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State lawmakers prepare for health care discussion
by Tom Scheck, Minnesota Public Radio
January 26, 2004

Sen. Sheila Kiscaden, IP-Rochester, says every Minnesota should have health insurance. She says the state should provide tax breaks to individuals. She also says Minnesotans should provide subsidies to those who can't afford premiums. (MPR Photo/Tom Scheck)

With health care costs and the number of uninsured people both rising, state lawmakers say health care will be a big issue in the upcoming legislative session. Senate DFLers and House Republicans are offering dramatically different proposals to lower the rising cost of health care. Meanwhile, a task force appointed by Gov. Tim Pawlenty is scheduled to release its ideas for reforming Minnesota's health care system by the end of the week.

St. Paul, Minn. — Health care is becoming a throbbing headache for many consumers, businesses and government agencies. They're seeing double-digit increases in health insurance premiums and are starting to ask for more than the equivalent of an aspirin to solve the problem. Employers say they can't continue to pay for the increases and are starting to pass more of the costs onto their employees. Employees say they're frustrated that more of their family income is going to health care. Former U.S. Sen. Dave Durenberger chairs Gov. Tim Pawlenty's health care task force. He says generally, Minnesotans who don't go to the doctor, the hospital, or the emergency room very often want people who do to pay more.

"People are asked to pay more and more and more in premiums," Durenberger said. "The politics of the non users in the system, the 70 to 90 percent of the people who are the infrequent users of the system, drive the system to find ways to shift the cost to the users. It's sort of an instinct to say it's really not my problem it's somebody else's problem."

Durenberger says his task force is considering some form of universal health care system to reduce costs and cover more people. The problem is that universal health care means different things to different people. Some would like to see a "single payer" system - where the government serves as a sort of big insurance company and covers everyone.

"We had caps on health care spending and we had caps on premium increases and it was then that the health care industry took seriously the need to bring down costs." - Sen. Linda Berglin

Sen. Sheila Kiscaden, IP-Rochester, says she supports universal coverage that relies on private insurance. She wants the government to require all Minnesotans to have some type of coverage. She says the state should then offer tax breaks to individuals and provide subsidies to people who aren't able to afford their premiums. Kiscaden says her plan would build on the changes made to the health care system in the early 1990s.

"We go through this about every 10 to 15 years in the United States," Kiscaden said. "We find health care costs to be unaffordable, unsustainable by employers, unsustainable by government and we begin to look for solutions. Those solutions have problems that we have to correct ten years later but the underlying problem is that costs keep going up."

Sen. Linda Berglin, DFL-Minneapolis, says Senate Democrats support a plan that would restore some of last year's budget cuts that tightened eligibility requirements for low income people. Berglin says 60 percent of those without health insurance in Minnesota work for businesses that have fewer than 50 people. She says she would help solve that problem by allowing small employers to enroll in MinnesotaCare, the state's subsidized health insurance program. Berglin also says she'd like to pass a law that caps the growth in health insurance premiums at no more than six percent a year.

"We had caps on health care spending and we had caps on premium increases and it was then that the health care industry took seriously the need to bring down costs," Berglin said. "Now when they went off in 1998, you could see that costs went up and continue to go up and premiums also continue to go up."

	Cap liability awards and allow for profit HMOs to operate in Minnesota.

Rep. Fran Bradley, R-Rochester, says he would allow for-profit HMOs to provide coverage in the state. Minnesota is the only states in the country that require health insurance providers to operate as non-profits. Opponents of Bradley's proposal say they're worried that for-profits would cut costs by cutting into quality.

Bradley also wants to cap medical malpractice awards and loosen other regulations on the state's HMOs. Bradley says Minnesota ranks third in the nation in terms of government mandates on HMOs. He says consumers are frustrated that they don't know how much medical procedures actually cost. Bradley says he's encouraged that more people are asking questions about the cost of their medical care but but he says people can't make informed decisions about the cost of health care without having all the information.

"We have a huge paradigm shift that we need to undergo so smart, incented consumers can actually see something on both the price side and quality side," Bradley said. "There is, folks, an underlying revolution going on."

Members from both parties agree that they'd like to see doctors and hospitals rely less on paper medical records and use an electronic system.

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