‘Will You Lose?’ campaign lays out HCMC’s fiscal challenge — and its potential effects throughout Minnesota

'Will You Lose?' campaign lays out HCMC's fiscal challenge -- and its potential effects throughout Minnesota
Each year more than 3,000 Minnesotans are transported to HCMC – the state’s largest Level 1 trauma center.

Last month, freelance creative designer Blair Fellman stared down a tall order from Hennepin County Medical Center.

Though Fellman worked previously on the Save This Brain campaign to tout HCMC’s brain injury programs, this time he was being asked to help preserve health care for the poor at the state’s largest public safety-net hospital.

And he was being asked to do it with a $30,000 marketing budget.

“I gulped real hard,” said Fellman, whose business is called Creative Wingman. “Hmm, I thought, how do we try to solve this problem? It’s so much bigger than a marketing problem. The important thing is to energize the base out there and get people talking so that it all starts to snowball.”

The result is the “Will You Lose?” campaign, which includes a website by the same name that went live Nov. 20 — along with social media (Facebook, Twitter, YouTube), some print advertising and a couple of upcoming billboards.

The website includes an interactive “fallout” map, which quantifies how HCMC serves each congressional district in Minnesota, a place for people to share their stories, and video clips of a 1976 film about HCMC narrated by the late Vice President Hubert Humphrey, a former Minneapolis mayor. “Webisodes” also are in the works, Fellman said.

An estimated $42 million loss in 2010
HCMC, in downtown Minneapolis, faces an estimated $42 million loss in state funding in 2010 and $50 million in 2011 — less than 10 percent of its $550 million annual budget — because of the scheduled March 1 elimination of the General Assistance Medical Care program. GAMC currently covers medical care for 36,000 impoverished uninsured adults without dependents in the state. Gov. Tim Pawlenty used his line-item veto last spring to cut $381 million in second-year funding and has said the program won’t be restored in its current form.

The prospect of losing GAMC funding has mobilized advocates ranging from hospital CEOs to homeless-shelter workers and their charges. And the predicament has led to campaigns ranging from videos of GAMC enrollees on St. Stephen’s Human Services website to a weekly email from Regions Hospital — the state’s second-largest safety net hospital — featuring a GAMC patient’s story, the costs of caring for the patient and the number of days to the start of the Legislature.

Now there’s the “Will You Lose?” campaign. Since the launch, the site has drawn 1,800 unique visitors, 650 Facebook fans, 70 Twitter followers and 100 names on its e-list. It’s unclear how many dollars have been raised through the donate button.

Will You Lose campaign
One of the dire messages in “Will You Lose?” campaign.

HCMC’s role in state
HCMC’s new Hennepin Health Foundation awarded a $30,000 grant to call attention to not only the loss of GAMC funding but also to show HCMC’s “unique statewide role,” said Tom Hayes, director of public relations for HCMC.

“We just feel it’s important that we illustrate what’s at risk,” he said.

Besides caring for the poorest residents, he said, HCMC trains thousands of medical professionals in Minnesota and offers a Level I trauma center, the most critical-care burn beds, a hyperbaric chamber and poison control, among other services. 
“HCMC isn’t just this hospital in Minneapolis,” Fellman said. “It affects a lot of people all over the state, along with offering state-of-the-art care. … A lot of people think HCMC is an inner-city hospital that treats the poor, and there’s so much more than that.”

A ‘fallout’ map

But how does a designer show that effectively? Fellman chose a “fallout” map, whose concentric circles resemble those Cold War impact maps of an atomic blast. As a user rolls a mouse over a congressional district, these details pop up: number of visits to the emergency room, number of uninsured patients and the cost of caring for them, and even a tally of calls to the poison control center.

The heaviest fallout is in the Twin Cities, where more than 40 percent of the state’s GAMC enrollees seek care — many of them at HCMC.

Early this month, the Minnesota Department of Human Services announced that GAMC enrollees on March 1 would be switched to MinnesotaCare, an insurance program with sliding-scale premiums and co-pays for low-income Minnesotans. Premiums are to be paid by counties for six months, which means Hennepin County could be on the hook for more than $600,000, said County Board Chairman Mike Opat.

The problem with the switch, Opat and critics say, is that MinnesotaCare doesn’t work well for a transient population (28 percent of GAMC enrollees are homeless). MinnesotaCare also has a $10,000 annual cap on hospitalizations, and it doesn’t offer immediate coverage and reimbursement as GAMC did for uninsured patients who seek care at a hospital emergency room.

