Nekima Levy-Pounds to run for mayor of Minneapolis

MinnPost file photo by Craig Lassig
Nekima Levy-Pounds

This will be fun. MPR’s Cody Nelson reports, “Nekima Levy-Pounds, an attorney and prominent civil-rights activist, said Monday night that she will run for mayor of Minneapolis. The outgoing Minneapolis NAACP president says her campaign will focus on racial disparities, particularly on the unemployment and underemployment rates, as well as an ‘overhaul’ of the criminal justice system. ‘There are many people who share my discontent with the current administration and we are ready to see a paradigm shift in the city,’ she said. ‘I think that I can help deliver that paradigm shift.’ While Levy-Pounds said she will run as a Democrat in the 2017 election, she hasn’t decided whether to seek the DFL’s official endorsement.” Wait, are they saying there still is a Democratic party?

David Montgomery of the PiPress digs into the reasons for MNsure’s problems. “It’s perfectly normal in health care to have a small number of people account for a large majority of the cost. Just one person with cancer can cost far more in a year than hundreds of healthy people who just get routine checkups. In Minnesota, for example, the most expensive 20 percent of the population paid about 83 percent of total costs, a 2014 study by the Minnesota Department of Health found — a typical figure for the U.S. The most expensive 2 percent alone accounted for 24 percent of spending. But Minnesota’s individual market takes this into overdrive. Just 2.2 percent of the roughly 267,000 Minnesotans on the individual market in 2015 caused almost 50 percent of health costs, a Department of Commerce study found.” Right. So you kill it and send them back to the emergency room. Problem solved!

Bob covered Leonard. Ross Raihala of the PiPress says, “Dylan was probably the first and debuted his own version of it in a July 1988 concert in Montreal. ‘That song ‘Hallelujah’ has resonance for me,’ Dylan told the New Yorker last month. ‘It’s a beautifully constructed melody that steps up, evolves, and slips back, all in quick time. But this song has a connective chorus, which when it comes in has a power all of its own. The ‘secret chord’ and the point-blank I-know-you-better-than-you-know-yourself aspect of the song has plenty of resonance for me.’” Has Bob ever covered “Everybody Knows”?

As for all the sentencing for the Minnesota “terror cell” handed down yesterday, Timothy Mclaughlin at Reuters says, “Three Somali-American men from Minnesota were sentenced on Monday for conspiring to support the Islamic State militant group in Syria in 2014 and early 2015, the Department of Justice said. The three are part of a larger group of nine men who will be sentenced in Minnesota this week for their attempts to aid Islamic State, which holds territory in Iraq and Syria. The group has sympathizers and recruits around the world who have carried out shootings and bombings of civilians. … Zacharia Yusuf Adburahman, 21, received a 10-year sentence, the harshest handed down on Monday.”

He’s in … and good luck. Says Adam Kelsey for ABC News, “Rep. Keith Ellison formally announced his candidacy for chair of the Democratic National Committee today, an expected move by the Minnesota congressman who, with the support of several prominent Democrats, is considered to be the front-runner for the position.”

This is completely understandable. Says Paul Walsh for the Strib, “A day after Americans voted for president, a motorist who allegedly was extremely drunk rammed into two vehicles stopped at a traffic signal in Lino Lakes, Minn., and explained to police afterward that she was drinking to drown her sorrows over Donald Trump’s victory, authorities said.”

Next time she may be stopping here. Jess Fleming of the PiPress says, “The Stone Saloon, the historic house on Smith Avenue that is being restored to its historic function as a German lager house, officially has begun construction. The Anthony Waldman House, which was initially built in 1857, is located on Smith Avenue between West Seventh Street and the High Bridge. One of the oldest still-standing structures in the city, the house has been a private residence most recently. Owner Tom Schroeder purchased the building in 2008. The historic building, which is being painstakingly restored, will serve as the taproom and restaurant.”  

No doubt “both sides are equally guilty.” In the Duluth News Tribune, Jana Hollingsworth writes, “Duluth school district teachers will talk with students this week about diversity and tolerance following reports of election-related hate speech coming from several schools, including East and Denfeld high schools. Last week racist and homophobic graffiti was discovered in a girls’ bathroom stall at Denfeld, and some East students were targeted by another East student with racist speech on social media. The Denfeld graffiti and the comments made on Facebook both made reference to President-elect Donald Trump.

Out of business … for four and a half months. In the PiPress, John Autey reports, “The Minnesota Children’s Museum in St. Paul is now operating while under construction, but it will be closed from Dec. 5 until its $30 million renovation and expansion is completed in mid-April. The museum currently has four exhibits, as well as satellite locations at the Mall of America and in Rochester. When the museum reopens in the spring, it will have a different layout and 10 new exhibits, along with a cafe and coffee bar, more bathrooms and elevators, officials say.”

