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Collaboration Is A Key To Health Care Reform

Stan Simpson

November 22, 2008

I'm not sure how I keep getting myself into this, but I was the master of ceremonies at another symposium on health care reform this week.

That's twice in two years.

What I know about health care reform can fit into a thimble. But the issue is actually interesting, and I'm learning. Really.

For example, last year in Meriden the panel was made up of representatives from Maine, Massachusetts and Vermont, states that moved past the talking stage and adopted laws to provide health care insurance for all of their residents.

What I heard from those folks are the three things that absolutely have to happen if meaningful health care reform is to be passed:

•The governor has to provide strong leadership.

•There has to be collaboration among health care providers, insurers, lawmakers, the uninsured and business leaders.

•Jargon, financing and actuarial stuff have to be translated into layman's language.

There was actually a fourth element: At the end of the day, it's all about money. But you probably already knew that.

On Wednesday, the panel at the Aqua Turf featured a union leader, Sal Luciano from Council 4 of the American Federation of State, County and Municipal Employees, and a corporate executive, Michael Critelli from Pitney Bowes. The two were in agreement about the need for health care reform and how it could enhance the economy. If a union guy and a corporate boss can agree on what's needed for meaningful health care, then there is hope for reform.

Hope is sort of what Gov. M. Jodi Rell is doing with her well-intended Charter Oak plan for the uninsured. It was launched with much fanfare in the fall and a couple of thousand signed up. But many doctors and hospitals have been hesitant to join due to concerns about reimbursements. From afar, it looks like the governor went light on the collaboration end of her health plan.

The questions about reimbursement should have been addressed before Charter Oak was planned, not after.

Instead, the Rell plan was hatched through a "small working group" of commissioners and aides who came up with a concept using the state's HUSKY health plan for kids as a template, according to David Dearborn, a spokesman for the state Department of Social Services. The plan, he notes, also went through legislative vetting, and some changes were made based on comments and suggestions made in that process.

Still, it's not clear whether the providers who are balking at the program now were at the table when the program was initially discussed. Charter Oak won't find its legs until it opens its ears and mind.

"It's the only way you can get something accomplished," said Luciano, executive director of AFSCME Council 4 in New Britain, the state's largest labor union.

"If you don't have the people that are involved in making the decisions, then it's a recipe for failure. ... It's easier to reach a decision without having to grab everybody in the room. But just because it's easier doesn't mean that it makes more sense."

When it comes to the complicated multibillion-dollar world of health care, sheer force of personality and influence from the governor's office are not enough.

"The collaboration has to occur on the front end," said Sen. Jonathan Harris, D- West Hartford. "Here, while there have been well-intended attempts at collaboration, it's happened after the lines have been drawn and the framework has been set up. ... The cart was put before the horse."

But, the senator added, "it's not too late. We can still make this work."

Governor, are you listening?