09_25healthcarereform by gegeshandong


          State should have bigger say in health care reform Rosen says

Recently, I was among a group of state senators who were briefed by policy analysts
from the University of Minnesota on the implications of broad national health care
reform legislation on our state health care structure.

The briefing was a bit premature because, although a lengthy bill was passed in the
House (HR 3200), any common ground amongst competing proposals in Congress seems
to change daily. Legislation with true bi-partisan give-and-take would take at least a few
months, although some in Congress seem to value speed above all and would pass the bill
solely with the Democrat majority.

Despite the politics and concerns that surround the bill, state lawmakers need to be ready
to react to whatever is handed down from Washington. Those of you who know me well
understand that I am probably most frustrated with the fact that Congress has apparently
overlooked Minnesota’s hard work and reforms of the past several years and seems ready
to penalize us for that. We have done backbreaking work to trim down skyrocketing costs
to better meet our state’s leaner total budget needs, both immediately and in the future.

I had the honor and privilege to serve on both the Health Care Access Commission and
the Health Care Transformation Task Force to tackle the need for reform in Minnesota.
An immeasurable amount of work came out of these task forces and has been
implemented in our current system. It would be a shame for all of this progress to have
been done in vain.

So when I told a Capitol reporter after the meeting that I am very nervous about what
federal health care reform will do to Minnesota, it wasn’t an understatement.

       I’m nervous that the work we have done to provide services specifically geared
       for Minnesota children, low-income families and the unemployed may be turned
       upside down as federal reforms categorically replace them.

       I’m nervous that the progress we have made in Minnesota to prevent disease and
       turn ‘sick care’ into real health care for some may be lost.

       I’m nervous that the work we have done with Minnesota’s health care providers
       to foster innovation and provide rewards for results, and that have brought down
       some costs, may be wiped out with one-size-fits-all government controls.

       I’m worried that Minnesota patients will lose the privacy and choice that we have
       worked for, and that our doctors may be forced to pay more attention to
       malpractice concerns than patient outcomes.

       I’m nervous about the vagueness about the price of this federal action and what it
       will ultimately cost Minnesotans in what they pay both the state and federal
       governments, and for their individual services.
       I’m nervous that reforms and moves to greater efficiency that Minnesota has done
       in good faith will not be acknowledged by the federal government and across-the-
       board cuts, like proposed in current legislation, will result in drastic loses in the
       basic needs of our hospitals, doctors and other health-care providers.

Reform is needed in many areas because costs have risen to the point where workers and
employers are straining to pay premiums while they have fewer choices and feel less
secure. In Minnesota, health and human services programs amount to $9 billion or almost
a quarter of the state’s total general fund budget.

In addition, the Minnesota Department of Health predicts that health care costs – public
and private spending together - could reach upwards of $70 billion in the next decade.
Without major changes, Minnesota will soon find itself with unsustainable health care

But by taking the steps to radically reform the system to include more services to the 30
million unemployed, the working poor, those who face catastrophic circumstances, and
others nationwide, the price tag rises for all of us. Along with that, we are uncertain that
we can maintain the doctors and services that we currently have, which polls have shown
we are mostly happy with and serve many of us well.

Even though Congress is passing bills that are 1,000 pages long, they still only provide a
basic framework for the massive overhaul. States will still be burdened with the
implementation and oversight of the changes, and will not know how they will be
affected until after the legislation is passed.

It is estimated that the Congressional framework of health care reform will cost taxpayers
$1 to 2 trillion, depending on which version they ultimately pass. Analysts say that
personal income, business income, payroll, and private health care tax increases will be
just a start. And don’t believe these costs will be limited to the so-called rich.

President Obama has said that he would like to pass the initial framework for the new
health care system and then get the states involved over the next 10 years. Throughout
this process, states will incur many new costs to implement. Reform means change and
change costs money.

That’s not to say that I don’t welcome discussion that leads to more affordable health
care being made available to more Americans, I am just concerned with this
administration’s charge-ahead approach. Minnesota has been a leader on this front for
some time, and I have worked with a tireless group that continues to seek new and
innovative solutions. Unfortunately, politics, bureaucracy and personalities are – as usual
– standing in the way of productive discussions.

In Minnesota, we have struck a balance where government can help the un- and under-
covered get adequate health care without taking away from the consumer marketplace
that provides high value at a reasonable cost. Many are looking to the flawed model of
the state of Massachusetts as an example of reform; instead, they should be looking at the
Mayo Clinic, HealthPartners, Park Nicollet, Medica, Regions Hospital, the University of
Minnesota, and many others who have contributed to reform in Minnesota to emulate.

As Minnesotans, we must make sure federal health care reform doesn’t undermine our
state’s autonomy and authority, that it doesn’t undercut the innovation and progress
we’ve made to realistically expand coverage and deliver quality care to our citizens, and
that it doesn’t ultimately bankrupt us in the name of political accomplishments.

Senator Julie Rosen was elected to the Minnesota Senate in 2002 and is a member of the
Health and Human Services Budget Division.

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