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Sen. Marty’s lonely quest for a Minnesota Health Plan

State Sen. John Marty thinks our society should view health care in the same way we treat police and fire protection — as a public service. He says his proposed Minnesota Health Plan would fill the bill.

State Sen. John Marty, DFL-Roseville, thinks our society should view health care in the same way we treat police and fire protection — as a public service.

“When you go home at night and find your home is broken into, you call 911,” says Marty, chairman of the Senate Health, Housing and Family Security Committee. “The police dispatcher does not ask you, ‘Do you have police insurance? Does your policy cover home burglaries?’ We’ve addressed that problem and we ought to see health care in the same way.” 

In the last three years, Marty has pushed a bill that would set up the Minnesota Health Plan, essentially a single-payer plan that would shift the premiums we and/or our employers now pay for health insurance to a public entity that would cover necessary health services from cradle to grave.

Hasn’t he heard that a single-payer plan isn’t politically realistic, as they’re saying in Washington? Does he ever feel lonely being in the minority? “Yeah,” the seven-term senator chuckles during our Q&A. “I’ve felt in the minority about a lot of things.”

Marty is making another run for governor next year after losing in 1994 to Republican Arne Carlson. “I won the primary but got clobbered in the election,” he recalls.

Regardless of what happens next year in the governor’s race, he thinks momentum is building for the Minnesota Health Plan. The bill now has 70 co-sponsors, and it has passed in not only his committee but also the “insurance-friendly Commerce Committee.” He thinks it will take another three to four years to work its way through the Minnesota Legislature.

State Sen. John Marty
State Sen. John Marty

Before you dismiss Marty’s plan as another pie-in-the-sky proposal from a progressive Democrat, take a look at the principles of the Minnesota Health Plan and the frequently asked questions (FAQs) on the website.

The “biggest misconception” is that it will cost more money, says Marty, who welcomes the opportunity to talk about the plan to tough audiences like Chambers of Commerce.

Meanwhile, he watches the national health-care reform debate and ponders how it got off-track from the original goal of universal health care. Here he shares his best hopes and worst fears for reform and more about the Minnesota Health Plan. (The transcript has been edited for length.)

MinnPost: What are your best hopes and worst fears for national health-care reform?

John Marty:
The best hopes are that we figure out what we need to do and we do it. The best hopes are that the nine principles I’m referring to in Article 1 of our bill — principles such as making sure everyone has access to high-quality health care; making sure we cover all necessary care including mental health, chemical dependency, prescription drugs, dental care, long term care, etc.; making sure — and this is key — that we don’t save money by restricting, delaying or denying care, reducing the quality of care but that we save it through administrative efficiencies and limiting bureaucracy.

My biggest fear, on the other hand, is that we get so wrapped up in the politics and the strategies of political power and who can score political points that we forget what we’re trying to do. In Washington, it’s happening in both parties. Some of the stuff is just hateful misinformation: the death panel stuff — “we’re gonna cut Grandma off, Grandma’s gotta die.”

Aside from the hateful stuff, there are a whole lot of people who get driven by ideological views of what they favor — “we want a free-market approach, we want this approach or that approach.” And they get into, “Well, this is feasible, we can do this.” [U.S. Senate Finance Committee Chairman] Max Baucus in Washington is saying, “Well, we’re not going to consider single payer because it’s not politically realistic.” People get so wrapped up in the politics and the political strategy they forget what they’re looking for.

The only thing you’ll hear about vision, about what we want, about what are we trying to accomplish in Washington … is you’ll occasionally hear politicians talk about universal health care. Even the ones who are speaking about universal health care, President Obama and others, the proposal in the House would cover 94 percent.

My math, my mind does not call 94 percent universal. … They start out talking about universal health care and the next thing they’re doing is talking about a proposal that will be some form of insurance, no matter how pathetic, for 94 percent of the public. So, then, what was the vision? What was the goal? What is the focus of what we’re trying to accomplish? What happened to that terminology? What happened to that reality? So, my fear is that politics and political strategizing and political point-making is trumping the discussion of what we need to accomplish in health care reform.

MP: Do you ever feel lonely being in the minority for a single-payer solution?

