Insurance doesn’t have to be like this

“I still need a lot of convincing,” Gov. Ned Lamont told me on Thursday.

He was talking to Hearst Connecticut Media’s editorial board about one of the top priorities of legislative Democrats this session, one that appears likely to pass but that business lobbyists have called among their own top priorities to defeat.

The plan is the public option for health insurance, an understandably touchy subject in a place still known as the Insurance Capital of the World. Opposition from that industry was apparently enough to kill the plan last time around, and though Democrats are armed with larger majorities this session off a string of victories in 2018 and 2020, they still need the governor’s signature to make it happen.

It’s not clear they’re going to get it.

Some of the statewide opposition is on ideological grounds. “The reason we fight it so hard is that it’s the path to single payer and that is completely unsustainable,” Susan Halpin, executive director of the Connecticut Association of Health Plans, recently told the Hartford Business Journal.

To make sense of American politics, you need to understand that single payer is an inalienable right for anyone 65 and over, but a nonstarter for everyone else. It doesn’t make much sense, and there’s not even a good slippery slope argument that a public option must lead to single payer, but those are the talking points opponents are going with.

Single payer would certainly be a blow to the insurance industry, though it wouldn’t be a death knell. Supplemental Medicare insurance is itself a $ 30 billion industry, something that would only grow if Medicare expanded. Nevertheless, the insurance lobby is sticking with its well- worn arguments.

Maybe Lamont feels the same way, and the public option is dead on arrival. But let’s take him at his word that he could be convinced. He’s surely heard these arguments before, but it’s worth laying them out as the governor prepares for the first of what could be many disappointments for the left wing of his party in the coming year.

Lamont styles himself a businessfriendly governor, as he must. But the evidence a public option would cost jobs in a core industry is not at all clear, as existing companies would be subcontracted to run the program. Jobs may shift, but a wholesale loss of positions is not the likely result of passing the plan.

The governor rightly pointed out that reforming insurance would not by itself solve the problem of high medical costs. “That’s 10 percent of the cost of health care,” Lamont said. “The other 90 percent is hospitalization, pharma, drugs and such. So if you really want to deal with health care costs, you’ve got to deal with the those underlying costs.”

All that is true, but not a reason to avoid taking on insurance. A plan doesn’t have to solve every problem to be worthwhile, and the truth is that a lack of good insurance options is a major hurdle for far too many people.

These are problems that were meant to be solved a decade ago by the Affordable Care Act. They weren’t. The health care exchange has been more successful in Connecticut than elsewhere, but it’s an incomplete answer. A governmentrun program that anyone could buy into, that would compete with private plans without needing to please shareholders and make multimillion- dollar CEO payouts, has a chance to level the playing field in a way that few other proposals would.

The inescapable reality of health insurance in this country, even for people with “good” coverage, is that it’s often a nightmare. Care when you need it most can be difficult or impossible to come by. Too many people fall through the cracks, even people with good jobs, to say nothing of those who are struggling.

We need to move toward a system that errs on the side of covering people’s needs, not denying them the care they deserve. A public option won’t solve all our problems, but it’s a humane approach to one of our most pressing concerns. We can’t know everything about costs, but we can change the basic equation and turn it in favor of people rather than some company’s bottom line.

It would make Connecticut a better place to live, which makes it a better place to do business. That much, at least, should break through for the governor.