Thursday, April 19, 2007

Connecticut’s “universal” health insurance plan

Connecticut was hoping to be the next state to unfurl a universal health insurance plan. But will it unfurl? My sources say no. The Hartford Courant reported last week:

In a year when legislators pledged to cure the state's health care ills, the most ambitious plan of all would have the state fund coverage for everyone in Connecticut under age 65 . . . The cost is slightly more than the entire state budget proposed by the governor.

More than the entire state budget???? And NO ONE in the legislature had a clue about the cost? It is decidedly so.

What about all those actuaries working in Connecticut - at CIGNA, United, Aetna, Anthem, Oxford Health Plans, Connecticare? Did anyone ask them? Don't count on it. Did they ask them and then ignore their advice? Reply hazy, ask again later.

Read the
whole article.

Recall that the Massachusetts legislature simply declared victory over cost and adopted a comprehensive plan but with a deductible of $2,000 and $4,000 for a family. The State’s $175 monthly premium target is met only for single persons under age 35. (Those persons will actually be self-insuring the first $4,000 of their medical expenses each year considering the premiums of $2,100 plus the deductible is $2,000). Everyone else will pay higher premiums, some much higher. Will most of the Massachusetts uninsured enroll in this plan? My reply is no.

California is also trying to find a comprehensive plan that won't cost much. Will they find it? Outlook not so good.

Tennessee is taking a different path. It abandoned the catastrophically expensive TennCare, in favor of a limited liability plan that will actually be quite affordable (premiums = about $155 per month per person, shared equally among individuals, employers, and the State). But the low premium is achieved by limiting the maximum annual benefits payable to $25,000 and limiting pharmacy benefits to $250 per month. This compares with comprehensive plans that typically have no annual maximum, and lifetime maximums of $1-5 million. The limited-liability plan has the advantage of small copays for office visits and medications. But keep in mind hospitals cost around $2,000 per day for routine care and intensive care is much, much more. Will the Tennessee approach work? Cannot predict now.

The Hartford Courant article goes on to state:

“Without a cost affixed to it, the so-called single-payer plan was approved 12-7 by the legislature's insurance committee last month.”

Without a cost affixed – they liked it? And that was only one month ago??? Say, how did those 12 Humpty-Dumpties ever get on the insurance committee? Better not tell you now.

Do ya think these situation comedies now being played out in state houses foreshadow a main-event political circus when the U.S. Congress takes up the debate on health care? Signs point to yes.
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