JM:
Yeah, I’ve felt in the minority about a lot of things. I call it the single plan instead of single-payer because a lot of people have more preconceptions and misconceptions about what single-payer is. I think public support for it is actually stronger than for any other option right now. I was calling one of my DFL colleagues from a very conservative part of the state to ask him to support my gubernatorial race. And he said that he’s not endorsing any of the DFL candidates for governor because politically it would be very tough in his district. But he said, “Keep pushing on your Minnesota Health Plan because my folks are desperately in need of it and they’re beginning to understand the importance of it. So keep talking about it.” That’s a very conservative part of the state, and I think it says a lot for it.

So, yeah, I’ve felt like a small minority in the past. But we now have 70 co-authors for my bill. I think the public is ahead of the politicians on this one.

MP: Any Republican co-authors?

JM:
We had a Republican vote for it in committee for the first time, but whether that will be sustained [is hard to determine]. The partisan politics has gotten so fierce in recent years that if a Republican supports such a plan they get beat up by their activists. But I think that when you look at other countries that have moved this way, at one point it was really controversial. But once they got it, everybody favors it.

The thing is calling it a health plan vs. single payer. What is single payer? Is Canada single payer? Is England single payer? Is Taiwan single payer? Well, they’re all different sorts of things so … I don’t tend to use that terminology because our plan is so different from everybody else’s that I think it’s worth talking about on its own.

We get into details such as the plan covers all prescription drugs except those that are marketed direct to consumers in Minnesota. Why does that matter? Well, $100 million are spent every year just in Minnesota marketing pharmaceuticals directly to patients, feeding a need where there may not be a need and pressing doctors to prescribe things they don’t think are appropriate. Why do we want to spend $100 million of our health-care dollars in one state, in one year, on advertising pharmaceuticals to people who may not be needing them?

MP: What motivated you to get involved in the universal-health-coverage movement and to propose the Minnesota Health Plan?

JM:
The reason I ran for office in the first place is the belief that we could do a better job in society. We’re a country that could tackle any obstacle. Right after the Depression, we battled fascism in World War II. In the 1960s we could put a man on the moon.

But we’ve given up; we’ve surrendered on so many issues as a society. Universal health care? “Well, it’s a nice dream but it’s not going to happen in our lifetime.” What kind of vision is that? What kind of defeatism? That’s why I got involved. It’s Martin Luther King Jr.’s statement: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

I’ve been involved in health care all along. I became chair of the Senate Health Committee a couple of years ago and I started working on these principles five, six, seven years ago. We’re trying to start the discussion beyond what we talk about in Minnesota: the Democrats pushing for insuring more people, the Republicans pushing for health savings accounts. I’ve thought that before we figure out how we’re going to get there, let’s figure out where we want to go.

When I became chair of the Health Committee, all of a sudden I had a chance to take a leadership role. Seeing no other proposals out there that were going to meet these principles, we put together a bill that would. I wouldn’t be wedded to the Minnesota Health Plan if someone else would come up with a plan that meets those principles. Take the plans in Washington. The plan I’m supporting is the best of the not-very-good options out there. It does not cover all people. It doesn’t stop people from restricting, delaying or denying care and reducing quality of care. It doesn’t cover all necessary services.

MP: Was there any singular experience in your life that inspired your involvement?

JM:
I’ve never been denied health care. … But I hear stories every week — every week. Last year, the Senate Health Committee had a hearing in Mankato, and one farmer talked about how he had taken his kid to an emergency room because there was something seriously wrong with the kid, they thought, and they took him in as any good parent would do. It turned out to be something they could have avoided if they’d known more. The kid turned out to be fine. But it cost them 500 bucks. … So, next time, you know they’re probably going to gamble and say, “Well, we’ll wait until Monday. We don’t have the 500 bucks.”

People are gambling with health care.

Just two weeks ago, I heard from another woman who told me about a sister of hers, 50 years old, who lost her job, lost her health insurance and lost her life because she had some sort of infection that was perfectly treatable but she didn’t have coverage and didn’t go in.

People are gambling their lives away on this. I didn’t personally suffer, but I’ve known so many people who have personally suffered and people who have lost their lives. I think everybody in the state knows people who have gone this way.

MP: What are the prospects for the Minnesota Health Plan bill in the next Legislature, given that national reform is front and center and that the state budget deficits have been running in the billions of dollars?

