When it’s time to settle old accounts, Puerto Ricans say, “Borron y cuenta nueva.” The idiomatic expression literally means erase and start a new account – in other words, move ahead.

This message carries good advice for the Malloy administration, which has gone out of its way to proclaim the proposed public health insurance option, SustiNet, “dead” when it should be focused on dealing with the gap in quality affordable health insurance.   Any plan to create jobs by the administration will be incomplete without addressing healthcare costs and providing small businesses with affordable and dependable health insurance options.

The link between job creation and healthcare was highlighted this month with the creation of the Working Group on Small Business Health Care organized by Speaker of the House, Christopher Donovan.  The group is scheduled this fall to make specific recommendations on ways to tie affordable health insurance options to economic recovery and growth.  Here’s a place for the administration to mine insights and move forward on real health care reform.

The state’s new health care laws, including the governor’s health care reform cabinet, should be another key focal point.  The cabinet is responsible for finding alternatives to private insurance for residents and small businesses such as a public insurance option.  The cabinet is to draw up a business plan for this in the next 12 months.  This is where the difference will be made between paper reform and real reform.

The cabinet is also responsible, together with the newly created Office of Health Reform and Innovation, with integrating key aspects of federal and state health reform, including health delivery systems reforms.  The vast majority of health care financing experts agree that delivery system reforms are necessary to bend the health care cost curve.   While the administration was busy changing the name of the cabinet from the “SustiNet Health Care Cabinet” to the “Health Care Reform Cabinet,” it missed the mark on a basic truth: The cost saving policy choices associated with SustiNet such as medical homes, value-based medicine and electronic medical records, to name a few, are essential components of meaningful reform regardless of what it’s named.

Another avenue for the administration is to establish a well-designed and consumer-friendly Connecticut Health Insurance Exchange. The Exchange is a marketplace for the sale of health insurance plans enabled and funded by last year’s federal health care reform law and expected to become operational in 2014.  The intent behind the Exchange legislation is to have a consumer-friendly and consumer-oriented market of health insurance plans that the average person and small business can rely on without the fear of fine print or going bankrupt.  In what undoubtedly turns the intent of the Exchange legislation on its head, there are no small businesses or consumers on the newly created Exchange Board.

The governor himself can take the lead in fixing this problem by asking the legislature to reconstitute the Exchange Board and make consumers and small business a majority of its members.

These are but a few opportunities for the administration to focus on helping small businesses tackle one of their most pressing problems and move from the moribund proclamations regarding SustiNet.  The irony of the administration’s handling of SustiNet to date has not been lost on many.  After all, this is the same administration swept into office running a populist, pro-SustiNet health care reform campaign. The governor’s 180-degree turn on the policy in addition to his giving the insurance industry, which has vehemently opposed SustiNet, preferential status, has come as a very disappointing blow.

Governor Malloy needs to live up to his campaign promises and provide relief to small businesses and individuals who can’t afford health insurance. It is an essential component of any job creation plan.  And if it makes the administration happy, it can be called the Mountain Laurel or Yankee Doodle Plan. Whatever.  Borron y cuenta nueva.

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