentation detailed SustiNet, a plan for health insurance designed to include all CT residents. The proposal is expected to be voted on during the current legislative session.
“This option is a completely brand new idea that deserves a chance to help all those people out there who don’t have health insurance,” said Mary Elia who travels the state promoting the new plan.
“The plan allows people satisfied with their existing private coverage to keep it,” said Marilyn Mackay, LWVSECT. “Folks eligible include those without access to employer-sponsored insurance – sole proprietors, other self-employed individuals and those offered employer-sponsored insurance that does not provide affordable access to essential care.”
SustiNet revolves around the concept of combining state employee coverage, HUSKY and SAGA with the coverage offered to small business owners. This would save money by forming a large block of insured that can negotiate lower costs for pharmaceuticals and medical services.
Ken Esposito, point-man for the presentation, said insurance companies would be paid as independent contractors to administer the plan “but they won’t be the deciders” of who gets what medical coverage as they are now. Instead, the plan will spell out exactly how benefits are awarded.
“The idea is to raise the fees for family physicians, who now get only about 35-percent of the reimbursement fees from health insurance as opposed to specialists who get about 65-percent,” said Ken, adding that with more family doctors, the emphasis will be placed on preventive care, ultimately translating into huge savings in hospital costs. The way it is now, family doctors are reimbursed a set fee for an office visit regardless of how long it takes. Under the new plan, doctors would be compensated more for doing more, like setting up a special diet for a patient.
According to Ken, this revolutionary plan differs from the one mandated by Massachusetts which is reported to be in financial difficulty. “That’s because they didn’t address the delivery system when they made health insurance mandatory,” said Ken. “SustiNet takes the time to do that.”
The proposal will take two years to implement, that is, to make the systemic changes necessary for the plan to succeed. Therefore, the insurance would not be offered to the public until two years after the state legislature approves it. “That’s why it’s so important to get it passed in this session,” said Judy Dolphin, Gales Ferry, co-president, LWVSEC, urging residents to write and phone their state senators to vote “yes” on the issue.
The proposal would be most beneficial to employers feeling the pinch of ever-rising health insurance premiums. “I think as more and more small business owners hear about this, they’re going to be excited about the potential for comprehensive health care coverage they can offer their employees while saving money in the process,” said Mary.
For more information visit www.universalhealthct.org, www.healthcare4every1.org, or call 203.639.0550.
