Monday, August 16, 2010

The Foley and Malloy Prospectus Compared Part 3 – Health Care

This is the third in a series of blog posting regarding the plans of the Republican and Democratic candidates for governor, Tom Foley and Dan Malloy. All of the information provided in the posting is from the candidate’s web sites, and clicking on the “Issues” and “Tom’s Plan” selections. The opinions are my own and not cleared with either candidate’s staff. In the interest of full disclosure, I am a supporter of Dan Malloy and worked as a volunteer on his 2006 campaign as well as the current 2010 campaign.

I will begin with some general observations about the plans that the candidates have posted on their web sites. If less is more, then Foley wins hands down. His plan turns out to be seven pages in my word document. The Malloy plan is a whopping forty eight pages with great detail. I guess that is fitting since most Republicans believe less government is better, obviously a short plan will lead to less government. From the Democratic perspective, government is good and Malloy shows just how he plans to shape and change much of the state government in great detail.

Of course, there is no guarantee that either of the candidate’s will do what they lay out on their web site when actually in office, but like a stock prospectus, it is an indication of the plan and direction each candidate will pursue once in office.

I am leaving out much of the explanatory text in the plans and just noting the planned action items. Both plans are written in the first person, so I will keep that same format as I quote or paraphrase from each plan. The reader will have to remember that the occasional “I” is either “Governor” Foley or “Governor” Malloy.

This comparison continues with the prospective governors’ take on healthcare. Since I started with “Governor” Malloy in the last post, I will start with “Governor” Foley in this post. I will continue this alternate presenting throughout this series of postings.

“Governor” Tom Foley
We must reduce those costs by reducing state mandates on coverage, promoting wellness programs, capping medical malpractice claims, moving to electronic record keeping, and permitting interstate sales of healthcare insurance.
Connecticut has some of the best healthcare businesses and facilities in the country. As Governor, I will seek to place Connecticut in a leadership role in lowering healthcare costs for everyone.

“Governor” Dan Malloy
Malloy briefly mentioned Healthcare costs in his policy on Jobs and the Economy but goes into more detail in the Healthcare portion of his plan.
I believe health care is something everyone should have. In fact, I view it as a moral issue. If a state can't work with the private sector to put in place a system to care for its people when they're sick, especially children, the frail, and the elderly, what does it say about the kind of society we are? Not something good. And not something I will allow it to say when I'm Governor.
I hold a fundamental belief that quality medical care shouldn't be a luxury affordable only to some.

State government is the largest purchaser of healthcare services in the state. I've been a vocal supporter of state legislation to use this purchasing power and large number of covered lives to help drive down costs for municipalities and boards of education – as well as other employers.

As Governor, I would use the purchasing power and influence of state government to convene all parties -- insurance companies, employers, unions, medical practices, hospitals and others -- to improve the quality of healthcare delivery and lower costs for everyone. The current system is broken. We need to connect all providers with electronic medical records, reduce duplicate testing and procedures, and change the way we pay for healthcare services in the State.

I was also an early supporter of legislation that would have established a health insurance option for Connecticut residents called SustiNet. In the end, the final legislation did not go as far as I had hoped. It did not create the SustiNet Health Insurance option, but did set the wheels in motion toward developing a plan that could become law.

No discussion of health care is complete without a discussion of mental illness. Mental illness is not discriminating. It can happen to our co-workers and neighbors, our men and women returning from extended combat, our friends and our families.
Connecticut needs to invest smartly, save money and save lives:
Assuring access to effective mental health care for all in need
Ending stigma and increasing awareness
Emphasizing prevention and early intervention
Adequately funding and staffing state facilities
Investing more in community-based treatment and support that sustains long term recovery through mental health care, housing, employment and peer support.
We can also work to improve care by caring for concurrent addiction and mental health issues. We treat alcohol addiction in one place and mental health issues in another. We need collocation of services and concurrent programming because each one feeds on the other. There are ways to incentivize this type of programming and we should be moving in that direction. When they are separated out, the care doesn't work.
Finally, we need to have insurance parity. In other words, we need to recognize that mental illness is an illness just like any other and should be covered at the same rates and levels as any other illnesses, not stigmatized and shunted aside with lower reimbursement rates that limit access to care.

As Governor, I will:
1. Change our fiscal focus from paying exorbitant costs of advanced preventable illness to prevention, early detection and treatment, thus saving lives as well as resources.
2. Push for a comprehensive pooling bill to allow municipalities, small businesses and the self-employed access to better coverage at a lower cost. In addition to providing more health care coverage, this will make Connecticut a more business friendly state – i.e., it's a job-creator.
3. Form strategic partnerships with Connecticut's community health centers, which play a vital role in our health care system by treating those who have been denied or cannot afford health insurance, or who don't live in close proximity to a hospital.
4. Properly fund our nursing homes to cover the actual costs of providing care. In urban areas, I will ensure the homes are kept open so local residents can remain near family.
5. Properly fund privately-operated (non-profit) group homes and day programs to maintain and improve care services and job standards. These services have been severely under-funded for years, leading to high staff turnover rates.
6. Establish a ‘Workforce Council' for the growing home care industry so that our caregivers have a voice in the development of care requirements and job standards, including wages, benefits, training, and more. This Council could also maintain a statewide list of caregivers to assist consumers in finding referrals.
7. Expand Connecticut's Primary Care Case Management (PCCM) system, HUSKY Primary Care, to 400,000 low income children and parents in the HUSKY program. Participants in PCCM receive comprehensive care that is coordinated by a primary care physician to optimize and integrate all of their healthcare needs. PCCM is key to prevention, early treatment and maintaining health. Like the pooling bill, this will deliver better health care at a lower cost.
8. Work with our congressional delegation to get our fair share of Medicaid and Medicare dollars.
9. Make mental health care the priority it should be, but still isn't.
10. Provide leadership to create all-payer Patient Center Medical Home primary care practices throughout the state to improve quality and lower medical costs for everyone.
11. Work with the federal government and medical schools in the state to train more primary care physicians, nurses, and other providers who will remain in the state to meet the needs of our residents.
In conclusion, We've made some progress on healthcare in Connecticut in the past year, and Congress and the President made history in Washington, DC. But the fact is that too many people in Connecticut still don't have access to quality, affordable healthcare. That will change when I'm Governor. So too will the incredible, job-killing burden the cost of healthcare places on employers. I am completely convinced that, with Nancy Wyman's as my partner in this effort, we can expand access and bring costs down. We can improve people's lives, and make Connecticut a more business friendly state. That's a promise we have a moral responsibility to keep.

As you can see, “Governor” Foley has a short list on reducing the cost of health care with little detail. “Governor” Malloy has a detailed list on actions his administration would take to both manage health care and reduce its cost to consumers and businesses. In fact I have shortchanged the Malloy plan by deleting all of the background information showing how he did similar actions in Stamford or how his running mate, Nancy Wyman, has managed some state health care systems. His plan is ambitious and I will let the reader decide if it is possible in the State’s current fiscal condition or whether the plan is one of the key items in getting the State out of its current fiscal problems.


  1. Foley gives the standard GOP reply- no change- keep the status quo- which means no expansion of coverage- still over 300,000 in the state w/o coverage & and an increasing amount with bad coverage.

    Seems that Foley thinks that in making Connecticut 'competitive' we need the same health care as in Texas or China.

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