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Tuesday Talk: What’s the biggest barrier to better health care?

January 17, 2012 By Joe Sheeran, Communications Director

Roughly 10% of Minnesotans don’t have health insurance. Many who do face cost and access barriers. Additionally, federal health reform that brought access to thousands of Minnesotans faces a U.S. Supreme Court challenge. Minnesota is forging ahead though, shaping a state health care exchange, and filing briefs supporting the Affordable Care Act. What’s your take?

What do you feel is the biggest barrier to better health care? 

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


  • Ed Rapp says:

    January 17, 2012 at 8:39 am

    Old age.

  • Joachim huber says:

    January 17, 2012 at 8:48 am

    The biggest obstacle to good health care for everyone is the greed of health insurance companies with no checks nor balances to how much they raise their rates even in a recession year! They also play a lot of smoke and mirrors so you don’t really know what you’re getting charged. That is plain dishonest. I get a statement that says my doctor got paid $250 for a 10 minute visit then my doctor says they actually got $60 for that visit plus the $30 copay I paid out of pocket.  I am paying 2ce as much out of pocket for family health care as I am for federal income tax then I have copays. It seems I am working to pay for health care coverage. Also there is the illusion we need health insurance other than catastrophic. Another obstacle are all the people who overuse the system, go to the doctor for simple colds or flu when they should wait it out a day or 2 because the doctors cannot do anything anyway.

  • John Crampton says:

    January 17, 2012 at 8:50 am

    Lack of single payer, universal health. 

    The U.S. pays twice as much per capita for health care than any other developed country of the world, and yet we have over 50 million people who don’t have health insurance.  We also rank 42nd in the world in health outcomes. 

    USA!  USA!  USA!  We’re Number 42!  But our medical insurance CEO’s are paid $$$ hundreds of millions a year.  They’re number 1 for sure!

  • Mike Downing says:

    January 17, 2012 at 9:04 am

    Obamacare has negatively affected many employees & retirees throughout the U.S. 3M has dropped retiree healthcare at the end of 2012 an 3M is not the only company to do so. Obamacare has negatively affected far more people than what it has helped.

  • Norm Hanson says:

    January 17, 2012 at 9:29 am

    What do you mean by “better health care?”  Lower cost coverage for health care services?  Better quality health care services as measured by???  Unrestricted access to coverage for any and all health care services whether they are medically necessary or not?  In many cases, as per Pogo, “we have met the enemy and he is us.”  We want access to all health care services, now, and at an affordable cost, whether our health plans cover such services or not. As such, the biggest barrier to health care, however one defines that term, is often us.

  • Michael C says:

    January 17, 2012 at 9:39 am


  • Tom Larsen says:

    January 17, 2012 at 9:58 am

    Political energy of the non-specific type
    you are inviting. What does “better” mean?

    The funding of “healthcare” is ARTIFICIALLY MADE COMPLICATED due to greed/profit motive. Single payer is the solution-anyone who says otherwise does not agree with the foundational deal in the Constitution(ie government is formed to SECURE equal rights to life…). They really don’t meet the criterion of my “fellow Americans”. I am not “flag waving”. This is the only reasonable interpretation I can fathom. Life trumps liberty-so don’t go there.

    Routine, “best practices”, are the bulk of procedures and they should happen with simple payment, the capture of incidence and outcomes-in real time for response and research purposes.Incremental improvement should happen over time.

    Man made hazards to health-like our food system, sex industry & automobiles-also should be diminished over time and this is where we wrestle with “liberty”, but must give “life” it’s rightful respect.
    Honest education,research & debate.

    Human health is ORGANICALLY COMPLICATED-that is why we have medical schools & disagreement on some issues between honest, educated practitioners.
    Better research & education are the answers there.

  • Steve Janusz says:

    January 17, 2012 at 10:01 am

    The biggest barrier to better health care is cost. The waste in our current health care system has resulted in 31 cents of every health care dollar not going to health care.  We must remove some of this waste.  A single payer plan, like the Minnesota Health Act, would cover all Minnesotans and cost us less.

