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Lawmakers talk to Duluth about plans to fix health care

Should Minnesota reform its current system of health care or throw it out and adopt a government-paid system? This week, lawmakers have been talking in Duluth about three plans to fix health care in advance of the opening of the legislative sessi...

Should Minnesota reform its current system of health care or throw it out and adopt a government-paid system?

This week, lawmakers have been talking in Duluth about three plans to fix health care in advance of the opening of the legislative session on Tuesday. Numbers already are being disputed and viewpoints are being argued.

Over the past few years, health insurance premium increases and out-of-pocket costs have made the cost of health care increasingly difficult for many Minnesotans, advocates of reform say. Families USA, a nonpartisan health-care advocacy group, says this year more than 1 million Minnesotans will spend at least 10 percent of their income on health care, even though the vast majority of those people have insurance.

Gov. Tim Pawlenty and members of the Legislature appointed separate groups to study ways to cut costs and improve quality. The plans unveiled during the past month by the governor's Health Care Transformation Task Force and the Legislative Commission on Health Care Access call for changes that Rep. Tom Huntley, DFL-Duluth, says will cut costs and promote better care. But they continue to involve the insurance industry. A third proposal, the Minnesota Health Plan bill, would provide health care for everyone, paid for by state government.

Huntley, who co-chaired the legislative commission and the governor's task force, said after a Duluth Area Chamber of Commerce forum Tuesday that he is determined to create a health care reform bill during the coming session that Pawlenty, a Republican, will sign.

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The governor, for his part, said this week that he is "hopeful that significant health care reform can be achieved this year." Pawlenty wants a new system that's "market-driven, patient-centered and it should re-establish the relationship between patients and doctors." And it has to lower costs.

Huntley said he expects to draft a bill that melds the recommendations of the two groups he led, which are generally similar. He said they should achieve a 20 percent savings -- much of which would go to businesses that provide health care insurance for their employees -- from what health care would be in 2011 if nothing changed.

The bill, he said, would change the insurance system in several ways:

Insurance companies would have to sell policies to anyone.

They would not be able to base premiums on a patient's health history.

Policies would be transferrable from job to job.

Furthermore, the state would subsidize premiums for people at up to 400 percent of the federal poverty level, and would expand MinnesotaCare, a state insurance plan for low income people, to people with incomes up to 300 percent of the poverty rate.

During the upcoming session, Huntley, who chairs the Health Care and Human Services Finance Division Committee, said he hopes pay-for-performance, chronic disease management and bidding on patient populations will be enacted as part of the legislation."I just want to get the waste and inefficiency out of the system," he said.

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But members of a newly formed legislative health-care caucus who were in Duluth on Thursday afternoon said their plan for state payment of all medical bills for everyone was better and cheaper.

Speaking at the YWCA, state Rep. Mike Jaros, DFL-Duluth, equated health care to public education and other essential services provided by government.

"The United States is the only country in the world that treats health care as a business instead of a service," said Rep. David Bly, DFL-Northfield.

Minnesota Health Plan advocates are taking their concept on a road trip throughout the state for three days ending Saturday. Their plan is to give medical, dental, prescription and mental health care to every man, woman and child in Minnesota, paid for through premiums that fund the health care system based on income. Businesses would be required to pay premiums, too.

Sen. John Marty, DFL-Roseville, said that covering everyone would be cheaper because care would be managed better and people wouldn't end up going for expensive treatment in the emergency room when they could have gone to their physician earlier at no cost. Administrative expenses would decline significantly as well, he said, citing Medicare's low costs compared with private insurers.

But he conceded that the single-payer plan will not be enacted while Pawlenty is in office. Rather, it's a three- to four-year plan and the push is just beginning, he said.

Marty, who was a member of the legislative commission, also said he might support enacting some measures that the governor would sign, as long as they don't make the system more complicated and costly. "If we can do something to help in the short term, great," he said.

Local supporters of the single-payer plan, Northland Health Care For All Coalition, will meet from 6 to 7:30 p.m. Feb. 19 at the YWCA.

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