As a nurse, mother and long-time resident of Connecticut, I am writing out of concern for the health and well-being of Connecticut residents, as well as the future generations of our state. As a hospital nurse, I have seen both the physical and mental health of our population steadily declining since 2020, as well as increasing moral distress and desperation of nurses trying to care for them.
I’ve seen nurses leaving the state, leaving the bedside, and even leaving the profession in order to escape the unrelenting abuse of our dysfunctional health care system. As a resident of Connecticut, I have seen the economic damage that corporate, for-profit insurance and pharmaceutical companies have done to make medical care unobtainable for working class people.
The problem: Many people in Connecticut are either uninsured or underinsured. This prevents them from accessing preventative care, recommended health screenings, and even treatment and medications for acute problems.
This puts a strain on the hospitals and specifically the emergency departments when these patients inevitably come in experiencing a medical or mental health crisis. Even people who have “good” insurance are burdened with high premiums, high copays, and restrictions on covered services or medications.
Solution: Expand Husky-type coverage for all state residents to cover medical, dental, mental health and pharmaceutical costs.
Rationale: According to the AHRQ 2023 National Healthcare Quality and Disparities Report, “Social determinants of health (social, economic, environmental, and community conditions) often have a stronger influence on the population’s health and well-being than services delivered by practitioners and healthcare delivery organizations.” They also state, “One of the most important social determinants of health is having health insurance.”
Unfortunately, for most working class Americans, private health insurance does not mitigate health care costs adequately. According to the AHRQ 2023 report, “the percentage of people with private, employer-sponsored health insurance reporting that premiums plus out-of-pocket costs consumed more than 10% of family income rose by 25.9% (from 12.3% to 16.6%) between 2002 and 2020.”
Conversely, the same report states that the percentage of people who had those exorbitant out-of-pocket costs DECREASED by 35.1% during the same time period if they had publicly sponsored health insurance (from 17.7% to 13.1%).
According to the Peterson-KFF Health System Tracker, 10.2% of Connecticut residents report having medical debt, which is higher than the national average of 8.6% from 2019-2021.
They state that “the fact that medical debt is a struggle even among households with health insurance and middle income indicated that simply expanding coverage will not erase the financial burden caused by high cost-sharing amounts and high prices for medical services and prescription drugs.” These high costs can result in people having to delay or skip needed care, reduce other household expenses, take money out of retirement savings, or increase credit card debt.
On December 29, 2022, the Centers for Disease Control published a press release stating that Type 2 diabetes in young people under 20 could increase by nearly 70% by 2060. This drastic increase can greatly impact the number of citizens who will need medical services and prescription medications, especially when considering the increased risk of heart disease, stroke, kidney failure, nerve damage, and cancer that is associated with diabetes.
Private health insurance companies create an unnecessary increased burden on hospitals and health care providers. Taking time for approvals and authorizations delays discharges, requires providers to have to take time on phone calls and letters to appeal denials, and creates confusion in determining treatment plans for patients. They also prevent providers from being able to provide best care for patients, as variances in coverage determine what diagnostics, treatments, and medications a patient can receive instead of evidence-based practices and professional standards.
According to a survey of physicians, 24% of physicians said that prior authorization led to a serious adverse event for a patient in their care, including:
- 19% of physicians who said a prior authorization led to a patient’s hospitalization
- 13% of physicians who said a prior authorization led to a life-threatening event or required intervention to prevent permanent impairment or damage
- 7% of physicians who said a prior authorization led to a patient’s disability/permanent bodily damage, congenital anomaly/birth defect, or death
Prior authorization also adds “significant costs to the entire health care system,” according to the American Medical Association. The survey found that 87% of physicians reported that prior authorization always, often, or sometimes leads to higher overall utilization.
Feasibility: While this would be a large undertaking by the state, it is not an impossible task and could even be expanded to other nearby states, if desired.
To pay for it:
- Income-based, sliding scale annual enrollment fee
- Protocols based on best practice guidelines to streamline services and decrease administrative costs
- Decrease prescription costs by purchasing common maintenance medications directly from manufacturers rather than reimburse high retail costs
Benefits:
- Improved access to health care for all Connecticut residents
- Decreased medical debt and financial burden of healthcare costs for CT residents
- Improved efficiency of ordering medically necessary tests and treatments, as well as streamlined billing and reimbursement for providers and organizations
It is my sincere hope that the State of Connecticut can implement some sort of program such as this to help mitigate both the needless suffering of our communities as well as the moral distress of our health care providers. Trying to help patients and improve their health while overcoming arbitrary barriers set in place by insurance companies is a herculean task added to an already strenuous workload.
Please consider signing this petition to ask Gov. Ned Lamont and the Legislature to make Husky for All or write to them directly.
Megan Mooney of Colchester is a Heart Failure Program Coordinator.