  • Bernice Vetsch says:

    January 17, 2012 at 10:06 am

    The biggest, and hardest to change, obstacle to better health care for all is the false belief that Americans are “not ready” for a single payer plan like Canada’s.  Research by Harvard Medical School physicians shows that over 60% of Americans are “ready,”  but apparently most of our politicians in Washington are not because they are beholden to the insurance and drug industries for campaign contributions.

    Nationally, about .001% of the uninsured die because of lack of access to regular preventive and curative care, preferably from a physician they know and trust. When the national uninsured number is 50,000,000, the number of those who will die is 50,000.  Covering everyone would save us $400 billion per year, those 50,000 lives and the suffering those people endured before dying.

    Our budget for defense is over $700 billion per year, plus additional billions within the departments of State and Homeland Security.  These dollars are to “keep Americans safe.” I’d be very interested in knowing whether this budget saves 50,000 lives a year.

  • John Crampton says:

    January 17, 2012 at 10:17 am

    Steve,  You’re right on.  31 cents on every health care dollar in our privatized U.S. health care system goes to administrative costs.  In other words, money we are paying companies like United Healthcare to deny our claims for the benefits we have paid for. 

    By contrasts, the administrative costs of Medicare, the U.S. military and other “socialized” health care systems are about 2 cents on every dollar.

    People who say that “government is the problem” and that private health insurance companies can do it better are just mouthing idealogical nonsense that are contradicted at every turn by facts.  Private health insurance in the U.S. is nothing more than the mafia by a different name.  What we need is Medicare 2.0 for every American.

  • wayne says:

    January 17, 2012 at 10:59 am


  • W. D. (Bill) Hamm says:

    January 17, 2012 at 11:26 am

    When the Supreme Court shuts down Obamacare it will be time to open an honest discussion on healthcare. We the people want bottom up health care that is patient based and gives us input and ownership, not top down single payer that is system based, socialist, and dictatorial.

  • Rick S. says:

    January 17, 2012 at 12:19 pm

    In my view, better healthcare starts with the individual paying attention to his or her own health and practicing healthier habits. Smaller preventative clinics for basic care and increased coverage(through insurance) for any additional care.

  • Paul says:

    January 17, 2012 at 12:21 pm

    I don’t recall anointing Mr. Hamm to speak for me and all others: “We the people…”?  Can someone please cite where he got that authority?

    In reality, a government run single payer system is managed by “we the people” because, through our election process, it’s accountable to all of the electorate.  The insurance based system on the other hand is run by executives who are only accountable to their shareholders and therefore subject to corruption of profit motives.

  • Peter says:

    January 17, 2012 at 12:29 pm

    Profit care.  The vultures circling above our heads are a protected industry.  This unaccountable, private tyranny will gradually fade away and be replaced by people who aren’t trying to make profit from the sickness of others.  You might say that health care will begin to care about people rather than profit.

  • Danie W says:

    January 17, 2012 at 12:41 pm

    While having health insurance and access to quality health care services are *very important*, research at Univ of Michigan showed that these things accounted for only 13 percent of health outcomes.

    The rest is affected by what is known as the Social Determinants of Health: Do you know your neighbor, do you vote, do you own a home, do you suffer discrimination, is there a large gap between what you earn and what others around you earn, how much education do you have, are you a member of a faith community? These and other social factors in a person’s life have an enduring affect on health. 

    Strengthening the social fabric and social safety net across these areas is vital for healthy communities.

  • W. D. (Bill) Hamm says:

    January 17, 2012 at 12:57 pm

    I got my authority the same place you got yours Paul, the first amendment. I have never and do not now support for profit insurance companies and have been clear about that in the past as you know. I support citizen owned and operated healthcare cooperatives that push control out to the local level rather than becoming top down authoritarian entities. Unlike some I put the patients best interest ahead of public employees interests or system interests. Under what I propose there would be no new public employees and no labor management conflict as labor would be co/owners of the system with absolutely no government interferance or participation needed. Neither of which is desireable for quality health care.

  • Bruce Kittilson says:

    January 17, 2012 at 1:04 pm

    Joachim (1-17) made a very good point, and there is more to be said about it.  Had he been uninsured he would have been billed for the entire $250.  This means that poor, uninsured persons get charged much more for medical treatment.  That is just plain backwards.

