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ROSEN CONCERNED BY FEDERAL HEALTH CARE REFORM ACTIONS 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 spending. 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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