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Tuesday Talk: What’s the best path for MN health policy?

March 27, 2012 By Rachel Weeks, Communications Specialist

Today, the Affordable Care Act enters its second day of Supreme Court hearings. Hotly debated since passing two years ago, the ACA expands coverage for vulnerable populations, reigns in insurance companies and offers small business tax credits. At the center of this week’s debate is the individual mandate.

Here, in Minnesota, with health care that has long been ahead of the curve, work on a health care exchange has already begun.

What parts of the ACA are best for Minnesota? With or without the ACA, what health care policies should Minnesota pursue?  

Thanks for participating! Commenting on this conversation is now closed.


  • KJC says:

    March 27, 2012 at 8:03 am

    I think you should use the whole name: “The Patient Protection and Affordable Health Care Act.”  Leaving out that “Patient Protection” part lowers the perceived value.  For example, who wants to be denied insurance because you have a pre-existing condition?  (We’re all going to have one of those, sooner or later…) 
    I would have preferred single-payer, but this is the compromise that came out of the negotiations. 
    I think we should look to the Switzerland example, they may be on a similar path, but ahead a little.  Maybe we could learn a few lessons without doing so much of it the hard way?
    Once the Supreme Court ruling comes down, no doubt before the election like the want, we’ll see if the rollout of health exchanges, etc will get changed.
    Recently the health insurance companies came right out and said?  That to deliver better care at a lower cost that everybody would have to be in the system… meaning either single-payer or a mandate.  Unless you want our runaway health care costs (double that of any other industrialized country) to slowly decimate our great land, something has to be done.
    Single payer or mandate?  You want to do nothing?  That’s just being part of the problem, not the solution. 
    How many remember the proud proclamations of Republicans in 1993, as they proposed the individual mandate as their solution, when the Clinton Admin wanted to do health care reform?  Check it, they had their own actual bill, with many Republican sponsors.  Now, fast forward to today, those very same people are saying the individual mandate is the end of freedom etc.  They’re counting on you forgetting that this was… first and foremost… their idea, did you?

  • Tom Larsen says:

    March 27, 2012 at 9:13 am

    ACA is more inadequate, sinister smoke and mirrors,heaping artificial complications on an already naturally complex challenge
    for our Union: How to SECURE THE RIGHT TO
    LIFE, EQUALLY, to all citizens?

    Anything but Medicare for all(SINGLE PAYER!) and a refocus on best medical practices will honor the just and noble cause for which our government was created.

    Listen again to John Marty’s efforts and

    (Let them pursue happiness in a different

  • Amy Wilde says:

    March 27, 2012 at 9:32 am

    Many opponents of the Patient Protection & Affordable Care Act conveniently forget that, as originally envisioned, citizens were to be offered a “public option” in the event they did not want to enroll in a private health plan. That option was scuttled in the attempt to win over the votes of a few Republicans & Blue Dog Democrats. (A vain attempt, for the most part.) Now those who feared a public option would expose the money-grubbing ways of private insurers & create havoc in the insurance industry are claiming that they don’t want to be “forced” to buy insurance “products.” In the event these hypocrites succeed w/the Supremes, perhaps MN should work on developing its own “public option.” We have several examples in the form of the county-owned health plans that are now providing care to low-income residents of approx. 25 Minnesota counties. These plans struggled in their initial stages, but are now Medicare-certified & providing a full range of services, care coordination, etc. to tens of thousands of people on several public programs. Best of all, their board meetings & minutes are open to public scrutiny. One of these plans is currently offering a product to under-served local businesses, on a pilot basis. (Full disclosure: I was a founding board member of one of these county-owned plans.)

  • Bernice Vetsch says:

    March 27, 2012 at 11:10 am

    The most valuable parts of the new health care law would have to include forbidding insurance companies from refusing to pay claims for what they call pre-existing conditions. 

    I met a 55-year-old man once who had fallen out of a tree at age five and hurt his knee. His perfectly working knee developed a painful condition at his current age that surgery would correct.  His insurer, however, claimed that his accident at age five caused his current trouble and refused to pay.

    A close second is to provide help to seniors who fall into the donut hole and end up paying retail for their drugs. This saved me personally $1,000 - $2,000 this year.

    There are ways states can choose to enact single payer and Minnesota can, if it will, enact John Marty’s Minnesota Health Plan.  Nationally, a single payer plan would save $400 billion per year, much/most of it in the unnecessary paperwork both providers and payers have to go through to maintain our current system. Including the salaries and benefits costs insurers pay to employ over two million “denial specialists” nationwide.

    The Minnesota Health Plan will achieve similar savings here while assuring appropriate and timely care to every resident of our state. No denials, ever. On Wednesday morning we can find out how much by attending a press release announcing the results of a cost study carried out on the Plan. 

    Room 181, State Office Building, 10:00 am.

  • Aaron Sinner says:

    March 27, 2012 at 11:16 am

    I’m of the belief that some of the best parts of the ACA are its experiments in cost control—competition-based exchanges, Accountable Care Organizations, the Patient-Centered Outcomes Research Institute, reimbursing doctors for preventive care, personalizing end-of-life care, etc. It’s only in keeping care affordable that we can ensure universal coverage is a realistic possibility.

    I don’t know which of these experiments will prove most beneficial, but I’m excited to see how they reshape the market. Ezekiel J. Emanuel and Jeffrey B. Liebman have a great article (here: on how ACOs could reshape health care in America. (Of the 32 Pioneer ACOs, 3 are in Minnesota.) And I’m sure if any other cost-saving measures prove effective, they could similarly improve our health care market in drastic ways.

