Today, Jan. 5, hundreds of Minnesotans are gathering in the Capitol Rotunda for a rally at 11:30 a.m. to support the Minnesota Health Plan, a proposal to fix our health-care crisis. The rally, featuring Jack Nelson Pallmeyer and the bill's two chief authors — Sen. John Marty, DFL-Roseville, and Rep. David Bly, DFL-Northfield — marks the start of a renewed push for this plan.
 
Why now? It's well understood that the crisis in unaffordable health care is financially crushing many families and businesses, and is an integral part of the overall economic catastrophe that our state and nation are mired in. Although Minnesota has one of the lowest rates of uninsured in the nation, a large portion of Minnesotans are badly underinsured, and increasingly so.

Medical costs continue to rise rapidly here. We need to realize that the severity of the problem provides an opportunity to think outside the box. As Rahm Emanuel, soon to be President-elect Barack Obama's chief of staff, recently said, "A crisis is a terrible thing to waste."

Burden or solution?
Some say that providing good, affordable health-care coverage requires additional state revenue expenditures to subsidize the cost. But with the state's $5 billion-plus deficit, it's hard to see how that can happen. As it is, there will be desperate fights to maintain existing health care spending. Any improvements, the reasoning goes, must wait until the economy improves.
 
That's where the Minnesota Health Plan comes in. Rather than competing for vanishing general revenue, this proposal (introduced last year as SF 2324 and HF 2522, with more than 50 co-sponsors) would achieve affordable, universal coverage by restructuring the overall financing of health care. A unified public plan for all Minnesota residents would be created with standardized comprehensive benefits, no copays or deductibles, full choice of providers, and financed mostly by a sliding-scale premium, according to household income. It would reduce and hold down overall spending by eliminating the huge administrative waste of our current multi-insurance system, create a common-sense distribution of expensive equipment and facilities, negotiate for reduced drug prices, hold down excessive fees for acute care, and emphasize primary and preventive care. (More information is here.)

Self-insured corporations could legally keep their current coverage for employees if they want to, but most would probably choose to join the statewide plan. The key point is that the new "tax" that people would pay the state for this coverage is less overall than what they pay now for health care, in direct, indirect and hidden ways. It would also be geared to ability to pay.
 
Such a major change cannot happen overnight, and would take two years or more to implement. Another issue is the displacement of thousands of insurance and HMO workers who generate the wasteful red tape that financially chokes health-care providers, other industries, and families. A target for retraining would be to fill the shortages of primary care and long term care health care workers. This plan will also slash the burden of businesses who currently pay for employee health care, and free up resources to create new jobs and compete in the global economy.

Any other way?
Some state leaders believe that health-care costs can be greatly reduced by other methods, without needing to remove the insurance companies' and HMOs' middlemen roles. "Health care transformation" measures were partially enacted in the last session, including the "medical homes" idea addressed in the Dec. 18 Community Voices piece by Elizabeth Rich. This idea, along with increased disease management, can indeed improve people's health. They will not, unfortunately, reduce health-care costs, as proponents claim; the Congressional Budget Office has comprehensively reviewed the relevant research and debunked these claims. Other market-based measures such as report cards on doctors will fail to reduce costs and could hurt levels of care.

Some place their hopes in the Obama administration and the new Congress. However, the most likely actions at the federal level won't address the underlying economic factors, which cause health-care spending to chew up a growing portion of GDP.

Minnesota has been a national leader in health-care policy, and it's time to lead again. We are told of a lack of "political will," which really is a fear of challenging the powerful HMOs. If our leaders were to listen instead to the people, they would see that plenty of political will already exists.

Buddy Robinson is co-director of the Greater Minnesota Health Care Coalition.

Want to add your voice?

If you're interested in joining the discussion by writing a Community Voices article, email Susan Albright at salbright [at] minnpost [dot] com.