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Today the Authority tried to narrow down the options they will consider for study through the rest of the process. The Chairs began with their list of issues that everybody agrees on. It is long:
Strong prevention and health promotion component
Medical home
Electronic medical record and health information technology
Enrolling everyone who is eligible for public programs
Management of chronic illness
Incentives for healthy lifestyles and wellness
Transparency – most emphasis on data for state policymakers to make decisions (if they will) but expanded to include information for consumers in response to a question
Evidence based practices
Improving Medicaid reimbursements – recent increases were not enough
Patient safety
Employer and individual contributions
Addressing workforce shortages
Members also suggested adding Medicare cuts, universality, military health care cuts, consumer education, sustainability, adaptability, increasing federal reimbursements, and access to specialty care.
They then moved onto components that may not be unanimous. They noted that the legislation requires the Authority to consider single payer universal health care and universal primary care options. They also agreed to model the CT Health Insurance Policy Council’s proposal. Other ideas included:
· Maintaining employer and Medicare coverage
· Expanding Medicaid
· Moving SAGA into Medicaid
· Insurance pooling – including what subsidies would be needed
· Shared responsibility (employers, government and individuals) as in Healthy San Francisco, this model includes undocumented immigrants
· Incentives for quality and wellness and support for Medical Home Services
After the list was read, there was silence as most in room waited for the debate to begin. We weren’t disappointed. Perspectives and concerns were predictable. Insurers want a cost benefit study of insurance mandates and lauded Florida’s new barebones policies. There was a great deal of support for studying how a Healthy San Francisco-style model would work in CT. A suggestion to pilot it in an urban area led to concerns about two tiered care. There was no real consensus on which options to move forward. Important decisions were put off until the next meeting. At the next meeting, the members will also each get a copy of the latest Health Affairs – we’ll see if it helps. They will also discuss financing vehicles and an individual mandate – I can’t wait.
Ellen Andrews