The legislative session began with Democratic lawmakers, advocates and state Comptroller Kevin Lembo all confident that a series of long-sought big ticket health care reforms — including a public option for small businesses — were finally within reach. When the session ended at midnight Wednesday, however, virtually their entire agenda had failed to pass, with several major initiatives dying in the final hours. It was a bitter pill for health care proponents, particularly the death of the public option. In the end, the state’s powerful insurance and hospital interests proved too big an obstacle to overcome, advocates said. As of May 10, the most recent date for which records are available, the biggest and most powerful among them had spent nearly $3 million on lobbying during the session, including $480,079 by the Connecticut Hospital Association and $191,021 by Yale New Haven Hospital.
Getting to the hospital quickly after suffering a stroke improves your chances of survival, but in Connecticut there are areas where access to the top level of stroke care is limited, health experts say. Two hospitals, Yale New Haven Hospital’s main campus and Hartford Hospital, are nationally certified as Comprehensive Stroke Care Centers, providing the highest level of stroke care available, which includes 24-hour access to neurological practitioners and the ability to perform complex endovascular therapies, including thrombectomies and endovascular coiling of an aneurysm, among other surgeries. Yale and Hartford hospitals are two of only 178 certified nationally as comprehensive stroke centers, according to The Joint Commission, which certifies hospitals. But when time is critical, traveling to New Haven or Hartford can be a risky commute from the northwestern and northeastern parts and other parts of the state, where hospitals certified in stroke care are sparse. In all, the state has 23 hospitals that are certified in some level of stroke care, up from 16 in 2013.
Every day for 10 months in 2012, Peter Antioho walked through dense, black smoke from an open burn pit on his Army base in Afghanistan. Human and medical waste, plastic water bottles, ammunition and chemicals were among the materials burned with diesel fuel 24 hours a day. Five years later, Antioho was diagnosed with an aggressive, terminal brain cancer called glioblastoma multiforme. The West Point graduate and Berlin resident was 31 when he was diagnosed, young for this cancer. He was second in command at his base, but now, with symptoms that include memory loss and impaired vision, speech and motor function, he can’t work.
While tolls, bonding and the budget have dominated this legislative session, a battle has been quietly brewing over the creation of a state-administered health insurance public option for small businesses. That fight is about to burst into the open as the session heads into its final weeks. It pits GOP lawmakers and some of the state’s most powerful lobbies—big insurers based in and around Hartford and the Connecticut Business and Industry Association (CBIA)—against state Comptroller Kevin Lembo, Democrats who control the General Assembly, and patient advocates. Backers say their legislation would provide small businesses with a desperately needed alternative to increasingly unaffordable commercial plans, while injecting greater competition to force down prices. Opponents counter that a public option would harm the state’s insurance industry, potentially leading to job losses.
Pharmacy benefit managers – the middlemen who negotiate drug purchases for insurers and large buyers – are coming under growing scrutiny and criticism both in Connecticut and nationwide for their role in the sharp rise of prescription drugs. The third-party companies, called PBMs for short, originally processed claims for pharmacies, but now are hired by Medicare, Medicaid and commercial health plans to manage pharmaceutical benefits. Their reach is broad: they choose what drugs are covered by insurance; negotiate purchasing deals with drug makers; determine co-pays for consumers; decide which pharmacies will be included in prescription plans; and decide how much pharmacies will be reimbursed for the drugs they sell. The growing legions of PBM critics, who include state Comptroller Kevin Lembo, pharmacists and their trade and service organizations, say that the industry is helping drive the unrelenting rise in prescription drug prices and insurance premiums.
PBMs, Lembo’s office and state pharmacists say, use a variety of tactics to capture cash from consumers, payers and pharmacies. One is spread pricing, where they pay the pharmacy less for a prescription than a payer gives them, sometimes even forcing the pharmacist to take a loss.
Betty Williams says giving up crack cocaine was easier than her ongoing struggle to quit cigarettes. “A cigarette is a friend,” said Williams, who lives with schizophrenia and chronic obstructive pulmonary disease. People with mental illness account for 44% of the cigarette purchases in the United States, and they are less likely to quit than other smokers. High smoking rates among people with mental illness contribute to poorer physical health and shorter lifespans, generally 13 to 30 years shorter than the population as a whole. About 37% of men and 30% of women with mental illness smoke.
State investigations of elder abuse, ranging from neglect to emotional abuse to physical abuse, more than doubled in Connecticut between 2011 and 2017, from 3,529 to 7,196. In 2017 alone, the state Department of Social Services (DSS) received 11,123 reports of elder abuse and decided that 7,196 warranted an investigation. That year, self-neglect—when adults are unable to provide for their own basic care—was the most common type of elder abuse reported to DSS, at 30 percent, followed by neglect by others, financial exploitation, emotional abuse, physical abuse, sexual abuse and abandonment. “It’s all trending up,” Dorian Long, DSS director of social work services, said. Some of the recent cases investigated by DSS Protective Services for the Elderly are chilling.
Advances in early detection and cancer treatments have resulted in a 27 percent decline in cancer deaths in the U.S. in the last 25 years, but those benefits are slow to trickle down to those who are lower on the socioeconomic scale, according to a report by the American Cancer Society. In the nation’s poorest counties, the cancer mortality rate is 20 percent higher than in the most affluent counties, and “the difference is much larger for cancers that are the most preventable: cervical, colorectal and lung,” said Rebecca Siegel, strategic director of Surveillance Information Services at the American Cancer Society and an author of the study. Robert Ciemniewski, 57, a longtime smoker from Connecticut, was on the wrong side of the statistical divide when he walked into the emergency room in 2017 with breathing difficulties from what he thought was pneumonia. He did have pneumonia, but he also had advanced lung cancer. Ciemniewski had not had a health checkup since 2013, when he quit his job as a mailman to care for his ailing mother.
People struggling with hunger suffer from a disproportionate number of chronic illnesses and often rely on food pantries for their groceries. So, pantries are now being urged to undergo a sea change and abandon their traditional emphasis on calories and nonperishable items in favor of more nutritional food. In Connecticut, 440,000 people are food insecure, which means they have limited or uncertain access to sufficient nutritious food, according to 2017 U.S. Department of Agriculture figures, the latest available. They comprise 12.2 percent of the state’s population.People with food insecurity are 25 percent more likely to have heart disease and diabetes, and 50 percent more likely to have kidney disease, cites Feeding America, a national food bank network. “These issues can be prevented or managed better with a proper diet rich in fresh fruits and vegetables, lean meats and whole grains,” said Michelle Lapine McCabe, director of the Center for Food Equity and Economic Development, based in Bridgeport.
Despite the best efforts of health departments across the state, the number of reported cases of sexually transmitted diseases (STDs) continues to rise dramatically, mirroring a national trend. According to surveillance data from the Centers for Disease Control and Prevention (CDC), the U.S. experienced steep, sustained increases in STDs between 2013 and 2017. In Connecticut, reported cases of syphilis rose 51 percent during the four-year period, while gonorrhea jumped 25 percent and chlamydia rose 27 percent. According to the CDC’s ranking of all 50 states, Connecticut was 27th for reports of chlamydia, 4oth for gonorrhea, and 45th for syphilis. Health officials acknowledge that the rise in reported STDs cases is partially due to better testing and tracking.