  • Bill Graham says:

    January 17, 2012 at 1:06 pm

    Universal coverage, outcome-based care strategies, healthy life styles, more uniform standards for care around the U.S., health care “homes” - all of these will help get us the care we need.  I am grateful to those Democrats and President Obama who hammered the health reform bill into law.  I would add that some form of price controls will be needed to keep health care affordable.  That could take a number of possible forms, and we should be looking at how Canada, Britain, Germany, Japan, Taiwan and Singapore have effected medical price controls.  It’s possible to do, and we all will benefit from it.

    Bill Graham
    Burnsville, MN

  • Dean says:

    January 17, 2012 at 1:09 pm

    Republicans and greed are the biggest obstacles.  Being bought off by the rich and powerful interests who care only about keeping their pockets full of $ is the great obscenity of politics today.  The interests of the few over the vast majority who could most benefit from realizing the full reform.

  • tony nelson says:

    January 17, 2012 at 1:21 pm

    The biggest cost is the extreme profits made by doctors, hospitals & private insurance. The rest of the free world has single payer healthcare that controls profit percentages for hospitals & doctors(a local magazine listed anethstesiologists(bad spelling?) at $700000 a year!!) & eliminates it in insurance, which allows for a more accessible medical profession & the resulting improvemnets in peoples health. Cost control is the biggest problem. The rest of the world thinks we are stupid…

  • Ed Andersen says:

    January 17, 2012 at 2:23 pm

      We need to cut out the marketing costs in our prescription drug and device markets.  In many cases there is a 40% markup to cover marketing and lobbying.  The same is true of the hospitals and medical insurance companies. The marketing costs should not be included from the medical field.  Doctors are trained and licensed to make treatment decisions on the basis of science not marketing power.  A cardiologist friend of mine says that all medical treatments, their costs, their benefits, their side effects are listed and evaluated on their medical research sites on the internet.  In their joint practice they discuss results among the caregivers in their association.

      We also need independent counselors to advise patients and their families about the probabilities of success of extreme treatments and surgeries.  My wife underwent a very expensive prosthesis treatment that had little prospect of success, was a complete failure and waste of her time, effort and medical staff.

      Governor Sarah Palin called these “Death Panels”, but she wants to cut the costs of caring for workers, the poor and the sick.

    Ed Andersen

  • Danie W says:

    January 17, 2012 at 3:49 pm

    It’s a relief to know that the Affordable Healthcare Act will limit the amount insurance companies can spend on anything other than delivering care to patients. I think 80 or 85 percent must be spent on patient care. Maybe someone else knows the number?

    To hear the GOP gripe about “Obamacare” is too much. The GOP had control of the House, Senate and White House for 6 years and did doodly squat to protect patients’ rights, increase the number of insured, or reign in costs. They did pass a massive expenditure—the Medicare prescription drug benefit—without paying for it, and prohibiting Medicare from negotiating prices with the drug companies, adding trillions to the debt. Now they screech about the deficit. Unbelievable.

  • Peter Rachleff says:

    January 17, 2012 at 3:57 pm

    Insurance companies, particularly United Health Group and others their size and ilk, use their already-earned monies to influence politicians and the writing of laws.  We must continue to strive for a single-payer system and the marginalization, if not the elimination, of health insurance companies.  That must be the first step.

  • KJC says:

    January 17, 2012 at 4:21 pm

    There are two fundamental issues facing our healthcare system:
    Universal Access and
    Cost Control
    Looking at history, there have been attempts to reform our system, which is based on a “get around those new wage controls with this benefit” way back in WWII.  This how we ended up this way.
    The current system is failing the country, putting our healthcare outcomes no better than average for a Western country, and yet our costs are Twice as Much.  So much that it affects our global competitiveness. 
    The “let the market decide” theory just doesn’t work for this… it is effective for controlling the cost of a dvd player or something… but when you’re sitting in the E.R. with a loved one, don’t tell me you’re going to say “no.”  So the market forces that might have cost restraint in so many other areas just don’t work in healthcare.
    In this last reform, only one of the two issues: universal access, got really improved.  Do you think the healthcare industry was against getting more customers, as long as they came with a full means of payment?  The industry lobbied furiously and got what it wanted. And gave?  Very little.
    That will have to change.
    And “We The People” will have to do it.

