Everyone needs it, no one doubts that. Universal healthcare became a national political hot potato during the Clinton Years and now it’s a political hot potato during the Supermajority Democratic year in CT.

With not less than 4 different proposals on the table that stretch from a single payer form of access to a modest expansion and public recruitment campaign of the Husky program to a provider tax to pay for increased access, the debate is taking front and center attention.

This week, the House Chair of the Insurance Committee, Rep. Brian O’Connor, joined Reps. Mike Christ, Deb Heinrich and Linda Scofield to introduce their alternative to a single payer health care system. The plan would give $290 million in tax breaks to small businesses that already provide health insurance and create a non-profit called “Connecticut Connector” to administer insurance to the uninsured. It also promises to increase reimbursement rates for Medicaid patients and create a marketing campaign with a goal to decrease the number of uninsured here in CT from 9% to 3% within five years.

How to fund this aggressive plan? How about a 3% provider tax on doctors, hospitals and others, an increase in the cigarette tax, and a new “vanity tax” instituted on cosmetic surgery unrelated to medical needs. You can imagine the reaction from CT’s 7,000 MDs, 32 hospitals, and thousands of other healthcare providers who would foot the bill for the state’s uncompensated care. This would be the second use for an increased cigarette tax that’s creating an interesting debate. Also, we began to hear rumblings about adding an increase to the income tax to cover whatever program is developed. That has education advocates seeing red, as well as campaign finance advocates who see a need to start putting money away in anticipation of public campaign financing.

One thing’s for certain: it’s not going to be over until it’s really over. So many ideas, so much need for funding, and not that many days left to get the right program in place with the funding it will need to ensure access to healthcare really will be improved.

This week a reporter finally posed the question on everyone’s minds to a group of legislators: With so many different initiatives being introduced, what exactly are you willing to sacrifice? The House Environment Committee Chairman, Dick Roy, stepped up to the mike and explained that there are three types of issues before the legislature: things they must do, things they should do, and things they would like to do. He continued that the general assembly needs to put aside what they’d like to do to focus on the prior two categories. His Senate Co-Chair, Bill Finch, made it even simpler, “We need to get back to basics.”

It seems that legislators are struggling to do just that this session. The biggest press conferences over the past couple weeks have been about open space, clean water, education reform, property tax reform, and universal healthcare. Preserving a healthy, sustainable, environmentally friendly lifestyle in CT is a familiar mission, but legislators have a new approach. No more band-aids; the goal is meaningful change from the ground up – in other words, BIG reforms.

But many are learning that implementing meaningful change can be a complex and time consuming process. First everyone has to be on the same page. Take universal healthcare for instance. Everyone has their own policy ideas: the Governor and Senate Dems have outlined their own plans, and the House Republicans proposed their own bill. Just this week, the House Moderate Democrats added their own ideas to the mix in the form of HB 6652: An Act Establishing the Connecticut Healthy Steps Program. HB 6652 would create a CT Connector as a “marketplace” for uninsured people to buy affordable health plans. The bill also targets small businesses by offering tax credits for at least 70% of the cost of health benefits offered to employees. Getting all camps to agree on the details is a challenge for any issue, but especially for issues of this magnitude.

And then there’s deciding how to fund any new initiatives. HB 6652 proposes a provider tax of 3% to help fund the plan. It would also be funded by the implementation of a “vanity tax” or a sales tax on elective cosmetic surgery, the cigarette tax, and tobacco settlement funds. Some proponents of universal healthcare clearly think this is the right funding route, while many others – and many in the press when the plan was unveiled – raised a lot of questions regarding the plausibility of the plan. Another roadblock.

Getting back to basics isn’t cheap either. Finding a dollar amount that will do the job, but that is actually feasible isn’t an exact science. So far, legislators, such as Rep. Roy and Senator Finch, and members of the Clean Water Coalition are requesting $157 million for FY 07-08 and $137 million for FY 08-09 for clean water projects. Overall, the DEP estimates that $5 billion is needed over the next 20 years. This money would be allocated to towns and cities for various wastewater treatment projects needed to keep the LI Sound, CT River, and other waterways clean. The bipartisan group proposing land conservation, including Senator McKinney and Rep. O’Rourke, are requesting at least $100 million from the current surplus to preserve critical farmland and increasingly threatened tracts of open space. The Governor’s education cost sharing plan will cost $3.2 billion over the next 5 years, while Senate President’s healthcare access proposal seeks over $450,000 to get things moving. That’s a lot of moola on the table!

It’s encouraging to see the legislature thinking outside of the box in order to formulate solutions to some of CT’s most basic and critical problems. However, working even the most well intentioned proposals through the process is often anything but simple, or as we have seen this past week, cheap.