JM:
We’re not realistically hoping to pass the Minnesota Health Plan next year. We have a three- or four-year plan to make it a reality. We are hoping to pass it through another committee or two. … This is one issue that is so big and so complex and so important — it’s [health-care] one-sixth of the economy and it’s easily bigger than state government. Frankly, I want to make sure that this is thoroughly aired. It has passed through two committees now — my committee and the insurance-friendly Commerce Committee.

This is a bill that bypasses insurance. We don’t use [the term] health insurance; we use health care. We want to provide health care. So, we’re hoping we can pass it out of another committee or so this year. I’ve been speaking to any group interested in hearing about it. I’ve spoken to the Ramsey County Medical Society. I spoke to the Minnesota Hospital Association CEOs. I’ve spoken to nurses groups. I’ve got an invitation to speak to a local Chamber of Commerce; I want to speak to more Chambers of Commerce. I don’t expect the state Chamber of Commerce and local chambers to endorse the bill. They are perhaps blinded by some ideological beliefs and they represent health insurance companies and the pharmaceutical lobby.

But there are also a lot of members from businesses who … are being killed by health- care costs. What I’m trying to do now both at the Legislature and around the state is to expose more people to the ideas behind it, get their feedback; get their advice. We’re constantly looking at changes and improvements in the bill.

MP: How do you explain funding this plan to your peers and the public? How much would the startup costs be and what would the payment mechanism be?

JM:
We estimate the cost will be 20 percent cheaper than what we’re spending now in terms of total health-care dollars spent in Minnesota. That’s extremely expensive; about the only thing that is more expensive is what we’re doing now. Unlike the proposals in Congress, which are looking for a trillion dollars or more over the next decade, we want to do more than they do: cover everyone and all medical needs and do it at less cost. That’s the good news.

Getting an accurate projection on it is not something that state agencies have the staff to do this sort of thing. Wilder Research is committed to doing a cost study of the bill, and they are putting up some of the money.

[Colorado hired] The Lewin Group, which as you know is owned by UnitedHealth Group and is not particularly favorable to single-payer plans like this one because it really doesn’t leave much of a role for them.

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The Colorado Legislature, like the Minnesota Legislature about two to three years ago, formed a health-care access commission and they did it differently than ours. They did it the way I think we should have.

Instead of doing a study of insurance reform and payment reform and public health and fixed cost containment, this and that, our commission was given the legislative charge to develop a system that would ensure that “every Minnesotan have access to the full range of quality health care by 2011.” Our commission just didn’t do that. Instead we looked at how we can change this and 50 little things that were nice things, but the bottom line is we didn’t come up with a proposal on how we could make sure that quote, every Minnesotan have access to a full range of health care services.”

The Colorado commission said instead, “Hey, we want to provide health care to people”; they took the four plans that were the most promising and they asked The Lewin Group to analyze them. [Here is PDF of analysis; look at Page 105 for cost savings from single-payer plan.]

I pulled together a chart of the number of people left uninsured under each of the proposals and the costs of each of proposals. First of all, Colorado starts out with about 792,000 people that are uninsured, which is twice as many as in Minnesota. The first proposal would cut the number of [remaining] uninsured to 467,000 and cost $595 million. The second plan cut the number to 138,000 and would cost $271 million. The third one was 109,000 [remaining] uninsured but that one cost $1.3 billion.

The way I sell it to my colleagues and to others wanting to know about the Colorado Health Services Program, which is a single plan like ours, is that it doesn’t take six digits to tell you how many people are left uninsured. It’s ZERO. And the change in total health-care spending is $1.4 billion, but it’s got a MINUS sign in front of it. …

So I’ve got this chart and I’ve waved it in front of my colleagues. The Colorado commission looked at four proposals and it seemed obvious which one they would choose: if one of the plans eliminates the number of uninsured … and it’s the only one that saves money, well, obviously they’d pick that plan, right?

But, of course, they didn’t, because it was not politically realistic.

The way I sell it to colleagues and others is saying, If one plan works and it saves money and all the other plans don’t work and they cost more money, I don’t care if it’s politically realistic or not. We’ve got to make it realistic to the people who are dying for lack of health care; we better make it realistic.

We think the Minnesota Health Plan would save money. The Lewin Group does not favor single-payer plans, but their own analysis of Colorado showed that the only plan that covered everyone was the single-payer one and the only one that saves money is the single-payer one. … Our plan, because it’s a much more comprehensive plan, has a lot of factors we think would save more money. That’s why we’ve asked Wilder Research to analyze it and why we’re asking state and national foundations to help with the cost of the study.

