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Connecticut companies prepare for health-care 'reform' - Monday, 23 March 2009 14:42

Stephen Glick was featured in this month's Business New Haven in an article titled: "Will the Cure Be Worse Than the Disease: Connecticut companies prepare for health care 'reform.'"

Exerpts from Stephen are below:

Right now we're doing roundtable discussions across the state on the issue of changes in health care. And there are four elements that emerge around the issue of reform: control, complexity, cost and access to health care. The small-business owner is under a lot of pressure, but the biggest problem is the complexity.

There is an area about to change, and that's the population that's uninsured versus those who are insured. If you take the people who are uninsured in the state, which represents less than ten percent of the population, and you look at the segmentation of those people, a lot of people have access and choice to purchase coverage - the young people. If they were mandated to have coverage or they had an incentive - they don't want to buy insurance the way a businessperson necessarily wants to buy. They want that skin in the game. They want that wellness program. There is a segment representing about eight or nine percent of that uninsured marketplace that needs to have coverage to spread out the risk and provide things. Now we have the illegal immigrants in the state of Connecticut who have come here and are forcing a pressure on all of us. Consumer-driven health plans are important and have added more people to the rolls of insurables in the marketplace. But the real issue for Connecticut and for physician care to gain more access to more people is that we have to look at the segmentation of the solution. The reverse of the question is what would affect the state of Connecticut if they had the ability to move to consumer-driven health plans? They can't. They can't even move to it. A $3 co-payment, in a very rich program, is by union contract. We're sacrificing $6 billion in deficit over the next two or three years. We have to make some changes, and we have to look at the segments of the market that are there. Everyone's using the easy way out, the pool. There are three pools that are swimming in the state right now.

The other area the stimulus bill talks about is the effect of medical care for seniors, primarily looking at a health plan for retirees called Medicare Advantage plans on which it's stated that carriers have made an exorbitant profit of 14 percent. They want to cut that profitability, and they also want to challenge the prescription utilization and how that works. This is an area of the stimulus bill that scares me because they're ultimately saying that seniors might not be able to have the same care, especially in the later challenges of their life, because of lack of incentives within the system to allow Medicare reimbursement and other services to be in there. This is definitely part of the bill that's going to have some major debate because the seniors, through their associations with others, are going to challenge the reduction of benefits for that marketplace right now.

Something that we're doing that is different, new and necessary is taking the business community and educating them about the fundamentals of health care. Another area that we're now taking a part in, because of the economics of the society, is that we're now involving ourselves in health advocacy. So we have recreated a health-advocacy program for members to actively participate in the marketplace. A doctor can talk to another doctor; it's another foreign language. The consumer cannot sometimes relate to a carrier or to a medical issue in the necessary language to get the job done. It's a major weakness, going back to the lack of education, so there has to be someone to translate. Advocacy is a translator in getting things done.

A full version of the article can be viewed at:

http://www.conntact.com/article_page.lasso?id=42639

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