UCare ouster could mean big loss for doctor training

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So the two are linked, you say? In the Strib, Jeremy Olson reports, “The ouster of UCare as an insurer in most of Minnesota’s public health care programs could have an unintended consequence: a squeeze on the training of much-needed family practice doctors in the state. As part of its mission, the Minneapolis health insurer has diverted excess revenue — often $4 million to $10 million per year — to the University of Minnesota’s Department of Family Medicine and Community Health. And over time, that money became the department’s primary funding for the training of 150 residents — doctors who have completed medical school and need on-the-job training in hospitals and clinics.”

Directly related: a commentary from Joel Albers, not a fan of America’s (and Minnesota’s) medical bureaucracy. “Do we really need managed care in Minnesota? … Before managed care, Medicaid and MinnesotaCare (for those with incomes slightly above Medicaid’s) were exclusively public programs run quite efficiently. Minnesota’s Department of Human Services contracted directly with hospitals, clinics and pharmacies. All services were integrated, there was one drug formulary, and billing and claims were processed in-house. Each county administered Medicaid’s outreach, eligibility and patient enrollment. In 1983, the Legislature added ‘fiscal intermediaries’ to the public Medicaid program as a ‘demonstration project.’ Private insurers were to micromanage patient care, placing both practitioners and patients at financial risk. Patient ‘copays,’ for example, a managed-care invention and difficult to administer, cause delays in seeking care, which studies show result in increased hospitalizations and emergency-room visits.”

Will the Wild save the old Macy’s store in St. Paul? Nick Woltman and Frederick Melo of the PiPress say, “Two restaurants, a brewery, a bank and the Minnesota Wild hockey team are lined up to move into the vacant Macy’s department store in downtown St. Paul, if and when the city’s Port Authority lines up a master developer. … [Port Authority President Louis Jambois] said an enclosed rooftop practice facility for the Wild is in the cards, and that has made all the difference in attracting retailers. ‘We’ve been working to get commitments on as much of the space as we possibly can,’ Jambois said. ‘I firmly believe that it is the presence of the Wild that has made the building attractive to many of these other prospective users. There’s an excitement about being co-located with the Wild.’”  

Southern Minnesota is weak on loons. The AP says, “Minnesota’s loon population is stable at an estimated 4,800 breeding pairs, but their numbers are weaker in southern reaches. And a study from the National Audobon Society last year suggested loons could be pushed out of Minnesota altogether by 2080 as the state’s lakes warm.”

This one is outside the norm. Mary Divine of the PiPress reports, “A 90-year-old Maplewood man called police on Saturday night to report a terrible crime: He had shot and killed his son with a pistol. … Police found Larry Bowser, 65, dead in the house, the victim of an apparent gunshot wound … .”

The Silicon Prairie (that’s us, apparently), gets a warm, wet kiss from the tech site CNET. Terry Collins writes, “Silicon Valley ideas get meshed with Midwestern values, resulting in a low-key and collaborative community of startups in Minnesota that stands in sharp contrast to the in-your-face, cutthroat lifestyle in California. Entrepreneurs are also convinced they have a better chance to get funding because there are fewer businesses to compete with for investors. The number of tech startups in the North Star State doubled in the past five years, to more than 500, with venture capitalists investing almost $600 million in 2014 in companies 5 years old or younger. Minnesota ranked 20th in the country last year in receiving venture funding for those types of startups … .”

It’s the market. Mark Steil at MPR says, “Minnesota farmers expect a record harvest this fall, but it may be mostly a money loser. With a nearly perfect summer in Minnesota, the U.S. Department of Agriculture is predicting record corn and soybean crops for the state. Corn may average 183 bushels an acre, 3 percent more than the record 2010 harvest. But for most farmers, corn prices are so low they may lose money on the crop. Northstar Commodities grain analyst Jason Ward says there’s simply too much corn for sale.” Next year: Only bacon. There’s never too much.

