Right now we are justifiably hearing a lot about the single-payer effort in Vermont, but the truth is that the government-sponsored health insurance program most likely to succeed in the coming years is just a few states to the south -- Connecticut's SustiNet program.
What is SustiNet? It's a model robust public option that states across the United States concerned for the well being of their citizens could start emulating right now. I urge you to watch the video below the fold and read further.
Cool stuff, huh?
SustiNet is based on the simple premise -- one shared by the rest of the developed world -- that health insurance is best financed by putting as many people as possible together into a single non-profit pool.
What does this mean in CT?
Well, when the exchange opens in 2014, CT residents will be able to choose from all of the big-profit, evil, blood-sucking crooks -- you know them as Aetna, CIGNA, Humana, WellPoint and UnitedHealthcare -- but they will also have the choice of a robust public option. Who's in the pool?
Well, to start in 2012, you'll have the following: state employees, Medicaid, CHIP, and pensioners. Once the plan is available on the "exchange" in 2014, you'll have: all of the above plus individuals and families that want to purchase SustiNet coverage instead of a private plan, individuals afforded federal tax credits to buy coverage for themselves or their families in the exchange, municipalities, small businesses and non-profits. Eventually, SustiNet will be opened up to any business or company in the state of CT that would like to provide its employees with the public plan over a private option.
Eventually, SustiNet, a robust public option, will cover 1/3 of the entire population of CT.
What else is good about SustiNet? It will feature "medical homes" for patients (a return to having a "family doctor" as your first point of contact in the health system) and electronic medical records. Both of these features will help to reduce health care costs in CT while also improving care quality.
Wow, those big-profit insurance crooks with all their headquarters in Hartford must be steaming mad, huh? You betcha!
The reality is that with a Democratic legislature and a Democratic governor, SustiNet, which is already the law in CT, is bound to become a reality. Like I said above, that's got some lobbyists pretty darn cranky according to the Hartford Business Journal:
Connecticut’s health insurers say the sweeping health care reform plan pitched by SustiNet board members is a "non-starter" and a "gratuitous shot" at the industry.
Keith Stover, a lobbyist for the state’s health insurers, said the plan to create a public insurance option in Connecticut to compete with private insurers is sending a "very negative message to an important component of Connecticut’s economy."
And the industry is ready to fight the idea, he said.
"Connecticut has an insurance market that is functioning properly and actively regulated," Stover said. "There is no need for a public option in Connecticut. The message that it sends to one of the largest employer sectors in the state is precisely the opposite of what Connecticut ought to be doing in terms of jobs growth and the economy."
Aetna CEO Mark "I'm Pretty Arrogant" Bertolini is especially displeased:
In a previous interview, Aetna CEO Mark Bertolini told the Hartford Business Journal that any attempt to create a state-backed health insurance plan would not be "supportive of the state’s private insurance industry."
So, why is the fact that CT residents will finally have a public option to liberate them from Bertolini and his cronies a good thing for the nation as a whole?
Well, once 1/3 of the population of CT is covered by a high-quality public option, do you think CIGNA and Aetna are going to stick around the CT individual market selling policies? Probably not. What does that mean for the residents of CT? A de facto single-payer program. And this new health care dynamic is achieved in CT without having to go through the hassle of securing 14 federal waivers as is the case with Vermont's more aggressive single-payer plan.
What would happen, then, if five states developed SustiNet-style public options? How about California? New York? Washington? Illinois? Are you thinking what I'm thinking? Once a critical mass of states start implementing their own public options, which is perfectly legal to do by 2014 (states must only wait until 2017 if they want to totally throw out ACA for something else), the for-profit insurance industry will start to crumble. And, once it starts to crumble, the speed with which we'll arrive at a federally-regulated single-payer program is hastened.
Don't lose hope, America! A public option is yours if you want it -- you just have to fight for it at the state level where it is truly achievable.
Note to Policy Wonks: This blog entry is a concise argument for why SustiNet-style reform is probably the best progressive policy to pursue on the state level. It also, if you're interested, includes a link to the official state report on SustiNet, published in January 2011.