  • Paul says:

    January 17, 2012 at 4:24 pm

    Mr. Hamm, where in the first ammendment do you find the right to speak for others?  When I exercise my first ammendment rights, I speak strictly for myself.  You won’t hear me arrogantly claim to speak for “we the people”.

    Can you cite any example of where healthcare cooperatives like you envision have been implemented and shown to work?  It seems you want to do away with government oversight as well as government operation, so I presume any old hack can just put up a shingle and start practicing medicine?  Thanks but no thanks.

    Single payer plans on the other hand are functioning well in many other countries with much lower costs and better outcomes than ours.

  • W. D. (Bill) Hamm says:

    January 17, 2012 at 5:04 pm

    Actually Paul, unlike you I have ran and am running for public office so I get to speak to lots of people who are sick and tired of an elitist middle class public employees power group trying to tell us what we want and need for health care. As for a working example, I have repeatedly spoken of the Basque Industrial Coops secondary medical coop. system. They provide the best medical system and service on the planet for 1 dollar out of 6 we spend, (that was year 2000 figures). Due to people like you who refuse to allow anything other than single payer socialism to be looked at, we are stuck with only 2 choices, the DEMs socialized medicine and the GOP free market neither of which satisfies “OUR” needs.

  • tony nelson says:

    January 17, 2012 at 6:44 pm

    Wow, Bill found a way to insert those evil public employees in a piece about health care. First off, I AM a county public official & work with public employees all the time & find them to be competent, highly trained & willing to work in a job that can be eliminated at any moment at the whim of some politicians discretion, no matter how important a job they are doing. For this they get a below market salary with some decent benefits(thanks to being in a union). Secondly, until someone shows a large healthcare system that has lower costs & better outcomes than the rest of the free world, picking some tiny project as an example, doesnt fly. Their numbers are there, yours arent.

  • W. D. (Bill) Hamm says:

    January 17, 2012 at 7:26 pm

    Tony, they began in 1962 with 1500 people and are now covering more than 55,000 workers and their families and retiree’s without any fraud. We are talking well over 250,000 people broken into several autonomouse local units working together. Replicate that hear by a hundred fold and we can give this country real quality health care at affordable rates rather than the political bonanza to public employee unions that socialized medicine offers at great cost to us and at no benifiet to our health. Your medicare program is presently running between 20 to 30% fraud and is growing steadilly with no effort to fix or contain it (according to PBS and 60 minutes).

  • Don says:

    January 17, 2012 at 9:54 pm

    ignorance is the biggest barrier to better health care. 

    In MN we have a great opportunity to experiment with a different way to experience health care as three of the largest health care “systems” in the state located in the metro are now designated as accountable care organizations by medicare to deliver more affordable and appropriate care.

    We are the only metropolitan area in the USA with three of the major health care organizations doing this at the same time.  So get ready for some new approaches and experimental strategies.  We are where the experiment to deliver care more affordabily is soon upon us.

    Insurance companies are also part of this experiment. 

    None of this activity will be stopped by opposition to “obamacare” or any other political drama created to distract us from real needs and issues.  No business wants the current system to continue with dramatically escalating costs. 

    This experiment we are embarking on will change health care as we know it.  Tighten your seat belts!  Fill out your Honoring Choices health care directive and talk to your family and doctor about your choices for care when you are seriously ill and can’t speak for yourself.  If you do that, you will solve major problems for your family and for the cost and appropriateness of health care.  Ignorance about this important issue because you didn’t express your wishes is one of the biggest reasons for wasted health care resources that do no one any good. 

    I’m hoping we will see the wisdom of covering everyone who will receive health care/sick care services.  That more easily comes when we understand that we live with limits.  One big limit is that all of us will die.  How we die can be peaceful with family and loved ones around us, or we can be poked and prodded and loaded up with tubes and machines, isolated from our loved ones.

    Guess which approach is most humane and supportive to family and the dying and which is fraught with unresolved conflicts between family members as the dying are isolated by machines?  And then guess which approach costs more and which approach delivers better care?

    This change won’t be easy or comfortable for those delivering health care.  It will require all of us to be involved taking responsibility for our health care and wellness.

    Don’t let ignorance of your wishes at the end of life provide an excuse to spend millions of dollars on futile medicine.

