Commentary–

Health Care In The Promised Land

By Bill Collins

Rent or food,

It’s tough to pick;

I can’t pay both,

If I get sick.

Please celebrate with me. I have reached the Promised Land. It’s called Medicare. I’m not exactly sure yet what it covers, but that’s not the fault of the bureaucrats. They put out clearly written brochures, and have so far sent all the paperwork they promised. Nor are they asking about pre-existing conditions or bugging me for painful premiums. They’ve accepted me as is, warts and all.

Younger Nutmeggers are not so lucky. About 14 percent are not covered. Countless thousands more cling to unhappy jobs for fear of losing benefits. The cost of prescriptions is ballooning too, even for us lucky ducks on Medicare. (Drugs aren’t included.) And folks with mental illness are at special hazard. Connecticut has shut down the bulk of its mental health beds, and has mostly failed to replace them with community care. Many patients have consequently found residence in state prisons.

But perhaps most intriguingly, we are told that the state cannot get tough on prescription drug prices because that would anger our local pharmaceutical companies. They might just go off in a huff, wounding our lively economy.

Needless to say, the result of this haphazard health care system is widespread suffering. Newspapers document it from time to time with powerful human-interest stories. And fortunately, the federal government has responded by giving money to every state to cover all its children. Our state does seem to have used that money wisely in creating the Husky program.

Otherwise, however, Connecticut, like Congress, mostly wrings its hands. Or worse. Reimbursements to Medicaid providers have gone down, psychiatric hospital stays have shortened, and many hospitals themselves are on the ropes. Our state, America’s Promised Land in terms of wealth, remains for many a wasteland in terms of health. To reach safety, one must survive to 65.

Ironically, the solution to this quiet crisis is known to all. Advanced degrees are not required. We need simply to create a state program like Medicare, but which covers everyone. Each employer would pay based on its number of employees and independent contractors. Citizens would pay in too, just as we do now for Medicare. But neither employers nor citizens would have to pay insurance companies anymore. And no one would lack coverage.

Another beauty of such a system is cost. Medicare is enormously more efficient than HMOs, and with the state able to bargain for pharmaceuticals in bulk, the price of prescriptions would plummet too. Nutmeggers would instantly gain a price advantage, much like that reserved today for Americans who live along the Canadian and Mexican borders.

In fact our current health situation is reminiscent of our tax situation before Lowell Weicker. Everyone knew that the income tax was the cure to our chronic budget shortfalls. The trouble was, no one had the guts to pass it. Finally Weicker and the Democratic legislature did it, and John Rowland has been savoring the fruits ever since.

Likewise today everyone knows that government-run insurance is the cure to our chronic health shortfalls. But again we lack the guts to pass it. Connecticut, being heavy on insurance and drug companies, is especially hard to reform. Still, the truth is the truth, and the sooner we act on it, the better.

(Bill Collins, a former mayor of Norwalk, is a syndicated columnist.)