Connecticut Health Care Issues-2005 Session

You asked for information on Connecticut health care trends and issues for the upcoming legislative session.

Since 1990, the United Health Foundation, the American Public Health Association, and the Partnership for Prevention have annually assessed the overall health status of the nation and of each state. This annual, comparative state-by state analysis of health status, titled America’s Health: State Health Rankings (2004 edition) provides useful information on the status of the health of Connecticut’s citizens. The rankings are based on 18 individual measures that look at risk factors (e. g. personal behaviors, community environment, health policies) and outcomes data (e. g. specific death and mortality information).

According to the report, Connecticut ranked eighth nationwide this year; it was sixth in 2003 and has always ranked in the top 10 states since the rankings began in 1990. Connecticut is in the top 10 states for 13 of the 18 measures. Following are some highlights:

• the state ranks third for a low percentage of children in poverty at 10. 1%.

• it ranks fourth for a low prevalence of smoking at 18. 6 % of the population; since 1990, the prevalence of smoking has dropped from 29. 6% to 18. 6% of the population.

• in the past year, the infant mortality rate declined from 6. 3 to 5. 6 deaths per 1,000 live births, for a ranking of 10th in the country.

• the prevalence of obesity has increased from 11. 7 % of the population in 1990 to 19. 1% in 2004, which still ranks sixth in the nation.

• since 1990, the violent crime rate has decreased from 419 to 311 offenses per 100,000 population, for a 2004 ranking of 18^th.

• the percentage of the population without health insurance has increased from 6. 4% in 1990 to 10. 4% in 2004, but still ranks sixth in 2004.

• the rate of cancer deaths has declined since 1990 from 203. 9 to 193. 6 deaths per 100,000 population, for a current ranking of ninth.

• cardiovascular deaths in Connecticut stand at 295. 5 per 100,000 population in 2004 (rank of 10th), compared to a rate of 374. 3 in 1990 (a rank of 15^th).

• Connecticut ranks third for a low rate of motor vehicle deaths at 1. 0 per 100,000,000 miles driven.

The legislature may consider ways to reduce the number of uninsured residents. Possible options are tax credits for individuals and small employers, lower-cost plan designs, an expansion of HUSKY, and outreach to increase enrollment in existing coverage opportunities.

The General Assembly will likely consider bills to address the rising cost and reduced availability of medical malpractice insurance for health care providers and institutions. Legislation addressing such issues as

damage caps; enhanced Insurance Department oversight and control; and other insurance, tort, and health reforms that might affect the availability and cost of malpractice insurance may be considered.

California voters’ recent approval of a $ 3 billion ballot initiative to fund stem cell research in the state along with New Jersey’s creation of a state-supported stem cell institute are prompting other states to consider taking action on this issue. Connecticut considered but did not enact legislation in the last session that would have signaled the state’s support for a stem cell research. Legislation most likely will be introduced in the 2005 session that makes clear to scientists, physicians, and other interested parties that the state is hospitable to this emerging research.

As spending on prescription drugs continues to increase for both individuals and governments, some are turning to foreign nations, particularly Canada, to purchase medications. A number of states and localities are pursuing a variety of avenues to either directly access prescription drugs from foreign sources or to enable their citizens to get information about ways to acquire prescription drugs more cheaply. These activities, while promoted by some, are also raising concerns, particularly from the federal government. The General Assembly may see legislation proposed on this issue in 2005.

In 2004, the General Assembly considered but did not pass a nursing home “provider tax. ” Such a tax could give relief to the financially strapped industry at no additional cost to the state because the tax would be matched by federal Medicaid funds. But provider taxes generally produce winners and losers, benefiting homes that serve large numbers of Medicaid recipients the most. Similar legislation will most likely be introduced in the 2005 session.

Medical students, as part of their training, are sometimes allowed by their training physicians to perform pelvic examinations in the operating room when the patient is unconscious and has not given explicit consent to the examination. Some states have begun to address this issue. For example, California law prohibits a physician and a medical student from performing a pelvic examination on an unconscious or anesthetized woman unless she gave informed consent, the examination is within the scope of care, or the examination is required for diagnostic purposes. Connecticut may see legislation introduced on this issue.

Since the events of 2001, the state, through the Department of Public Health and its related health partners, have made significant progress in improving the state’s ability to prepare for, respond to, and recover from various types of public health emergencies. The General Assembly has enacted important legislation in this regard. A number of components that would improve and enhance these efforts could be further developed as preparedness efforts move from the planning to the actual performance stages. The General Assembly may be asked to address this through further legislation.


December 14, 2004		2004-R-0945
CONNECTICUT HEALTH TRENDS AND ISSUES

By: John Kasprak, Senior Attorney