In a Q&A on lawyers’ effort to overturn the death penalty for Alfonso Rodriguez, convicted killer of Dru Sjodin, the AP says: “What happened in court last week? Rodriguez’s attorneys are alleging juror misconduct based mainly on responses to a 121-question survey and interviews with prospective jurors as the panel was selected. Court documents on their motion are sealed from public view, but on Tuesday, one of his attorneys grilled juror Rebecca Vettel for several hours. The attorney suggested Vettel hadn’t given truthful or complete answers on things like traffic citations and lawsuits she was involved in, and also didn’t mention at the time that she had once alleged being the victim of an attempted sexual assault. What happened after that isn’t clear, because on Wednesday, the judge closed most of the proceedings when he said there were issues that involved minors.”

In the PiPress, Mary Ann Grossmann has a round up of new books from Minnesota writers. “”Everybody’s Heard About the Bird: The True Story of 1960s Rock ‘n’ Roll in Minnesota” by Rick Shefchik (University of Minnesota Press, November) From Augie Garcia and Bobby Vee to the Bops and the Castaways, former Pioneer Press critic Shefchik tells of local bands that almost made it in the 1960s, delving deeply into The Trashmen’s rise to fame with a fluke novelty hit ‘Surfin’ Bird’ that inspired hundreds of Minnesota bands. Shefchik captures a time when live bands flourished in clubs, ballrooms, gyms and halls across the Upper Midwest.” The boys even got a check from Stanley Kubrick.

Twenty-seven?! Kelly Smith of the Strib says, “Homeowners staining their deck or garage before winter may not realize they’re dealing with chemicals that can all too easily ignite. From Orono to Robbinsdale, metro area fire departments are responding to an increasing number of fires started by spontaneous combustion of rags soaked in stain or oil. Firefighters across the state are seeing the same problem, with crews reporting at least 27 of these types of fires so far this year in Minnesota, according to the state Department of Public Safety.”

Ordinarily I’d say, “One at a time.” But plan away. Also in the Strib, Janet Moore writes, “The controversial Southwest light-rail line that would link Minneapolis to Eden Prairie has yet to break ground and critical state funding for the $1.77 billion project remains unclear, but that has not stopped regional transit officials from busily laying the groundwork for a fourth line. The Bottineau rail line would be an extension of the existing Blue Line, running north from Minneapolis to Brooklyn Park. The project already has a preliminary price tag of $1 billion, and could find itself plagued by many of the same issues that have driven up costs on the Southwest project, including concerns over wetlands, railroad right of way and political opposition. While only 1 percent of Bottineau’s preliminary environmental work is complete, the general footprint and plans for up to 11 stations along north Minneapolis, Robbinsdale, Golden Valley, Crystal and Brooklyn Park have quietly emerged.”

Walker Watch (i.e. pretending there’s still something to watch). In Newsweek, Peter Suderman of Reason magazine writes, “Scott Walker, who just months ago was viewed as a top-tier contender for the GOP presidential nomination, is tanking in the polls. … Walker started his run as a candidate with a record of accomplishment who would get things done in Washington. He quickly turned into a candidate who couldn’t even describe what it is he’d do. And in the process, he lost what made his campaign take off in the first place. Walker rose to prominence earlier this year not only on the strength of his governing record but on his ability to clearly and powerfully articulate that record and why it mattered. The natural extension of this, as a candidate, would have been to take the issues that he was already known for at the state level — public sector union power, budget deficits, state spending and taxes — and develop them into a coherent national agenda. Instead, Walker has pandered to Iowa voters, prioritizing issues like immigration and the nuclear deal with Iran that were never core to his appeal, and let his campaign be drawn into the day-to-day absurdities of the Trump circus.” I say we build a wall on the border with the Pacific Ocean!

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Comments (5)

  1. Submitted by Pat Berg on 09/14/2015 - 07:31 am.

    Copays

    How DO they justify copays on top of a customer who is already paying hefty monthly premiums? I suppose they think it’s a way to get a patient to think twice before running to the doctor for every little thing. And that made sense when the copay amount was a token $30 or so with a reasonable yearly cap.

