The debate about health care generally focuses on the high cost of medical care and who will pay for it, not whether medically necessary health care should be provided to those who need it.
But here in Connecticut, we’ve gone a step beyond by becoming one of the nation’s leaders in state-mandated coverages. It’s a dubious concept that suggests sound coverage decisions can be legislated.
All in all, the state has 54 mandates in place and is considering adding more this session.
There certainly are good arguments to be made for many of the coverages on the table. When your child is diagnosed with autism, for example, coverage does not seem a gray area. It is a necessity.
But legislators need to be in tune with the times. They need to exercise caution in adding mandates that somebody — either business or the consumer — must pay for in these trying economic times.
The debate, unfortunately, pits some lawmakers against business groups on coverage for ostomy-related supplies, prosthetic devices, hearing aids for children, wigs for patients who suffer hair loss due to certain medical conditions, and bone marrow testing. The bill is similar to the one the General Assembly approved in the last session but was vetoed by Gov. M. Jodi Rell.
This time around, efforts to legislate preventative care co-pays and wellness incentives have been added. Some things are better left to the marketplace.
The Connecticut Business & Industry Association maintains that the proposed mandates will hurt small- and mid-sized businesses the most because they are least able to financially absorb the increased costs the mandates will create.
Health care advocates argue that the increased costs will be minimal.
The Council for Affordable Health Insurance, an advocacy group, argues that these mandates have increased health care coverage between 20 percent and 50 percent.
There is a basic assumption that if an individual pays for health care insurance, medically necessary procedures, products and prescriptions would be covered, such as ostomy-related supplies.
That often has not been the case.
Lawmakers aren’t proposing Botox for everyone. But they should limit themselves to assuring insurers cover all medically necessary claims.
Business groups and lawmakers need to get on the same side of the debate so they can develop a workable strategy that provides appropriate coverage for those who need it.
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