The reason foundations might be interested, even though the plan is seen by most of the political experts as “oh, it doesn’t have a chance,” I think they’ll see that we’ve got a lot of co-authors. We’ve gotten it through a couple of committees. There seems to be growing support, and it’s fundamentally different from all the others.
 
What’s happening in Washington is that they’re looking at a mix of what Massachusetts and Minnesota and other states have done, and Minnesota and Massachusetts are spending a lot of money on health care and not solving the problem. So maybe we should try and figure out what solves the problem instead of doing more of what’s not working.

I think Wilder is recognizing that in the next couple of years we’re going to have to do something bigger. This is what’s so disappointing to me about the Washington debate. Obama is putting all of his political capital on the line on this thing and even if he gets everything he wants, which he’s not going to get, it hasn’t solved the problem. We’ve got a more expensive system, and it doesn’t cover everyone.

When people say, “Well, does he [Marty] really think this thing has a chance of passing in three or four years?” That’s one of the reasons I’m running for governor. … It used to be something where low-income people couldn’t afford health care. I’m sure you’ve seen that of the people who go bankrupt because of medical expenses, 78 percent had health insurance at the time of their illness or injury.

If you look at how much we spent on health care in Minnesota last year, it was $35 billion, according to the Minnesota Health Department. That’s $7,000 per person, slightly less than the national average. But projections are that it will grow from $35 billion in 2008 to $55 billion by 2015.

Just to put that into perspective, $20 billion in growth in the next seven years is bigger than the entire state budget. The entire state budget is about $18 billion a year. It’s (health care) already bankrupting the state, bankrupting local government, bankrupting businesses, bankrupting families and we’re going to add the entire cost of state government to what we’re spending on health care in seven years?

It just doesn’t work, and saying we’re going to reduce the curve in increased spending … well, maybe that suggests we ought to start with what we want to accomplish first. If there’s something wrong with the principles, then tell me. We’ll modify them … if these principles make sense; that’s what we want, then let’s start with what we want to end up with and how we’re going to get there.

We save up money to help send our kids to college. We save up money for a down payment on a house. We save up money to buy a new car sometimes. People save money for those things, but saving money [in Health Savings Accounts] so you can afford to get sick? I don’t want to do that, and I’m sick of it. Every Saturday night, every other town across the state has one of those sign boards out front of the Legion Hall [or another community meeting place] saying, “Come out Saturday night for the fundraiser for the Chris Johnson family” or somebody because their kid got leukemia. It’s immoral that people can’t get the health care they need or they have to go bankrupt to get their kid health care.

The reason I like focusing on the principles is because people are so ideologically bound. Let’s figure out not what kind of ideology we believe but what we want to accomplish. I want health care to be like a public service. The reason I think government has a role to play in this is it’s a public need and it should be treated like a public need.

Police and fire are a perfect example of that. That’s why I use this example: When you go home at night and find your home is broken into, you call 911. The police dispatcher does not ask you, “Do you have police insurance? Does your policy cover home burglaries?” We’ve addressed that problem and we ought to see health care in the same way.

We all need police and fire protection. We hope we don’t need much but we need the protection and we need it to be there when we need it. It’s the same thing with health care. We know it’s going to be needed sometime. You may need 10 times as much as me; I may need 10 times as much as you. We can’t know that but we all are going to need it in some way, shape or form.

MP: You have quite an extensive set of FAQs on your Minnesota Health Plan website. What are two of the toughest ongoing questions you’ve faced about your single-payer bill, and how do you address your critics? And, what key points of the plan seem to get lost?

JM:
I wouldn’t say that any one key point is getting lost right now. We’re still at the stage where people are trying to find out more about it, or they don’t know anything about it and they’ve never heard of it. That’s why I like tough audiences and why I’m looking forward to talking to chambers of commerce about it; I’m glad to speak to doctors, hospitals and administrators about it. So I don’t know that there’s any particular point that’s being lost.

When I met with the CEOs of the hospitals, HCMC and Regions and all the big ones, they gave me an hour and a half to present. At the end of the session I’d say a lot were skeptical but very interested. … I raised the point of how do we deal with uncompensated care. I pointed out that a former Senate tax committee chair proposed to help HCMC and Regions, by far the biggest charity hospitals in the state, by changing the fiscal disparities pool. … I told hospital administrators that’s kind of backwards. … Why don’t we fix the uncompensated care problem and make sure everybody has compensated care? Let’s make sure we have fair payments to the hospitals. I think that as we present and discuss, they learn from it.