    But copays are no longer a “token” amount. They can constitute a considerable outlay for a medical visit, and yes – they DO disincentivize people from going in for needed medical care (yes, even people who are not right at the edge of the poverty level.)

    Given how expensive the premiums themselves are, I think it’s time to take another look at how reasonable co-pays actually are (or are not) and whether it’s time to start bringing them back down to a level where they are once again just a speed bump rather than a set of road spikes.

    • Submitted by Todd Hintz on 09/14/2015 - 11:53 am.

      CoPayment

      Personally, I think we should do away with co-pays entirely, partially due to the reasons Pat cited above, but also because we want to encourage people to go to the doctor. Like the old adage that a stitch in time saves nine, it’s much cheaper to treat a minor issue early before it turns into a raging and expensive disease later on. Antibiotics for a small infection is much cheaper than an emergency room visit when the patient is crashing and needs intensive care.

      A $30 co-pay may not be much to someone who’s middle or upper class, but it’s a huge consideration to someone who doesn’t make a lot of money and every dollar is precious.

      Rather than just look at co-pays though, it’s time to take a step back and take a run at universal health care. Get insurance for everyone always and not only eliminate the co-pay, but also all the other out of pocket expenses. One of the ways insurance companies get premiums so low is they put these ridiculous out of pocket caps of $5000 and $10,000 on the accounts that no poor person can possibly afford. Basically it becomes catastrophic insurance that can only be used when someone has a major disease or a horrific car accident. That’s simply not a practical product for the vast majority of people.

      • Submitted by Pat Berg on 09/16/2015 - 08:48 am.

        Another weird offshoot

        I just heard a report on MPR that strikes me as truly bizarre.

        It seems that increasingly, people are visiting community clinics with sliding fee scales not because they have no insurance, but because they have insurance but cannot afford the copays.

        http://www.mprnews.org/story/2015/09/16/underinsured-community-clinics

        So this means they are paying money to insurance companies for a service they are not utilizing because they can’t afford to use it? That’s nuts!

        And furthermore, it means these insurance companies are essentially getting their money “for free”.

        (There is an interesting side issue of whether the money being provided to subsidize care is being appropriately used this way, but that’s not the gist of what I’m getting at here.)

        Anyway, what a scam these insurance companies have going! Get a bunch of premium paying customers that never cost you any more money – just keep pumping money into your coffers month after month while they go elsewhere for their care.

        That is just crazy!

  2. Submitted by Tom Christensen on 09/14/2015 - 08:17 am.

    All you have to do is listen to Walker

    No research required. Walker will provide you with all the answers why he is rapidly diving for the bottom. He is so busy pandering he doesn’t have time to figure out who he is. Some of the reporters questions are too hard for him to have an opinion. He was against a Canadian wall, before he is for it, and against it again all in the same week. His positions on labor are the reasons unions were formed in the first place. He specializes in beating people down. He wants to be someone’s puppet, but the Koch brothers are interested in him any longer. Wednesday night, at the debate, they all will be tripping over each other spewing “in the tradition of Ronald Reagan”. I predict Walker will look ridiculous trying to look presidential and dive further yet. Walker is Pawlenty version 2.0. The GOP circus continues.

  3. Submitted by Pat Backen on 09/14/2015 - 08:34 am.

    “Quietly”?

    I am not sure what “quietly planning” means to the Strib.

    There have been hundreds of meetings, public hearings, open houses, mailings and pleas for feedback over the last few years regarding the Bottineau project. Every city along the line voted on the Locally Preferred Alternative over two years ago.

    The process hasn’t been entirely smooth, with several Golden Valley and Brooklyn Park meetings contentious, but overall the idea and planning process has been generally well received.

    Apparently when there aren’t press releases about lawsuits, the paper thinks there isn’t news.

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