Want to know why Itasca County went Republican?  An MPR story says, “ ‘The way of life that folks have in rural Minnesota has been under attack,’ said Gary Cerkvenik, a former DFL lobbyist. ‘We live in an area that’s heavily dependent on logging, on mining, and when you have a situation like KeeTac, a major taconite plant in Itasca County which was shutdown primarily as a result of foreign imports of steel. When you have a paper mill in Grand Rapids is substantially below where it was 20 years ago in terms of employment. When the new taconite plant at Essar went into bankruptcy. … You have this cascading economic impact for people who work with their hands,’ in the mines and in the woods he added.’ I get it. They want to be great again.

Here’s something to cleanse your head. Dan Kraker of MPR reports, “Finding the rattlesnake plantain seed was a vital step in [David] Remucal’s quest to save it and other rare orchids native to Minnesota. His goal is to build a seed bank of all 48 orchids in the state, including the showy lady’s-slipper, Minnesota’s state flower. It’s part of a broader effort led by the Smithsonian Institution to bank the genetics of the more than 200 orchids in North America — more than half of which are endangered — before they’re gone. Researchers often describe orchids as the plant equivalent of the canary in the coal mine: Their deaths can be a warning of environmental changes likely to be exacerbated by climate change.”

Hey! It’s an explanation. Not a good one. But an explanation. Barry Amundson of the Forum News Service reports on a guy arrested for exposing himself … in a library. “ … a 19-year-old woman had been sitting at a library table Oct. 11 when 34-year-old Jesus Gabriel Rivera approached her. … Rivera left for a few minutes, then came back to stand next to her and she realized his pants were unzipped and he was exposing his genitals, the charges say. In talking to police he denied exposing himself, telling officers he did not think surveillance cameras would show that happening, though he may have inadvertently forgotten to zip his pants up after using the restroom.”

Comments (9)

  1. Submitted by Jim Million on 11/15/2016 - 09:41 am.

    “David Montgomery…

    digs into the reasons for MNsure’s problems.” Ha!
    Catastrophic claims (“cat claims”) are historically fairly regular and predictable by population segment.
    Nothing new here, or there, or wherever Montgomery thinks he’s going with this. No surprises, either.
    While Brian scans Strib, Montgomery follows MinnPost comments?

    Get more sleep, Brian:
    “Right. So you kill it and send them back to the emergency room. Problem solved!”
    Snarky and sophomoric, in the least.

    Note to Editor: Lambert moderating required here.

  2. Submitted by Jon Kingstad on 11/15/2016 - 11:17 am.

    Maybe you know

    . . . but I hadn’t heard about those stats. What remains unclear to me is whether the “individual market” is segmented from the group market, so those “cat claims” are not pooled with the risks and costs of an insurer’s other group, employer based plans. And it’s unclear how much impact “competition” has by creating multiple plans and insurers to divide the risks and costs among them. It seems to me competition runs counter to the idea of insurance in this context by preventing the risks and costs from being spread among as many premium payers as possible.

  3. Submitted by Barbara Skoglund on 11/15/2016 - 12:11 pm.

    Individual Market

    Nope, the insurance companies don’t mix their group and individual markets. I’m not sure they even mix their group markets.

    The reason that the individual market has a larger share of high cost folks is because these are people include:

    People previously denied health insurance due to pre-existing conditions
    People living in poverty who have higher rates of health inequities
    People who are older, retired early, and not yet eligible for Medicare
    People who are self-employed or work for a small employer who doesn’t offer health insurance

    It would be interesting to see what the actual income breakdown is. How many people are in that APTC group of folks under 400% FPG and how many are in different segments above that. I’m going to go out on a limb (not) and guess that most unassisted QHP folks are closer to 400% FPG than middle class. That is if anyone can agree on a definition of middle class!

    By the way, 400% FPG isn’t really 4x the poverty rate. 100% FPG is way below the actual poverty rate. Per Minnesota DEED it takes income of ~$30,000 for one person to meet basic needs – no vacations, no movies, no books, no eating out, just food, shelter, clothing. See https://mn.gov/deed/data/data-tools/col/

    • Submitted by Jim Million on 11/15/2016 - 09:27 pm.

      Thanks for Details, Barb

      Prior to ACA, both HMO and Indemnity companies did some pooling of large group, a definite industry risk rating, as well. BCBS was very good at this. Their MNsure withdrawal signals something went very wrong in latitude of risk assumption under ACA. Participating companies surely understood the fundamental ACA medicaid enrollment mission. They certainly also considered their own false realitites of “younger-healthier”
      participation, and projected them to forced ACA subscription. No surprises here for industry practioners.

