I wonder where the ACLU comes down on this? Will they defend my right to smoke and eat cheeseburgers and not get charged a higher rate than the health nut?

This is what inevitably occurs once you make something a "government responsibility."

Individual liberty gets eroded in direct proportion to government involvement, which in turn has a natural inclination to grow: 1) government gets involved and makes the problem worse (e.g., Medicare and Medicaid), so 2) the government solution is to add more government, which 3) brings us back to 1, and the cycle continues.

Where oh where in either the U.S. or Rhode Island Constitutions does it say ANYTHING about health care being a government responsbility?????

I still don't understand how health insurance is a government responsibility but homeowners and auto insurance ISN'T. What's the difference?

C-O-M-P-E-T-I-T-I-O-N

That is what is needed in Rhode Island. You have Blue Cross, United and....? Hmm...

I'm disappointed that the Carcieri administration did not embrace a free-market approach. State funded public health programs in RI under Carcieri's predecessor were perhaps the biggest cause of our state's deficits. In fact, Koller was the head of Neighborhood Health Plan.

Now after screwing up the government version, the response is to force a government solution onto the private sector. This is the latest of many steps towards government control of healthcare.

I fear that we are setting up a system that may be doomed to fail. The insurers have already said that many of the savings that the state hopes to realize won't occur until years from now, if at all. Are we just setting ourselves up for increased goverment intervention down the road?

Look at what has happened in the past with government intervention. RI increased health benefits over several years only to yank them after people came to rely on the benefits. Didn't we just have this debate over mental health cuts. When Carcieri announced the original cuts in health-related areas, I supported them as necessary to improve the state's financial situation. But it truly is a crime not to cut healthcare programs without provide those needing help an alternative outside of government.

We're on the road to doing this with healthcare in RI. We should be looking to provide citizens with MORE healthcare options, not fewer healthcare options. That requires increasing competition among insurers. Blue Cross might not like it, but it's the way to ensure the long-term healthcare needs of our state.

Wow, Anthony went an entire post without blaming Laffey for something.

Greg,
I only blame Laffey when he is to blame.

You are all correct. This new plan won't help a BIT. If the TRUTH BE TOLD, Rhode Island needs to RADICALLY OVERHAUL its entire legislative and regulatory foundation for the health insurance industry here in the state. It needs to TAKE THE ADVICE OF PROVEN NATIONAL HEALTH POLICY EXPERTS that know what they are doing and have a TRACK RECORD to show for it. Actually The Rhode Island chapter of the National Association of Health Underwriters has already contacted the experts that helped certain other floundering states get back on track and restore their markets by helping to craft GOOD legislation that was SUPPORTED BY STATE OFFICIALS and had the effect of BRINGING HEALTH INSURERS BACK to their states in a matter of months once passed....and it dramatically LOWERED HEALTH INSURANCE COSTS and IMPROVED AVAILABILITY of a WIDER CHOICE of AFFORDABLE plans and REDUCED the numbers of uninsured.

Actually, the work has already been done but our esteemed Rhode Island leaders decided to RESIST, IGNORE or outright REJECT these reforms for the past two years! These are reforms that would have ended our crisis as long as three years ago and cut our helth insurance costs by a had to 2/3s for some people.

The majority of the rest of the country proves day in and day out that GOOD legislation brings carriers to states and enables the market to function. Carriers are more profitable and consumers have more lower cost quality plans to choose from.

But Rhode Island has never looked to the successful states as models for reform. They continue to look to states that are just as crippled (and stubborn and arrogant)as we are. By allowing our officials to continue to try to do their own thing and reinvent the wheel, I promise. Things are only going to get worse.

Now going back to the PRO JO article and the description of the plan, if you compare it to the plan one of the plan designers, Valerie Tutson, said she had which was so terrible because she had to pay for "everything" herself, the Governor's "landmark" plan is MORE EXPENSIVE. She said her plan had a $2000 deductible and her premiums were $229 per month but the Governor's plan is $314 per month and has a $3000 of our of pocket responsibility which may or may not include a $500 deductible -- IF and ONLY IF you do a wellness program, otherwise the article said it will cost you even MORE money out of pocket.

Now if you had a choice between the two plans, which would YOU rather have to protect you in a worst case scenario?
The first one would cost your premiums for the year of $229 x 12 or $2748 plus the $2000 deductible for a total of $4748. The new "landmark" "lower cost" plan would cost $314 x 12 or $3768 PLUS the out of pocket amount of AT LEAST $3000 for a total of AT LEAST $6768!
The first one lets you choose your own doctors and the second one charges you more for that. The first one saves you over $2000 in a worst case scenario and has BETTER PROTECTION. The so-called lower cost plan is actually MORE EXPENSIVE and provides a LOT LESS protection. The first plan would save $85 in premiums per month which is MORE THAN ENOUGH to go towards a wellness program.

