Health care reform is a very complex issue; is often not understood; so the ideas developed this year by the Conn. General Assembly are approaches, which have not been effective anywhere!

Based on what was communicated about SustiNet it sounded good to people frustrated with high medical insurance costs. However, the way it would manage medical insurance is not efficient, nor effective for residents, and would be especially costly. Thus, the SustiNet approach is not good for Connecticut.

SustiNet’s big idea was to bring small employers and individuals together and use self funding, which advocates say would save lots of money. However, if pooling and self funding had any impact at all it would just be on a very small part within the 15% of the premium dollar that is for administration. A couple important questions:
• How can pooling improve the health care situation when the primary problem is that 85% or more of each premium dollar goes to skyrocketing medical treatment expenses?

• How will SustiNet be different from pools in other states, which have not resulted in lower medical insurance costs? In most cases, they failed. For example, the Health Insurance Plan of California closed Dec. 31, 2006! It had operated with rates above the private market.

Why doesn’t pooling work? Actuarial studies tell us if say 10,000 employees who work for a couple hundred employers come together there are still administrative costs to interact with a couple hundred organizations. Then too, when grouping small organizations and individuals it brings in more higher risk individuals than found in 10,000 people working for one company.

Wonder why advocates did not investigate and find pooling unrelated individuals, no matter how many people are in it, is more expensive administratively and results in higher claim expenses?

The question becomes - what approach to health care reform is best for our residents?
• Do people really want a plan like SustiNet that would make decisions on all aspects of their medical insurance coverage? Working with consumers every day I know they want choices and would not like to deal with a public authority and all the pitfalls of government interference it will bring.

• Do people instead want private market coverage, with premium support as appropriate, so they can buy what is best for their needs? Yes because consumers like many options and want minute details on what, where, when, and how before making a choice.

Residents deserve real details on questions such as:
• How can a public authority, with no actual experience, run a complex health plan system to control costs and gain efficiency? It contracts with an insurance company, but just pays a fee to pay claims!

• Where will all the money come from to pay providers much higher payments? Quality is questionable and doctors are very limited in Husky because it just pays 57% of Medicare! How will residents benefit from a medical insurance plan with provider payment control, which is what would happen in a Connecticut public authority plan?

Connecticut residents expect health reform, whether at the state or federal level, which provides choice; keeps them in charge of their treatment; and deals with the problem we face – medical treatment costs.