    As for health policies Minnesota should pursue, I think the next big health care challenge will be moving away from employer-based insurance. It’s not good for employees, who risk losing their insurance at the worst possible time, when they lose their job. It’s not good for businesses, who have to pay for their employees’ insurance while competing against companies based in countries with government-run systems or other structures that take the cost off their roles. And it’s not good for entrepreneurs, who might have a great idea for a start-up but can’t risk quitting their jobs and losing their insurance.

  • Bernie says:

    March 27, 2012 at 11:27 am

    Can someone help me to understand why 1,231 organizations have been granted waivers?  26 Minnesota companies and unions have been granted a waiver. Here is a breakdown from Self insured Employers (722), Multi-Employer Plans (417), Non-Taft Hartley Union Plans (34), Health Insurance Issuers (50), State-Mandated Policies (5), Association Plans (3). Some of those Minnesota companies granted waivers are; Anderson Corporation, Pearson Candy Company, Minnesota Electrical Workers, Minneapolis Retail Meat Cutters, Regis Corporation, Minnesota Cement Masons, Minnesota Teamsters Construction Division—- just to name a few. Why should any organization be granted a waiver? It seems to contradict the objective of this legislation which is to cover everyone.

  • ChristeenStone says:

    March 27, 2012 at 11:40 am

    I would say “Amen"to all that Amy Wilde has said, she covered it all. I have been very much involved in the Health Care issue for 25 years now as a volunteer advocate at the legislature. I spent a lot of time in 1989-1992 working with the Bi-Partisan bill called Health Right and later Minnesota Care. At that time we wanted very much to have a single payer type insurance, but accepted MINN Care as a compromise every one would accept. I was and still am a representative of AARP, but am speaking for myself now.
    We only managed to provide Health Care for families with lower incomes and small business, and farmers families self employed. Our dream was too through the years make it an insurance available to everyone who wanted it. But the Pawlenty years has taken its toll on that.
    We were very interested in the Clinton’s Bill and followed it very closely.We were disappointed when it failed. AARP did endorse the Health Care ACT even though it didn’t have the public
    option we would have preferred. We are supporting the Health Care Exchange and other Option in this ACT.
    As I weigh in on this Bill I would say those who want to kill it have done a great job of demonizing it. To those who
    feel they should not be forced to buy insurance, I would like to say I am really getting tired of paying for your insurance, when you have an emergency and can not pay for your own. I pay about $3,000 per year for my insurance and see my doctor once a year when she reminds me. I am 91 and blessed with wonderful health. Last survey I saw every insured person pays about$500 per year for the uninsured and that was done 7 years ago. So I hope the Court judges this fairly.

  • Bill Graham says:

    March 28, 2012 at 2:07 pm

    I applaud the Democrats’ health reform law and hope the Supreme Court lets it stand as is.  We should remember that health reform is about (1) covering everyone, (2) collecting from everyone, and (3) hammering the price of medical and insurance services DOWN!  In other words MORE medical services for LESS money.  I support a single payer system, but whatever emerges MUST be some form of price control.  The industry will fight that with everything they have, and Democrats will have to jam it down their throats if there are enough of us.

    Bill Graham

  • Bernice Vetsch says:

    March 28, 2012 at 3:07 pm

    You might all be interested in a new report released today by Growth & Justice that introduces the results of a cost study by the Lewin Group.

    What they call a “Unified” system describes several alternative ways (including single-payer) of achieving universal coverage for Minnesota residents.  Health care costs in Minnesota would be reduced by about 9% in spite of expanding coverage to include eye care, dental and mental health (but not long-term care).

    The report and the Lewin study may be viewed at

  • KJC says:

    March 28, 2012 at 4:12 pm

    Plenty of good on this thread.  In listening to the questions of Supreme Court Justice’s I am left puzzled.  Why? 
    We have, long ago, had a life mandate: if you are at the E.R. and need medical care, you will receive it.  We do this out of humanity.  Anybody for just letting people die in the E.R. because they don’t have insurance?
    This has left us with a problem, and one that few want to talk about.  Once someone gets care in this situation, and if they can’t pay (usually because they have no insurance, and they have few assets) this means?  SOMEBODY else gets forced to cover this….it’s either the taxpayers, or the cost gets shifted onto other (paying) customers.  One part of the excess bureaucracy of this system is?  The not-so-thinly-veiled paperwork turf game designed to ensure that “we” try to get less share of these “hidden” costs put on “us.” 
    So what is all this gnashing of teeth about being “forced to buy/pay?”  Where have these people been?  I don’t get it, aren’t we already deeply involved in the “who’s going to be forced to buy/pay for the uninsured” game?  Isn’t the individual mandate really just an admittance of what been going on for some time now?.  Only this time, trying to rectify it more openly and fairly?  Right now it’s done without real visibility or express consent, which tends to leave some people in denial, because they would like to think they’re not being affected. (!) Yet another cost of system non-transparency, in this case as the cost is shifted onto other paying customers, or taxpayers, when they aren’t “looking.”  So, isn’t it way too late to complain about the principle of being “forced to buy/pay?”
    A single-payer system would have gotten us out of this ugly dilemma, with far more grace and at a lower cost, too. 
    Until then? Unless we’re going to let uninsured/poor people die in the E.R., somebody (else) is going to be forced to buy/pay… or there is going to be an individual mandate to greatly reduce this huge problem.  Isn’t the individual mandate just a matter-of-fact way of doing this in a more open, and fair, way than the current hope-the-buck-doesn’t- stop-here, some game-the-system, shell game?
    It IS what we as a country have to do, if we don’t have single-payer… or universal service will remain a myth. 
    Maybe the Justices will surprise me?   

  • Dan Conner says:

    April 3, 2012 at 8:14 am

    Minnesota should pursue single-payer like Vermont is doing.  Then, I can again be proud of the Minnesota that says, “we don’t follow the fashion, we set them.”