The Universal Health Care Foundation of Connecticut released their public policy proposal, called SustiNet, today.

The goals of the Universal Health Care Foundation of Connecticut are:

• Guarantee all Connecticut residents access to their choice of high quality health coverage and health care.
• Control costs so that health care is affordable and sustainable for individuals, families, businesses, and taxpayers.
• End residents’ worries about losing access to care when they change jobs, finish school, start a business, experience other life-changing events or have pre-existing conditions.
• Prevent illness and disease where possible and improve health.
• Eliminate racial and ethnic disparities in health care and health outcomes

The city of Hartford has 34,000 uninsured residents. With a population of about 125,000, this means that around 27-28% of Hartford residents are uninsured. In July of 2008, Where We Live spoke with Mayor Perez about the city task force created to help provide health insurance for those who are uninsured, but who make too much money to qualify for assistance (welfare). This task force has been, among other things, looking at partnering with corporations/private sector. As said in the discussion, someone with an income of $30,000/year can not afford existing options like the Charter Oak Health Plan. Part of the task force’s purpose is to promote healthy lifestyles/prevention.

The SustiNet policy, however, would merge:

state employees and retirees with HUSKY and SAGA participants into a self-insured pool. Three other groups can enter the pool:
• people without access to employer sponsored insurance, including sole proprietors and other self employed individuals;
• people offered employer sponsored insurance that does not provide affordable access to essential care; and
• and employers, starting with small businesses, nonprofits and municipalities, but ultimately including any employer in the state.

HUSKY and SAGA are health care-related forms of welfare.

SustiNet would include home medical services, mental health care, and dental care. Medical home services are broken into three categories: care coordination (non-medical referrals and reminders about immunizations etc.), patient empowerment (encouraging people to quit smoking, improve diets, etc.), and timely access to care (goal is to reduce unnecessary emergency room visits). People with pre-existing conditions would not be turned away, which makes sense since they are among the most vulnerable and in the most need of medical treatment. They are proposing that co-pays and premiums be based on income. For those whose employers do not offer any insurance, they could be self-insured regardless of pre-existing conditions. Those who have inadequate coverage could also switch to a self-insurance plan. What makes something inadequate? “Coverage is also deemed inadequate, regardless of income, if out-of-pocket health care costs are at least 7.5 percent of adjusted gross income.” Under this proposed plan, anyone who is currently satisfied with their coverage can maintain it. (Okay, so the railing about how the Obama presidency is ushering in an age of Socialism can cease!)

An interesting part of this plan is to expand coverage of HUSKY, so that all adults within a certain income bracket, regardless of whether or not they have children, are covered. To essentially state that people are important, regardless of their reproductive abilities or choices, matters. We do not become necessary only upon giving birth, thank you for realizing that!

The SustiNet proposal would automatically enroll people who lack insurance when they begin or end employment, seek unemployment benefits, file state income tax, request health coverage, or when children start school. If people do not want to be enrolled, they can opt out (see, still no Socialist state).

If this proposal is taken seriously, I doubt it will be out of the kindness of humanity. The Universal Health Care Foundation of Connecticut was smart; they included in the proposal the ways that adoption of this plan would help Connecticut’s economy by saving households and employers money. If you are interested in the unsexy details about how this gets paid for, see page 15 of the proposal.

Disclaimer: I have something at stake in this. I am the one of the one-in-ten Connecticut residents without health insurance. I have been without since 2001. Although one of my employers does offer insurance to me, the rates are so high that I would have to move and make drastic lifestyle changes just to afford what would be taken from my paycheck every month. They do not see any difference between a single person and a family in this case, which is unjust both financially and morally. The last time I went to the doctor, it was after I had experienced certain symptoms for months. I had to pay $125 upfront, and then about $40 for the medicine. It could have been worse. Before this, with the exception of an emergency room trip, I had not been to a physician since 2003. I won’t lie and pretend that I would be doing annual physical exams, but I would have gone in several times when sick. As for the eye doctor, I had not gone since I had insurance, up until last year when I was able to get a discount because of knowing someone who worked there. When I go to the dentist, I also am expected to pay upfront. For nonessentials, like cars and college education, people have the ability to make monthly payments, yet for the most important thing–staying alive–we are expected to foot all or most of the bill as we’re leaving the doctor’s office.

My options? Find a random person and get married just to have insurance coverage. Quit a job that I love for one I might not enjoy or feel useful at just to have insurance coverage. Move into a studio apartment and sell my car just to have insurance coverage. Go back for my Ph.D mainly for insurance coverage (I know people for whom this actually is the reason for going to school, as they have tried to convince me that this makes sense).

What are not my options? I avoid a lot of activities that might result in broken bones– skateboarding, snowboarding, and biking year round. I am also not able to have children the natural way–at least for the time being–because of the medical expenses. By the time I have insurance coverage, I will probably only have adoption as an option, and while I have no problem with adoption, I would like to actually feel like I really and truly have reproductive choice.