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IN 1994, THE CLINTON ADMINISTRATION'S EFFORTS to reshape the American health system collapsed. Since then, changes have been made in piecemeal. Now, in this year of mid-term elections, gubernatorial candidates have proposals and promises of their own as they respond to a collective national anxiety over affordable and attentive health care.
This year, attacks on health maintenance organizations have become standard weapons in the campaign arsenal. Mike Freeman recently launched his attack when he said if elected governor, he'll establish a process to handle complaints that people have about the kind of care they received from an HMO.
Freeman: When I'm governor, no HMO will be bigger than the rights of any Minnesota patient. While some progress has been made on patient protection issues over the last several years, we have a long way to go. Patients must be guaranteed a full voice in their health care decisions and protection, and health care companies fail to meet our expectations.Freeman also points a finger at Medicare.
A survey in Consumer Reports magazine says the federal Medicare program charges Minnesotans considerably higher premiums and offers fewer benefits than those living elsewhere. The disparity among states is the result of the federal government's decision to base reimbursement rates on the regional costs of health care. Minnesota trimmed the fat from the system years ago and Freeman says the state's getting penalized for efficiency.
He says he'll investigate the discrepancies and file a class action lawsuit on behalf of Minnesota's seniors if he has to.
Freeman: While the government pays $750 a month to a senior living in Miami, they pay only a little more than $400 a month for a senior living in Minneapolis, and even less for a senior in Duluth or in Mankato.Critics say such a lawsuit would be unprecedented, and the federal policy is best dealt with at the Congressional level.
Freeman also wants to create a state purchasing pool to reduce prescription drug prices for older Minnesotans.
Freeman: This pool matches the multi-state plan which the Department of Administration purchases prescription drugs for state institutions, such as hospitals and prisons, in 30 states at considerable discounts. Well, we passed the language and the Republican governor vetoed it. I'll request in the 1999 Legislature a one time expenditure not to exceed to $250,000 for start-up costs to fund this worthy program.The problem of the uninsured runs deep nationwide. The number of Americans without insurance is rising steadily to nearly one-sixth of the population today.
Freeman says Minnesota should strive to have every child insured by the year 2002. The first step, he says, is by making it easier to apply for MinnesotaCare, the state's insurance program for the working poor.
Freeman: 25 percent of those applying give up before completing the application, and no wonder. Look at the form! (He drops the form, and it unravels across the floor with a thumping sound)The unfurled form stretched across the width of the room. Freeman says the complex application is partly to blame for over 400,000 uninsured Minnesotans - 60,000 are children. He promises to secure $28 million in federal funding from the KIDCARE program to help pay for the coverage.
Freeman also wants medical providers such as chiropractors, massage therapists, and midwives to be protected from charges of practicing without a license. And he opposes the sale of non-profit hospitals to for-profit chains.
Freeman: Four large Twin Cities hospitals control 80 percent of the insured population in Minnesota. I believe that health care decision-makers must be put back in the hands of local providers and patients. We must work to foster increased health care choices by allowing local communities, businesses, and governments or providers to create new and innovative ways of delivering and purchasing. Several creative efforts are emerging. Small business purchasing pools and direct contracting for counties and state government. I support these efforts.And, like most of his DFL gubernatorial counterparts, Freeman favors legal abortion.