Health Care: Is it a right or is health care all wrong?

Most agree, health care is the most critical issue we face and yet few folks want to talk about.

As Mike “Barry Casper” says in his book, ‘Lost in Washington‘ (2000), recollections of his time as policy advisor to Senator Wellstone.

In all discussions of health care reform, there is general agreement about the major problems in delivery of and payment for medical care that need to be addressed, from spiraling costs which threaten the economy to our virtually unique position among industrialized nations in failing to provide universal health care coverage for our citizens.

Forty million lower income Americans have no health insurance or medical coverage, and many more have only limited or catastrophic coverage. Most industrialized nations regard health care coverage as a right of citizenship, like police and fire protection, but health care and coverage is routinely denied to American citizens.

It is costing us all a great deal of money, 14% of the GDP, according to Casper. He notes that “in 1991 the General Accounting Office concluded that a U.S. single payer system would save nearly $70 billion in administrative costs alone.”

Groups like the Taxpayer’s League have infected the publics thinking so that we are afraid of taxes, even when investing our tax dollars in a single payer plan would save each tax payer a far greater amount than the expenditure in out of pocket costs and protect everyone from the threat of catastrophic health care costs. Why do they make this argument? Because they and can afford to take their health care for granted, and the rest of us be damned.. They don’t want to have to contribute to anyone else’s well being if they don’t have to. So they say, “It’s your money” and encourage us to begrudge every tax dollar, while they’re selling you on employer provided health care which costs you more each year in more expensive health care and lowered take home pay to cover the increased premiums.

It is true that people in our system can always “choose” not to have health coverage, they can always “choose” not to go to the doctor, but that notion of “choice” is as non-sensical as someone’s “choice” to have a root canal. When crisis comes in the form of an accident or catastrophic illness, we all need medical care, and those without coverage are forced into bankruptcy. If they can’t pay who does? All the rest of us pay for the uninsured through increased premiums, as hospitals attempt to recoup loses from ‘cost shifting’.

An article in the Bemidji Pioneer by Brad Swenson, “Health care costs loom as next crisis in Minnesota” cites the changes of the last legislative session:

Among the many changes in the program for families and children, Skoe notes that:

— Pregnant women whose income exceeds 200 percent of poverty ($24,240, single pregnant woman) will not be eligible for Medical Assistance but could be eligible for MinnesotaCare by paying a premium, effective July 1, 2004.

— The asset limits for parents in Medical Assistance and MinnesotaCare (upon federal approval) will be $10,000 for a household of one and $20,000 for a household of two or more.

— MA eligibility will be limited to children between ages 1 and 18 for families with incomes no greater than 150 percent of poverty ($22,896, three-person household), a decrease from 170 percent of poverty, effective July 1, 2004.

— For newborns of mothers on MA or MinnesotaCare, coverage for the infant’s second year will be through an eligibility review rather than automatic coverage.

“Cuts like these make it harder for families to make ends meet, and will drive up costs in other areas of the health care system,” state Sen. Rod Skoe, DFL – Clearbrook said. “The expected savings to the state budget are not what the governor expected when these other costs are factored in. I wish these issues had been fully considered when the governor held out for these cuts.”

The Governor says he is studying the situation and has appointed a commission headed by former Senator Dave Durenberger, read what one editorial has to say:

Pioneer Editorial: Big job for new health care panel Sunday, September 21, 2003

The Kaiser Family Foundation has some very good data on the condition of health care in Minnesota, it’s worth checking out.

Information about Minnesota’s health care programs can be found on the Minnesota Department of Human Services website , MNCare, and various eligibilty requirements,

Last June the DFL Education Foundation Forum brought together Sen. Linda Berglin, Jim Koppel (Children’s Defense Fund), Paul Ogren (Aristone Corp.), Mark Anderson (health policy consultant), and Erin Murphy ( MN Nurses Assn.) to discuss what to look for in the health plans of the various Presidential candidates.

There was general agreement with some variation on what we should be looking for:
– Cost containment,
– Increasing the numbers of those insured to universal coverage,
– Making sure the health care delivery systems and value based healthcare are supported so quality care can be maintained,
– Comprehensive coverage (are participants needs met)
– Is it affordable
– Is it understandable

Senator Berglin reminded them all that in an effort to reduce the costs of health care insurance, advocates will awaken the resolve of those who benefit from those higher costs to protect their interests. We shouldn’t kid ourselves thinking that making change will be easy.

I find it irksome that private institutions are often exempt from criticisms of wasteful spending when government is always watched closely. It seems to me open hypocrisy for the Chamber of Commerce and Minnesota Business to say government and all its beneficiaries should do “more with less” when their response to shortfalls is to bill the customer. I know in many cases small business owners can’t do this but corporations can and do. They can spend millions on lobbying efforts to protect their interest and when their voice is the only one being heard they shape the policies we end up with.

My parents always told me not to spend beyond my means. I am conservative by nature, drive an older car with over 130,000 miles on it and find it hard to convince myself to drive something newer, buy used whenever possible, from clothes at used clothing stores to anything under the sun at a yard sale, and I buy very few luxuries – obviously my thousands of books are a necessity! But think of your own budget and then look at the office buildings insurance companies build. Look at the country club fees paid by some health care providers. Look at how many lobbyists they retain. We know where they get the money for that — they get it from us.

Yes, of course individuals and governments need to be challenged to eliminate wasteful spending, but what about corporations that have power to eliminate the egregiously wasteful spending that directly drives our costs up but yet do nothing about it other than categorize it as a “cost of doing business.” What about the corporations that rather than act in the public interest as required by their charter instead raise our premiums to cover their losing market investments, protect their inflated salaries,generous stock options and pension funds?

State Attorney General Mike Hatch has been working hard to make changes in how health maintenance organizations do business. Law Enforcement Efforts

This is not easy work and he is to be commended for his efforts to safeguard the public interest.

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