Delayed reimbursement
In effect, after GAMC funding ends March 1, care for new uninsured patients won’t be reimbursed until they are declared eligible for MinnesotaCare, said DHS spokeswoman Karen Smigielski, who acknowledged the eligibility process could take some time.

In the interim, providers are on the hook for paying for that care. At present, 5 percent of GAMC patients at HCMC require hospitalization, but their care constitutes 70 percent of GAMC payments to HCMC, Hayes said. Half of the hospital’s GAMC patients are seen at HCMC clinics.

Will You Lose campaign
Campaign emphasizes potential statewide effects of funding losses.

Since HCMC lost $12 million in funding in a state unallotment in December 2008, the hospital has cut 200 of its 4,700 jobs through attrition, eliminating open positions and layoffs, and could cut another 150 to 200 jobs in 2010, he said.

The Hennepin County Board of Commissioners is considering a 3 percent property tax increase to help cover the gap in funding for HCMC, which would raise about $18 million, Opat said. (Hennepin County taxpayers provide 5 percent of the hospital’s $550 million annual budget.)

But even with the potential new tax revenue, job cuts and elimination of some programs, HCMC is left with a $25 million funding gap next year if a GAMC solution isn’t found after the Legislature convenes in February, Opat said.

Coalitions seeking solutions
Community and safety-net provider coalitions have met in recent months to come up with alternatives to present to the Legislature. And HCMC and Hennepin County officials have been meeting with other hospital representatives.

“None of us are under the illusion that GAMC will be restored in full,” Opat said, adding he expects a proposed solution to be announced in coming weeks.

If no GAMC funding is restored, HCMC would no longer provide “non-emergency outpatient pharmacy services or clinical care” for uninsured residents outside of Hennepin County, Hayes said. Also on the chopping block: the outpatient cardiac rehabilitation program and the senior care clinic, the latter of which would be folded into another clinic.   

Meanwhile, HCMC is trying to build up the coffers of its new foundation to help cover uncompensated care. A “Together We Can” campaign raised $270,000 in employee contributions through payroll deductions next year, he said.

And there’s hope that the community will get involved and/or donate to the Hennepin Health Foundation after seeing HCMC’s reach described at willyoulose.org.

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

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Comments (11)

  1. Submitted by Hannah on 11/30/2009 - 11:31 am.

    Where did you get the picture of the sign that says 0 doctors in Mora? The photo must have been doctored. There is an Allina Clinic in Mora, and its website lists 11 doctors but several other medical practitioners such as podiatrist, optometrist, etc.

  2. Submitted by Jeremy Powers on 11/30/2009 - 11:37 am.

    HCMC is the provberbial bird in the mine for Minnesota health care. And it further shows why a national, universal health care system is needed. At what other level would it cover something like HCMC.

    I went to the Guthrie yesterday to see A Christmas Carol. I hadn’t seen it in years, nor thought much about Scrooge’s similarities to the typical mindset of current Republican thinking. But if you renamed Scrooge to be Tim Pawlenty or Mike Huckabee or Michele Bachmann or any of the rest of the current collection of Republicans, you wouldn’t have to have rewritten a single word of the script.

  3. Submitted by Daryl Hanson on 11/30/2009 - 12:48 pm.

    So I have to take care of your health care hmmm? Tim, Mike and Michele are talking about personal responsibility but I guess that is loss to you. OK lets steal (ie tax) other peoples money and give it to you. hmmm? that doesn’t sound very xmassy either. But you can only look at it from one side. We need some type of reform but not the stupid reform requested by the health care bill in front of congress.

  4. Submitted by Casey Selix on 11/30/2009 - 01:16 pm.

    The photoshop of Mora’s population sign is from HCMC’s website, willyoulose.org. It is part of HCMC’s campaign to publicize the potential impact of funding cuts on HCMC, which trains thousands of medical professionals in the state.

  5. Submitted by Grace McGarvie on 11/30/2009 - 01:40 pm.

    Daryl – god forbid you are ever the victim of traumatic brain injury, were born with cerebral palsy, have a stroke, etc. or what if you work at a minimum wage job? Then you might find out that all people are not capable of “personal responsibility” when it comes to buying health insurance. People like you make me sick. Thank goodness I have very good health insurance.

  6. Submitted by Eric Ferguson on 11/30/2009 - 03:06 pm.

    Daryl, yes, you have to pay for Jeremy’s health care, he has to pay for mine, and I have to pay for years. Being part of the same society means we watch out for each other. If you don’t like that, I suggest you move to a shack in woods where you can be by yourself and hide when you see strangers.

