Remarks of Kevin P. Lembo, MPA, State Healthcare Advocate
on the occasion of the 5th Anniversary of the Office of the Healthcare Advocate
October 17, 2006, 11 a.m.
Legislative Office Building, Room 1B, Hartford, Connecticut
Good morning. I am Kevin Lembo, and I have the unique honor of serving as the State’s Healthcare Advocate. Thank you for joining us to celebrate the 5th Anniversary of our agency.
As many of you know, some better than I, the Office of the Healthcare Advocate was created as a reaction to unaddressed abuses in the health insurance market. With greater HMO penetration into Connecticut, came the need for greater consumer protection and greater HMO accountability.
Every day, since the creation of the agency, we have tried to keep those goals of protection for consumers and accountability for insurance companies at the front of our minds.
I am proud of the work we have accomplished – you, and our agency, together. Here are a few of the highlights:
- Almost 8,000 people served since the doors opened in 2001. Two thousand (2000) people projected in this calendar year, alone.
- Over $3.5 million put back into the pockets of consumers when denials are reversed. In 2005, more than $2.50 was returned for consumers for every dollar spent on our operation from the Insurance Fund. In other words, the Office of the Healthcare Advocate paid for itself 2 ½ times last year.
- And finally, satisfaction. In our most recent survey of consumer satisfaction for the first two quarters of 2006: 95% of respondents said they would call again if they had another problem; 91% considered our service “valuable” or “very valuable;” and, perhaps the most important indicator, 91% said they would refer a friend or family member to the Office of the Healthcare Advocate.
That said, it is my impression that the people we serve only represent the tip of the iceberg. Despite our continual efforts to protect them, Connecticut residents are still being ground up in the gears of the Connecticut health care financing machine.
Every day consumers are confused by their choices; are frustrates by the complexities of their plans; are paying too much; are getting too little; have great difficulty in finding providers; are refused care by their insurance company; and, many walk away empty.
I don’t mean to give the impression that there are white hats and black hats in this debate. Quite frankly, if that were the case it would be much easier to fix.
Instead, we have an immensely complicated system that has grown up over the years – cobbled together from the good and the bad of ideas that have gone before. It is in its complexity that we find the nooks and crannies where bad behavior can flourish.
Now, more than ever, we need bold leadership on this issue. The present system, with its high cost and poor outcomes, is collapsing before our eyes.
Our conversations about change in health care must begin with the question, “What kind of health care system do we want?” Once we know the answer to that question, we can ask, “How do we pay for it?”
We need to shake off the confining thoughts about how to twist our present system into something that works only marginally better.
We need the courage to ask “why” the system needs to look this way, and we need the courage to look foolish or naïve as we ask the questions that deconstruct our health care system to its most basic elements: good health & prevention; doctors & patients; dollars & outcomes.
We, as an independent agency, are committed to meet and talk and work alongside any and all who have an idea that furthers the goal. But, please understand, that as a small (dare I say under funded) advocacy agency, we must always keep the interests of our core constituency first. We are committed to remaining behind in the old system – fixing problems and protecting consumers – until the very last Connecticut resident is brought into the new, efficient, patient-centered health care system that you will design, and that we all so desperately need.
The jury is still out on whether the health care financing reforms in other states will lead us to an answer on how to fix the problems in Connecticut. I know we’re all watching closely, and not one of us is too proud to steal good ideas that work.
I, like you, am relying on the vision of the people standing here today – and many who could not be with us – to lead us to that new system.
Thank you.
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