The biggest misconception is that it costs too much. This is one thing [on which] I’ll agree with Obama: Doing nothing is not an option. We can’t afford to do nothing.

MP: How again does your plan save money?

JM:
There are a whole range of things. The biggest single savings are administrative. We’re spending 31 cents on every dollar on administrative costs. Now, if you look at most of the proposals in Minnesota in recent years and most of the proposals in Washington, everything they say they’re going to do to save money administratively, somehow that’s going to knock down Medicare costs.

In other words, we’re going to increase administrative costs to reduce medical costs. There are times you can do that, and I’m not saying you can’t. But the bottom line is … your head spins. Even if you’re an economist, your head should be spinning when you hear all these ideas of how they’re going to do this. If we’re spending 31 cents on the dollar now, we’re going to be spending 35 cents on the dollar when we’re finished. Maybe we’ll be able to knock down the medical costs enough to make up for those new administrative costs, but you’ve got a big burden before you even break even.
 
One analogy I give is that if we ran an elementary school the way we ran a hospital, every teacher would be required every day to sit down and calculate how many notebooks and pens each kid uses, how much of his or her time is devoted to each kid — five minutes here with this one, the next 45 minutes will all 30 of the kids, and two minutes with this kid.

You’d have to tally up those things, and all of the overhead costs, give each parent a school insurance plan, and the insurance plans obviously pay different rates for the same things. So, two minutes of a teacher’s time might pay more for one than another and some of the plans don’t cover everything and some of the kids wouldn’t have school insurance. You have to re-allocate everything and re-bill everybody for the difference; you’d spend half the school day every day trying to figure out who owes what.

We don’t want that. We want schools to teach. We want hospitals to heal. We don’t want nurses to be tracking for the billing department how many doses of whatever does a patient get.

We save money through administrative savings, we save money through negotiations and bulk purchasing of supplies. … We’d save money through eliminating certain functions like underwriting and marketing. We’d save money through efficient use of services. For example, people are going to emergency rooms for dental care 22,000 times a year in Minnesota because they don’t have a dentist.

The vast majority aren’t people who had their teeth knocked out in an accident. They are people who had tooth decay. It was untreated, it got infected; they got an abscess. It hurts like hell. They go in to the emergency room, the emergency room gives an antibiotic and pain relief, and tells them to go see dentist in the morning. So, in other words, they didn’t fix anything other than the infection.

Boy, at 500 bucks roughly a visit times 22,000 … just for dental problems? So, our plan would have a 24/7 nurse line available to everyone in the state. That avoids people going into emergency rooms. We would have access to urgent care everywhere in the state where you have an emergency room. If you don’t have an emergency you go next door to urgent care. We would deliver health care in a smarter way.

When I was in kindergarten, it was the year the polio vaccination came out and they lined us up in the gym and we all got the vaccination. When my kids were in elementary and high school and we wanted them to get the flu shot, which they now recommend for everyone, every kid at least, it would mean my wife or I would have to take time off work, pick up the kid at school, take them to the clinic, get the shot, bring them back to school. Maybe 10 percent of kids will get flu shots, and we’re at risk of a flu pandemic.

What if we went back to a single plan where somebody’s in charge and somebody can say, “Look, if want kids to get vaccinated, let’s put a nurse in the schools, have the nurse send home a note to the parents asking if they want their kid to get a shot, and line up all the kids in the school gym. It costs a third as much and gives nine times as many kids the shot.

It’s also the allocation of the medical infrastructure of hospitals and surgical centers based on need.

There are two radiation therapy clinics across the street from each other in Maplewood, which used to be in my district. … They’re not located there for convenience. One of them is owned by the hospital, the other one owned by some doctors who are making a buck off doing that.

We’ll have a logical distribution of the medical infrastructure and we’ll be negotiating provider fees. We would actually pay more for some groups in rural areas because there’s a shortage; we might be paying less to others and certainly for pharmaceuticals. The Canadian average price for pharmaceuticals is 40 percent less than what we’re paying here. You negotiate prices and you get a fair rate, so it’s a whole range of things.

