Friday, April 11, 2008

Steve Gottwalt on Health Care...

From a letter:

Health Care Reform Bill:

Thursday was a long day/night; for 14 hours, we debated and discussed one of the most important priorities for our state: health care reform. We considered HF 3391, Rep. Tom Huntley's bill that mandates major changes including some crafted by the Governor's Health Care Transformation Task Force.
Although we agree on the need for improvements in our health care system that focus on wellness and prevention and offer consumers more transparency about cost and quality of care, the bill takes us down the wrong road, too far and too fast.
On the whole, the package represents a massive shift toward socialized health care, based on a broad assumption that government must save us from ourselves. It leavesserious concerns and many more important questions unanswered.

What's more, we literally can't afford it! The state estimates the price tag at more than $1.23 billion -- even as our state faces a $1 billion budget deficit. The bill puts more people on taxpayer funded programs, but uses up all of the state's Health Care Access Fund, and runs out of money in 2012, at which time state law requires us to dis-enroll people from state programs. There is no plan for funding beyond 2012. That's making promises we can't keep, and that's why I voted against the bill.

CentraCare Health System wrote me a letter which I shared with lawmakers Thursday, and I'm sharing it with you because it illustrates why this bill is the wrong approach for health care reform:

"We are writing to . . . ask you not to support the bill when it is considered later this week. We do not make this request lightly. . . .We do understand that significant effort has gone into crafting this legislation, but it is our belief that the underlying process was flawed because it specifically failed to include individuals with actual experience in health care from Greater Minnesota. In addition, it has been moved through the legislative process without adequate time to
fully study the implications of many of the initiatives included in the bill. There are parts of the bill that do have merit . . . There are, however, many parts of the bill that are problematic, and we fear will destabilize health care delivery in rural Minnesota. We urge you to work to eliminate the potentially harmful aspects of the bill or, failing that, oppose adoption of the entire bill until such time as these issues can be addressed. HF 3391 includes many initiatives which we believe have been poorly designed. Many of these issues could have been addressed if health care providers, especially those from Greater Minnesota, had been allowed to participate in the design of meaningful health care reform legislation.

After careful analysis of HF 3391, we have identified the following concerns:
* Budget neutrality – which is simply not reasonable when attempting to increase the number of persons covered under MinnesotaCare.

* Creation of numerous new state commissions to collect data, design benefits sets, monitor quality and restrict access to new technologies. These commissions (and the staff that will serve them in the legislature) will add additional cost/administrative burdens to the health care system as well as the state.

* Implementation timelines that are far too short to allow thoughtful design and implementation of initiatives.

* This bill fails to address the rising cost of health care insurance in Minnesota.

* The bill requires transparency of health care providers but fails to require similar transparency from medical device manufacturers, pharmaceutical companies, medical equipment manufacturers and suppliers or insurance companies. All of these are major cost drivers for providers.

Most importantly, this bill fails to address the importance of the ever increasing consumer demand for health care services as a driver of escalating health care costs. In fact, the increasing utilization of medical services is, along with cost shifting due to inadequate compensation for Medicare & Medicaid services, among the most
significant drivers of increasing health care costs for government, businesses and consumers. . . . The cost of providing Medicaid services does not go away. When the state cuts reimbursement, those costs must simply be shifted.

Minnesotans are already served by some of the most innovative, lowest cost and highest quality health care providers in the nation. Minnesota providers are recognized collectively and individually across the nation for the value they provide for Minnesotans in health care. We must not jeopardize those successes."

-[signed by the presidents of CentraCare Health System]

As a member of both Health Care and Human Services policy and finance committees in the House, the Legislative Health Care Access Commission, and Minnesota’s Rural Health Advisory Committee, I’ve been pushing for common sense, market-based reforms that preserve consumer freedom and choice, protect patient data privacy and security, and prevent a government takeover of our health system. Those are the best and most
sustainable ways to address quality, cost and access for our families and businesses.

A House-Senate conference committee, in conversation with Governor Pawlenty, will now work to develop a final bill on which we will vote in about a week. At a bare minimum, the bill must have high confidence of decreasing health care costs, and must be fiscally balanced so we can follow through on what we commit to.

Minnesota is the healthiest state in the nation, our costs are 15 percent below the national average, and our outcomes are second to none. We also have the highest percentage of population with health care coverage in the nation – nearly 94 percent. The vast majority of those without coverage are eligible for existing state programs, or have simply refused private coverage options available to them.

As I’ve pointed out before, Minnesota is in a “first-and-goal on the five yard line” situation. We need carefully planned and executed plays that move us toward the goal line, not aggressive and risky measures that threaten to get us sacked back at mid-field. I sincerely hope that is what I will be able to vote on when the bill comes back from conference committee.