State says goodbye to a health care fighter in Hartford

American health care and the way we pay for it are well-known to be a mess, even before the ravages of COVID. It’s the reason why America leads the world in medical bankruptcies, a phenomenon that’s basically unknown in other wealthy countries.

There are better ways, but getting there is among our toughest political challenges. Connecticut recently lost a champion of that cause.

Despite the problems endemic in our system, there have been some improvements. Jan. 1 saw a new federal law take effect that bans what are called surprise medical bills, which is that uniquely American experience where you could face a medical emergency, be treated by professionals who you might have thought were covered by your insurance, but still face bills after the fact for tens of thousands of dollars because some specialist you might not even have been aware was in the room (it was an emergency, after all) was out of network, and therefore not covered.

A bipartisan law signed by the previous president and enacted by the current one puts an end to that. Sort of. It doesn’t apply to every situation, and of course doesn’t do anything about co-pays or high deductibles, or help much for people who lack insurance altogether. And as an interesting side bonus, while transportation by helicopter is covered by the new law against surprise charges, transit via old-fashioned ambulance is not, so you might still get a giant bill for that. Maybe you should have planned ahead better for your medical emergency? Either way, surprise!

This is the system we all live with, at least until we age into Medicare, which covers many but obviously not all of our basic health needs, but only if you make it to what was once considered retirement age. This is the system that entrenched interests fight so hard to save, that gets a meaningful upgrade maybe once a generation and then, like the Affordable Care Act, faces years of demonization and attacks and false characterizations in an effort to give people the right to, say, continue to receive giant medical bills and possibly bankruptcy in celebration of what might have been the worst day of their lives.

Anyone fighting effectively against that system demands our respect, and our thanks. State Comptroller Kevin Lembo, who stepped down at the end of 2021, was one of the best.

His signature policy initiative, the public option for health insurance, never came to be. That’s where a state would come up with its own insurance plan that anyone could sign up for and which would compete against private plans.

Elsewhere, the idea is gaining strength. Nevada, Washington and Colorado have each recently enacted a version of a public option, while New Jersey, New Mexico and Maine have advanced proposals. It continues to poll well nationally, and President Biden once campaigned on enacting one, though good luck seeing anything happen there.

But as other states move ahead with this idea, Connecticut will not be joining them.

The chances probably ended last year, but no doubt officially died with Lembo’s departure. Formerly the state’s health care advocate, he was the most vocal and effective proponent of health care reform in Connecticut.

Lembo pushed the public option in multiple sessions, and his plan had many supporters in the Legislature. It was done in, over and over, by the sway that the insurance industry holds over state politics. Companies threatened to leave, and the governor faced the prospect of explaining away job losses in a sector that maintains a major albeit diminished presence in the state. And so the plan died.

You don’t need to think the public option would have solved all our problems to believe it should have been enacted (and still should be). Private companies have a primary motivation to increase profits, which often means not covering people’s health care even when they need it. A government provider does not have the same incentives. There were smart people who had questions about the public option’s effectiveness, and its rollout in other states has not been without some bumps, but the overall direction is the way we need to be headed.

Lembo left office at the end of 2021 with a year left in his term over health concerns. He spent years in service of the people of Connecticut, constantly looking for ways to make things better. He was unafraid to speak up when regular politics got in the way of effective solutions, and was better at explaining complex topics than anyone else in government.

The state is worse for his departure.