It does cost more to cover more people for more things, but it saves money because realistically, those who aren’t uninsured we pay for them now at the emergency room. We pay for them now through untreated chemical dependency. We pay for them now through our prisons and jails.

MP: Aren’t you essentially putting the insurance industry out of business in Minnesota, and any idea how much Minnesota’s insurers and/or health-care providers have spent lobbying against you and your bill?

JM:
I’ve NEVER heard that question before. [He chuckles.] It’s an obvious question. The insurance industry is not particularly fond of this. First of all, we’re not putting the insurance industry out of business. I have homeowners insurance, I have auto insurance, and I’ll continue to have them. We would be putting the health-insurance industry out of business in Minnesota. [In turn] you’d be saving money on auto insurance, you’d be saving money on homeowners insurance, you’d be saving money for businesses; you’d be saving money on workers compensation because all the medical stuff would be covered by the Minnesota Health Plan.

But, yes, there would be some displacement of jobs and employees, and I don’t mean to minimize that at all. It is a very, very serious issue, and the health plan has in it a requirement that the board address dislocated worker programming to retrain people, help them financially adjust to loss of jobs. There are a couple of things that mitigate that of course, which is that this kind of proposal clearly creates more jobs and creates more business because it takes a big headache out of business.

Think of the stereotypical entrepreneur who has come up with some great invention and they’re working in the garage 80 hours a week to bring it to market. That stereotypical person isn’t so much there anymore because they’re working 40 hours a week to get health-care benefits and working nights and weekends in the garage.

This will stimulate the economy in a lot of ways. An awful lot of people work for health insurance companies but a decent number have medical degrees. Let’s get them practicing medicine where we need them instead of denying claims, which is what we’ve been using them for. … I wouldn’t encourage this but we’d actually save money if we just took all the people working in the health insurance industry and paid them to do nothing but sit at their desks all day because it wouldn’t require hospitals like HCMC to have 100 people in their billing department.

This past year, from January to now, Minnesota lost 2,000 to 3,000 jobs every week. There’s one advantage for people who would be losing their jobs under this bill, which none of those people who lost their jobs had this past year, and that is that they would have their health insurance taken care of. Why? Because the Minnesota Health Plan would cover them. The woman I told you about who died after losing her job and losing her health insurance last year … you wouldn’t have that kind of tragedy. The biggest unknown for anybody who is laid off is, “What am I going to do for health care, how am I going to pay for it and am I going to be able to get it?”

It’s not to trivialize or minimize the difficulty when you’ve been laid off. It’s a tragic thing. It’s almost as tragic as the workers losing their jobs in the last year and a half under the recession. The good news is we’re creating more business, creating more jobs by this plan and making the community healthier and bringing in more business that way.

MP: Any idea how much the insurance industry has spent trying to block your plan?

JM:
You’ve seen the numbers on how much they’re spending in Washington [$1.4 million a day]. They haven’t really started fighting this yet. It’s on their radar screen for sure. When this bill starts moving forward, they’ll put a lot more resources into it but I don’t know if they’ve spent much on it so far. They’re just tracking it now. Again, if we have a governor who has this at the top of the agenda, if we have a Legislature that’s really hearing from people … again I’m hearing from some of the most rural parts of the state. Health care is a mess in the metro area, but it’s a disaster in Greater Minnesota.

The article in which you talked about the subbasement (the individual insurance market) — that’s a good way to describe it. It might be a housing-loss prevention policy and it may stop some people from going bankrupt. But the thing is, we hear testimony from farmers who have to demonstrate to the banker that they have some form of health insurance before they can get a loan. … Our health system has been screwing up every part of the economy, and it’s getting worse fast.

MP: Anything else you’d like to say that I haven’t asked you about?

JM:
To get back to your first question on best hopes and worst fears: Again, my fear, my disappointment is over how wrapped up everybody in Washington is over the strategies and the partisanship and so on. Other than the initial talk about universal health care, there’s no real look at what we expect out of the health care system and no real expectation that we can do better.

This is a country that for years was always the country willing to tackle anything. Obama has basically said we need a single-payer plan if we want to cover everyone. He’s admitted that. To say that in this country, the richest country in the world, where we think of ourselves as way ahead of the world; to say that we cannot provide health care to everyone and we don’t expect to be able to in our lifetime, that’s just not acceptable.

Casey Selix, a news editor and staff writer for MinnPost.com, can be reached at cselix[at]minnpost[dot]com.