  7. Submitted by Jeremy Powers on 11/30/2009 - 03:23 pm.

    Daryl Hanson

    First, I don’t need anything. I am in a tax bracket that almost certainly would be hit with increased taxes. My health care coverage is so good I swear there is a gold star on my folder. Every time I walk into a doctor’s office they want to give me more tests, etc. So your first concept is blatantly wrong.

    Scrooge, if you remember the story, doesn’t to help anyone but himself. He asks if the poor farms and the treadmills, which he is taxed too highly for, “are they still in existence.” That’s more than personal responsibility. That’s plain greed. No other word for it.

    Daryl, in this Christmas season, I hope you are visited by three (non alcoholic) spirits one evening so you, too, can hold Christmas in your heart all year long.

  8. Submitted by Daryl Hanson on 11/30/2009 - 04:26 pm.

    First, the invalid should be cared for, yes… they ARE cared for, help for a brain injured person should and does happen (have a relative that is living it today, with a family.) Casatrophic insurance is needed but here you all stand around and preach because you have a golden parachute health insurance. OK go out and give your money to help the other folks that need the health care but don’t steal from someone else just because you think they are rich.

    Please define to me what is greed? If I make 80K but I have to pay taxes that leaves70,60, 50, 40… 20K left, haven’t I been wronged? (bad English) don’t I have a point? Where do you come off telling someone that they are greedy?

    Freedom means that people can fail and people will fail and possibly fall through the cracks in society. Should these people be helped? Absolutely !!!! which I personally do but I have no right to come into someone elses home and steal (tax) money from them because I think my neighbor down the street needs assistance. It is MY responsibility to help that individual if that person needs help. Not a beaucrate in Washington and not my representative. Church and home it where the assistance should come from, not government.

    So please get away from the Scrouge label. I give and give with the hope of helping man kind but I will not justify stealing from one so I can help another. That I believe is not right.

  9. Submitted by Jeremy Powers on 11/30/2009 - 04:48 pm.


    Taxation is not stealing. It isn’t stealing in any country on earth. In our early days, we were taxed without the ability to choose who it was that was taxing us and how much. You may not like who represents you, but you are represented — even if you don’t vote. We all are part of a county and a state and country. It costs money to operate them. We all pay in something.

    However, if you live in Minnesota and don’t feel taxes are fair — they’re not. The rich pay much less of their income to taxes than does the middle class. How this got passed was that the lobbysts for the rich made you feel like you were one of them. If you make 80K — that’s a good salary — but you are not in the looking for a million dollar vacation home crowd.

    If the Scrooge label hurts, maybe the shoe fits.

  10. Submitted by Rebecca Hoover on 11/30/2009 - 05:53 pm.

    Some people have been given an education at the public’s expense but forget the debt they owe to those who paid for it. Some people drive on roads that are paid for with the cooperative efforts of us all but forget the need for cooperation. Some people are helped day and in day out with the kindness of strangers but forget the obligation to help others. Daryl, does this sound like you? It sounds like you to me.

    By the way, I signed up on the Facebook page for this group and invited all of my friends to do so too. Let’s all do that and raise a real ruckus so we save HCMC! Let’s open our arms and our hearts and take action!

  11. Submitted by Richard Schulze on 11/30/2009 - 06:12 pm.

    The last time I was in the emergency room it was about ten years ago. Eight staples, one Tylenol 3 and I was done out the door.

    The staples were $100.00 ea. The single dose of Tylenol 3 was $50.00. It was explained that the costs were high was so that the insured “subsidize” those that were unable to pay and were therefore using the emergency room as a form of universal health care. My insurance deductible was 50.00 for the emergency room, my insurance paid the rest.

    The cost of care for the uninsured is shifted to people with insurance, in the form of higher premiums, co-pays and deductibles.

    Through this cost shift, the average person with insurance pays about $100 per month to cover the cost of care for the uninsured.

    Employers, faced with those higher premium costs, are facing the difficult decision of either passing on the costs to employees, eliminating coverage for dependents, or eliminating work-based coverage altogether

    The current structure of the US health care system results in higher taxes, lower wages, increased health care costs and, often the inability to get timely access to needed care. We have “universal access” but only through the emergency room, which is both expensive and inefficient.

    Whether one wants acknowledge it or not, we all pay for the uninsured.

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