Office of the Healthcare Advocate State of Connecticut

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Office of the Healthcare AdvocateState of
Connecticut

• Kevin Lembo, MPA
• State Healthcare Advocate
• Council of State Governments - Eastern Region
• 47th Annual Meeting
• Quebec City, QC
• August 14, 2007

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Some of the numbers
Source Health Policy Monitor, Country Facts,
International Network Health Policy and Reform,
European Observatory on Health Systems and
Policies
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A few more
Source Organisation for Economic Co-Operation
and Development 2004, 2005, 2006 Joint
Canada/U.S. Survey of Health, 2002-03
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Issues for Policymakers

• Agreeing on a Goal
• Adopting a Common Language
• Define meaningful coverage
• Research What can we learn from other states or
  countries?
• Balance Will the actuaries and ethicists please
  stand?

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The Goal

• Access ?
• Better Health and Outcomes ?
• Equity and Fairness ?
• Or
• Decrease the of Uninsured ?
• Slow the Increasing Cost of Health Care ?
• ALL OF THE ABOVE ?

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The Themes

• American Ingenuity We need an American solution
  in the health care crisis.
• Future/Prevention We need to make investments
  in our families and countrys future.
• Enough is Enough / Fairness Were paying more
  and more, but cant count on coverage when you
  really need it.
• Values Its just wrong for anyone who works
  hard and plays by the rules to go without decent
  affordable health care. We can do better.

Source Herndon Alliance, January 2007, American
Environics Lake Research Partners
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Finding Common Language

• What is Risk ?
• Loss-Ratio ?
• Medical Necessity ?
• Preferred Provider Networks ?
• Co-payments / Co-insurance ?
• Capitation ?
• More, more, more

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Meaningful or Basic

• How much coverage do we need ?
• What should it cover ?
• Who decides ?
• Everyone needs some kind of coverage. You know,
  something to just get by until they hit the
  lottery.
• - Uninsured Project Participant, Sacramento

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Who Killed Managed Care ?

• Sold as a way to contain cost and improve care
  in that order
• Employed gatekeepers, restrictive provider
  panels, and drug formularies
• Costs continue to climb
• Consumers reject
• Policymakers concur

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Learning From OthersBuilding the Hybrid

• Should the American system become more public?
• Should the Canadians privatize?
• What about the Dutch?

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Balance

• Is healthcare a commodity like any other?
• Who will be the winners and losers?
• Whats the impact on the state economy?
• State reform vs. regional

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Begin by Fixing What You Already Control

• Medicaid, S-CHIP, etc.
• How does your state buy healthcare for employees,
  retirees, municipalities?
• Do you have a Certificate of Need (CON) process?
  Is it working as intended?
• Wellness Programs for Employee Incentives
• Can you spend your way to reform? Should you?

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QUESTIONS?

• 1-866-466-4446
• or
• www.ct.gov/oha