Kevin Rennie: Be thankful for our health care system — and beware of new proposals for state-funded health insurance

We will celebrate this Thanksgiving in isolation as the surging coronavirus continues to mar daily life. In this year of torments, we will be united Thursday in one of our gratitudes: our remarkable health care system.

Successful vaccines have been developed at a record pace. Our debt to hospital workers and others who have put themselves on the front line of risk to serve the rest of us continues. Our knowledge of the virus has increased, allowing the creation of more effective treatments.

This is not what we expected November would bring as we contemplated the rest of the year in the bleak spring, when national treasure Dolly Parton was quietly donating $1 million for vaccine research. Our health care system is a marvel of innovation. It’s also complicated and expensive--but we knew that before a global pandemic struck.

In this intense year of ideas in health care, there were always going to be some terrible ones in the harvest. One came this month from State Comptroller Kevin Lembo. He wants to revive a proposal for the state to offer a health insurance policy to the public that will put taxpayers at risk for its costs.

State government closely regulates insurance companies. The state, however, can exempt its own health insurance dealings from those regulations. That exemption could have significant consequences for consumers. The state requires health insurance policies to feature networks to provide the wide range of medical services a policyholder might require. This year’s proposal left that out. It would not have to be available on the state’s Affordable Care Act exchange, Access Health CT, where consumers could compare it to other options.

The insurance enterprise operated by the comptroller would not be subject to the same financial monitoring standards applied to private companies. One of the most important state regulations requires health insurance companies to keep hundreds of millions of dollars in reserve each year because sometimes all those health care and finance experts get their calculations wrong. If they do, there needs to be money to pay for care they cover.

If history is any guide, many years there would be no spare state cash when the comptroller miscalculates how much it costs to cover policyholders medical expenses. Look in your wallet--there’s the reserve fund. You.

Connecticut’s government adds to the price of many private health insurance policies with a tax that costs $225 million this year. Health insurance companies fund the public exchange administered by Access Health CT. That costs $36 million a year. Health insurance policy owners pay for other programs, including lead treatment, sexual abuse clinics, and pediatric asthma clinics. They cost more than $11 million a year. There’s a $62 million vaccine program that is administered by the state and paid for by health insurance policyholders. Based on last year’s proposal, the state’s plan would not contribute to these programs. It wouldn’t pay part of the $40 million a year insurance companies headquartered in Connecticut hand over to fund the state’s insurance department and other employees salted in state agencies.

Last year’s proposal was free of those obligations, but someone would still have to pay them. You, again.

Here’s a practical suggestion. Instead of taking on this expensive experiment, Lembo could engage in a different challenge. Put the comptroller’s office in charge of the University of Connecticut’s money pit, UConn Health in Farmington. The state-owned hospital has been a financial burden on taxpayers for decades. Its leaders have searched without success for a private partner. No one wants to get near it.

To keep money flowing into the maw of UConn, the state pays the hospital to provide care to prison inmates. It has been a mess, according to state auditors, but the state continues to decline to let other hospitals bid on a comprehensive contract. UConn receives the highest reimbursement rate of any hospital in the state for medical services it provides to the poor. Still, it is not enough.

State budget makers have even off-loaded millions of dollars a year in UConn Health employee costs to the comptroller’s office, so Lembo has a running start at figuring out what to do with it. Let him begin with that.

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