  • W. D. (Bill) Hamm says:

    January 18, 2012 at 8:23 am

    To get back to Joe’s original question, the biggest barrier to better healthcare are the 2 political parties. First there is the GOP who want to turn us all over to the insurance companies under a free market system. Second there are the Democrats who will never let us have a health care system unless it creates a new federal bueracracy with hundreds of thousands of new public employee jobs. Sadly both sides know that neither plan will work, yet neither side will allow any other choices to be added to the discusion. That is exactly how we got Obamacare as a worthless compromise between two failed concepts. As much as Don would like to praise Minnesota’s experimentation, it will either fail because of the above criteria, or it will cater to the DFL and be too costly to afford.

  • W. D. (Bill) Hamm says:

    January 18, 2012 at 2:12 pm

    I am thoroughly convinced that the only way we are going to solve the healthcare issue is to eliminate political parties and politicians from the discusssion. Only by turning this over to a wide civilian discussion followed by a civilian committee action, much as Taiwan did, will we ever see all the possibilities fairly on the table. Left to the self serving on either side and we get garbage in garbage out.

  • kenlyn says:

    January 19, 2012 at 8:41 pm

    There are, however, some healthcare bill exemptions. First, the new law creates a religious conscience exemption for those who are members and faithful adherents of a recognized religious sect or division. The provision may exempt those individuals from the mandatory health insurance purchase requirement if they are members of religions that have established tenets or teachings that bar the “acceptance of the benefits of any private or public insurance.”

    The religious conscience exemption is defined as:

    RELIGIOUS CONSCIENCE EXEMPTION. – Such term shall not include any individual for any month if such individual has in effect an exemption under section 1311(d)(4)(H) of the Patient Protection and Affordable Care Act which certifies that such individual is a member of a recognized religious sect of division thereof described in section 1402(g)(l) and an adherent of established tenets or teachings of such sect or division as described in such section.

  • Dan Conner says:

    January 24, 2012 at 6:39 pm

    Someone needs to tell Mike Downing that when 3M drops health insurance for anyone, that is not the cause of “Obamacare.”  3M made that decision, not Congress or Obama.  There was no mandate in the Affordable Health Care legislation that mandated any employer to terinate or change their coverage, except to cover dependents to age 26 and to stop denying for pre-existing conditions.

    3M’s decision was based on greed and economics.

  • Mike Downing says:

    January 24, 2012 at 7:19 pm

    Someone needs to tell Dan that 3M retirees were VERY happy with their health care provider for decades and the only reason for dropping 3M retiree health care benefits was Obamacare and Obamacare’s effect on health care insurance to 3M.

    It really is this simple…....

  • Dan Conner says:

    January 25, 2012 at 11:02 am

    As with so many of your conclusions, which are wrong, you answered my question.  It was 3M’s perception of the improved health care act that they decided to terminate healthcare.  No doubt with a large ingredient of cost savings for the company.  Hey, 3M is doing like the thousands of companies that have moved overseas for cheap labor (3M among them).  Their answer isn’t to American, it’s about exploiting unprotected workers in foreign lands, as well as decimating American workers.

    I hate to say it Mike, but you are again ill-informed.  3M not only made the decision to terminate health care, but you haven’t even offered one piece of information bolstering your wild allegation.  The healthc care legislation even had incentives to keep and improve health insurnace for their workers.

  • Danie W says:

    January 25, 2012 at 12:56 pm

    I know several people who work in human resources at 3M. They told me in 2006 that 3M would be cutting healthcare benefits to employees and retirees, and they (the HR employees) were reconsidering retirement plans as a result.

    This plan by 3M to cut benefits was in place before the economy tanked in 2007 and while Bush was still in office.

  • Bernice Vetsch says:

    January 25, 2012 at 5:26 pm

    The Massachusetts plan on which the Affordable Care Act is modeled fines companies a puny $250 if they choose not to purchase insurance for their employees.  I’m assuming that’s for one year.

    The way this plan SHOULD work is how Switzerland, Norway and other European countries do it, starting with the belief that no one should profit from the suffering of others:

    -The government reviews health care costs annually and decides if providers need to have increases
    -The government then TELLS insurance companies exactly what they may charge for premiums
    -Co-pays, deductibles or coverage denials for any reason are not allowed
    -Insurers are listed in the exchange, but patients choose on the basis of good customer service rather than premium prices

    This is why those countries provide coverage to all their people while spending half or a little more of what we do, even though we have 50 million persons uninsured.