      One prior Minnesota complication was the definition of “large group” as 50+, never a good statistical model, especially given frequent mandate expansions. The Minnesota small group market “blew up” early, given its rather unrealistic ratings cap, assessed in 12 steps from Table 1 to Table 12. I recall a Blue Cross exec. noting they typically rated from 3-12, with a very rare 1 or 2. It took only one complicated maternity or heart case, for example, to move a small group from 4 to 12. Everyone in that employer group was equally affected in premium increase. Because groups were small and subscribers often socially close, social dysfunction was sometimes difficult to prevent. Everyone pretty much knew they were paying for Roy’s heart attack or for Jill’s preterm baby. That was patently unfair to everyone–those with the unfortunate health issues and those who paid much more due to them. Any “national” plan must obviate that issue.

      The ACA must be dramatically reformed with respect to access and risk sharing. Many promote “single payer,” because it seems most fair and lower cost. Perhaps, perhaps not. Depends on the design of care delivery more than claims payment. Those who laud certain European models must understand they do rely on queing theory, intended or not. Wait times control access and, therefore, help distribute claims costs in the short run. We are so rightfully pleased here by several decades of “open access” treatment, we will feel a much harsher backlash should any ACA revisions, single payer included, threaten us with active gatekeeping.

      Whatever the scheme becomes, some pooling arrangement must exist for data collection and analysis, if nothing else. This can be “blind” or passive pooling, not noticed by the individual. Medicare employs this device now, allowing primary physicians to set encounter frequency according to patient risk profile. What is typically one annual prevention workup can be moved to semi-annual or even quarterly sessions, should patient health profile warrant. The physician must notify Medicare and document the request.

      I no longer have a grasp on data life or generation curves, but suspect any U.S. single-payer scheme must admittedly buy into probably a 50 year “break in” period, covering three generations of statistical modeling.
      We must be ready to simply “eat” years of higher geriatric claims before expected advantages of “wellness”
      practice slow the claims curve acceleration rate. I suppose Medicare might be retained as a separate pool, but that depends on how the benefits array is designed for all others below the entry age.

      In any case, any new scheme needs to keep the risk experts of BCBS, United Health, and others on the design team. As noted elsewhere, I also believe we need to keep the Ivy Leaguers out of this, as much as possible. Theoriticians will kill the next plan in the nest, as they pretty much did the first one.

  4. Submitted by Beth-Ann Bloom on 11/15/2016 - 12:22 pm.

    Reinsurance

    Insurance companies received generous federal funding to cover catastrophic losses during the 1st years of the ACA. That funding has ended and rather than building a market strategy that would have supported cat losses the insurance industry raised the rates excessively.

    • Submitted by Jim Million on 11/15/2016 - 10:19 pm.

      Maybe it really wasn’t realistic for carriers to build a market strategy to support cat claims under functional ACA particulars. One would rightly believe that United Health would wish to insure all possible lives within corporate risk limits; that BCBS as well, would do its best to remain in the MNsure program. Corporate profit is not the single determinant here. UHC is for-profit shareholder owned, BCBS is non-profit confederation of 50 state BCBS operations.

      Of interest to all readers, should be the irony that BCBS had a “national” health insurance operation years ago, by way of its fully integrated national claims system. It took much time and money to build the “Blue Card” system, where a Minnesota BCBS member could find medical services in any other state from that state’s BCBS provider list (generally 98% of all providers in a given state). The claim was then adjudicated under providing state contract particulars and electronically transmitted to the Minnesota system, where the claim was posted and “explained” to the Minnesota subscriber. The patient paid whatever the Minnesota benefit structure dictated: $15 copay, 20%, deductible responsibility, etc. It essentially made no difference to the subscriber that she saw a doctor in Kansas City rather than at home in Blaine. Much better than having to go to a KC hospital ER, as some comments have speculated.

      Blue Cross had a national health insurance program nearly 20 years ago, by this example. What was missing was some excess premium margin to fund transfer payments to expand Medicaid [or a separate Federal scheme]. That required forced enrollment of lower claims units (young adults) to create “free premium.” And, that’s the piece that could never work, and did not, even under Federal mandate. Whether pooled or not, no program could greatly expand claims liability in Pool #2 without collecting excess premium from Pool #1 to subsidize those claims. The only financial remedy would be to increase premiums to other Pools, thereby driving out many members providing “contribution margin” for such use. That’s exactly what has happened to MNsure and other ACA outlets. This is the classic “death spiral” behavior model.

  5. Submitted by Cathy Erickson on 11/15/2016 - 12:52 pm.

    Note to Editor:

    Often the first thing I read most week days is The Glean and a part of that is looking forward to the snark from Brian Lambert – please don’t change a thing.

    PS…I’m sad he’s only once a day now.

  6. Submitted by Jon Kingstad on 11/15/2016 - 01:39 pm.

    Explains a lot

    Comments by Ms. Skogland and Ms. Bloom explain a lot about these premium increases. The President-elect is going to try to replace the ACA with a “plan” that increases competition, just like the Republican “plan” in 2010 supposedly did. It sounds good because competition=good. But anyone who understands how this works will understand that competition in this context is very bad and self-defeating. It runs contrary to the underlying whole concept of a pooled risk for this form of insurance, if that is really what it is.

Leave a Reply