If the Governor wants to provide incentives to small businesses, why doesn't he do what he does for big businesses and give them some kind of a tax break if they have a wellness program or give the employee the tax break.

Establishing a Health Reimbursement Arrangment is a method that would enable employers to reimburse an employee for medically related expenses and then take a 100% tax deduction for doing it. The HRA is a great way to pay only for the benefits the employees actually use because it just reimburses employees who have incurred costs. Employees that don't have expenses aren't reimbursed. Employers could reimburse employees who decide to try to get off their prescriptions and get rid of their chronic problems by going to see a Naturopathic doctor who is trained to look for and eliminate underlying causes of disease by helping to strengthen and restore the body's own immune system and natural ability to heal and fight off disease. Whereas M/Ds are only trained in Allopathic medicine which only treats SYMPTOMS of disease. They are not trained the way N.D's are to actually help a person regain their robust health by helping them get completely RID of their disease. Encouraging something like THIS in Rhode Island would REALLY be a way to put Rhode Islanders on a fast track towards getting well and we can leave the insurers OUT OF IT. Of course the medical establishment would HATE it if people started getting well and not needing so many prescriptions and office visits but it would be the right thing to do.

Then to address the high costs of insurance, lets for a change INSIST all our elected and appointed oficials support the reforms we need to get carriers back that Senator Marc Cote has
sponsored for years. For details on what they are and more about state health insurance regulations and our crisis in general, visit www.riahu.org.

I won't hold my breath however. It has been said that states like Rhode Island that insist on doing things differently are like alcoholics. They keep making stabs at legislation continuing to try to fix it themselves, not having a clue, while they gradually make things worse and worse until things get so bad that the state FINALLY hits bottom. Then and only then do they finally TAKE THE ADVICE of the TRUE EXPERTS and the state finally recovers.

VERY well said Emily. Governor Carcieri has spoken about increasing the number of carriers in the past, but for some reason his administration seems to be moving in a different direction. Why is that?

The apparent blog hysteria directed at this plan is completely unwarranted.
First, the Plan, as proposed, is directed to the small business community and is an option, not a requirement. There is no government requirement stating that a small business has to offer the plan, or that the employees of the small business offering the plan (as an option) have to participate.

Additionally, the Plan was designed by members of the RI small business community who run small businesses, including direct payees, and leaders of small business organizations such as Chambers of Commerce. Chris Koller and his group functioned primarily as facilitators to address the challenge provided to his department by the Legislature.

The premium targets were set by the Legislature. The Plan was designed by the small business community, in reaction to rapidly rising health care costs that threaten to survival of their businesses.

Writer comments belie a complete ignorance of the RI governments current involvement in health insurance. There are over 40 mandates, established by the legislature, that have to be offered by health care providers.

Emily is evidently unaware the Senator Elizabeth Roberts (soon to be LG Roberts) has proposed a bill (Jan.06) to offer tax credits to small businesses that offer Wellness programs.

The small group Wellness component of the Plan was modeled on lower cost success stories from the Wellness model applied at the big business (large group) level. No data exists that indicates that a wellness component will ultimately result in cost savings in a small group, but it's certainly worth a try.

Also, the Wellness component of the Plan promotes individual responsibility, as opposed to government intrusion into lifestyle choices. Simply put, if an individual decides to participate in a healthy lifestyle, via smoking cessation or weight reduction, etc., that individual will pay lower premiums. A non-smoker or someone who controls their weight hardly qualifies the person as a "health nut".

The Plan is an attempt to address a problem that nobody else has been able to solve. From that point of view, it should be applauded as an attempt to solve the problem, as opposed to being condemned, particularly from individuals who did not participate in the Plan design, or who are not familiar with the mechanism used to develop it.

Finally, the inference that a Naturopathic approach to wellness and immune system enhancement and ultimately elimination of medication is the best answer to disease elimination is complete nonsense and has little if any scientific credibility or data to support it. Rapidly mutating RNA viruses or virulent forms of bacteria can rapidly wear down the strongest immune systems, and the best means of defense is by the development of vaccines and antibiotics that help the immune system combat the invasion.

Weaning people off of unnecessary prescriptions is certainly an admirable goal, just don't try to sell Naturopathy as the answer to our health care problems.