  • Mike Downing says:

    January 26, 2012 at 9:45 am

    Bernice has identified the reason why so many companies have or will drop employee health care benefits. The fine is so low that companies save a lot of money. And there is no fine for dropping retiree health care….......

    So why doesn’t Obama want to run on his record of Obamacare? Is it because 65% of the voters didn’t want it in the first place?

  • Bernice Vetsch says:

    January 26, 2012 at 3:48 pm

    President Obama’s base wanted a single payer “Medicare for All” plan (but without co-pays, deductibles and having to buy gap insurance).  It would have assured access to health care for 100 percent of our population while saving $400 billion per year.

    As usual, however, the Congress and the president believed the insurance and drug companies and decided America was “not ready” for single payer and that enabling legislation could not pass. This caused the removal from the Affordable Care Plan of the modest Public Option because lawmakers on the Right were afraid it would lead to a national single-payer plan.

    Poor America.

  • Mike Downing says:

    January 26, 2012 at 6:00 pm

    President Obama’s “base” was the 21% of the population that are liberal. The majority of Americans did not want Obamacare OR a single payer system. The Democratic Majority in the House & Senate wrote and passed this awful Bill; President Obama signed this Bill & was proud of this “accomplishment!. Yet President Obama will not run on his Obamacare “accomplishment”.

  • TONY says:

    January 27, 2012 at 10:26 am

    Mike, yes, the majority of people did not want Obamacare as it was written, most wanted the public option. To say the majority wer against to support your argument is ludicrous. Your including all the Dems that wanted single payer. Fortunately most people now approve af at least parts of it, like the millions of college students now on their parents insurance, or the millions on the high risk pools. If it is so bad, why did Mitch Daniels, Scott Walker & all the other repub govs. apply for funding for the insurance exchanges(a repub. amendment, 1 of 144 adopted into the bill). If a repub. wins & cancels Obamacare, what do you tell all the people now covered? Go eat cake?

  • Mike Downing says:

    January 27, 2012 at 6:00 pm

    Tony, Obama won’t run on his own Bill because he can’t win on it. It was written by Democrats, ramrodded by Democrats and passed by Democrats.

    It will become the fourth Democrat sponsored entitlement that will go bankrupt: SS, Medicare, Medicaid & Obamacare. Yep, that’s a great record now that the U.S has become one of only six countries with a debt/GDP of >100%!

  • Kenlyn says:

    January 29, 2012 at 9:54 am

    You probably are unaware that the legislation has made it a legal requirement for every American to get health insurance coverage that conforms to the government definition of “minimum essential coverage,” which means that simply having insurance does not necessarily meet the requirements of the legislative mandate. This individual mandate is one of the most important aspects of the legislation. And, one is in trouble if you do not get covered through your employer or some other group because then you are required to purchase individual coverage on your own. Beginning in 2014, those who failed to get insurance would be subject to a tax penalty that is minimal initially ($95 or 1 percent of your annual income in 2014), but then is raised quickly after that to $325 or 2 percent of your annual income in 2015, and so on. If you earn less than an income threshold individually then you are exempt from penalties (the threshold is roughly the poverty level), or if you cannot get insurance that will cost no more than 8 percent of their gross income. In 2016, about 4 million Americans could be affected by penalties that average around $1,000. The federal government hopes to raise several billion dollars from such penalties between 2014 and 2019!
    The new law should be considered a massive failure because it is not designed to meet the three most important goals:
    ■Health insurance for all Americans
    ■Reduced insurance cost for individuals, businesses and government
    ■Increased quality of care

  • Mike Downing says:

    January 30, 2012 at 9:34 am

    Kenlyn, thank you for summarizing the impact of Obamacare on most Americans. Bureaucrats will decide what our insurance needs are without even knowing our family situation, our finances, our current health, our “genes”, etc. We have moved our country to a point that our Founding Fathers would find foreign to them, i.e. “government knows best” with few individual freedoms. We can’t choose the type of light bulbs, toilets, etc. and now insurance. “Father forgive them!”