In healthcare debate, all sides must talk to each other

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Greg Bordonaro, Editor

On the last day of the legislative session, Comptroller Kevin Lembo found himself in what could be described as an awkward situation.

While lawmakers were busy debating and passing last-minute bills, Lembo graciously agreed to keynote Hartford Business Journal’s C-suite Awards event, which recognizes top business leaders from around the region.

Two of this year’s honorees — Mark Boxer, executive vice president and global chief information officer of Cigna and Roberta (Bert) Wachtelhausen, ConnectiCare’s chief sales and marketing officer — happen to be from the health insurance industry, while Harvard Pilgrim Health Care was an event sponsor. It’s fair to say a quarter of the 200 or so people in the room were health insurance executives or employees.

In the weeks leading up to the event, Lembo caught the ire of the health insurance industry, having been a major backer of legislation that proposed to create a state-run public health insurance option for small businesses and individuals, likely with some amount of state subsidy to keep premiums lower. That, unsurprisingly, was viewed as a threat to insurers.

Then, Lembo stirred up further controversy when he told the Hartford Courant that Cigna helped kill the public-option bill after threatening to reconsider where it’s domiciled if it were passed. Cigna disputed that characterization of the matter.

Before he went on stage, Lembo joked that he thought we might pull his invitation. We didn’t, nor did we ever think about doing so.

In fact, Lembo’s presence in front of insurance-industry officials represented what we need more of in terms of figuring out how to create a more affordable healthcare system: to hear opposing viewpoints and be willing to listen.

Lembo’s talk actually wasn’t about healthcare issues. He mainly discussed the state’s current fiscal condition and outlook, though he did mention a few facts about the high cost of health care, mainly that a quarter of Americans skipped medical care in 2018 because they couldn’t afford it.

“Something is not working here,” Lembo told the audience.

I think we can agree the U.S. healthcare system lacks efficiency and costs too much. Nationally, the average American spent $10,739 on health care in 2017, according to the Center for Medicare and Medicaid Services, a number that is projected to grow by 5.5 percent annually over the next decade, higher than the rate of inflation. It’s safe to assume the average American’s wages won’t keep up.

Businesses and individuals alike are suffering under the increasing costs.

Who’s to blame? There’s enough of it to go around. Many people like to point the finger solely at insurance companies, but healthcare providers, pharmaceutical companies, government policy and even Americans’ own health habits play a role in the high costs of health care. So, we can keep bickering about who’s to blame or who’s blocking progress, or get various stakeholders to sit in a room to figure out ways to make health care more efficient.

Connecticut has an absolute advantage in this respect. Not only is the state home to many of the nation’s health insurers, it has some of the best hospitals and care providers in the country. Their combined wisdom should be able to come up with a better way of doing things.

Is a public option the answer in Connecticut? I’m skeptical of the state expanding its role as a health insurance provider, especially given its fiscal instability, but sometimes political pressure can spark change. That may be the state’s most powerful lever.

The reality is, a public option in Connecticut would have little impact on Cigna’s business. The perception of its home state adopting a public option was likely the main concern, because the real threat to Cigna and other insurers is a single-payer healthcare system at the federal level.

That should motivate insurers to work with other healthcare stakeholders in Connecticut to develop new, innovative ways to control costs and improve care. If that doesn’t happen, Congress may turn the system on its head.

A public option bill will likely come up again next year in the General Assembly. We can have the same old private-sector vs. public-sector fight, or try a different, more collaborative route. It won’t be easy, but we need to at least get all sides listening to each other.