Local View: Public health option would hurt more than help Minnesota

From the column: "Instead of looking to a government option, Minnesota should promote a system that empowers patient choice and removes barriers that drive up costs and reduce quality of care."

Adam Zyglis / Cagle Cartoons

Minnesota lawmakers are considering legislation to expand government-run health care. The House Commerce Committee recently passed bill HF96 and referred it to other House committees for consideration. If enacted into law, this bill would harm Minnesota patients through higher prices, reduced access, and lower quality care.

Government-run health care is the wrong prescription for Minnesota, which had lowered insurance premiums that skyrocketed following Obamacare, according to a recent report by the Center of the American Experiment. When Obamacare went into effect, premiums increased 119% from 2014 to 2017, resulting in Minnesota ranking 37th for affordability — in the bottom tier of unaffordable states.

Minnesota today has become a role model for health care by focusing on private insurance and other consumer options. A waiver from the federal government allowed Minnesota to shift federal funds from Obamacare toward offsetting the highest-risk individuals in the individual market. The state currently ranks third in the nation for affordability, according to the report. Enrollment in unsubsidized health plans has increased by 21% since 2018, expanding coverage to over 100,000 individuals. In 2021, the state health department announced a historic low in uninsured Minnesotans.

Legislators are poised to make a grave error if they adopt the public option and undermine the private insurance that covers millions of consumers across the state. Doing so would not address the real issues facing health care in Minnesota — it would exacerbate them.

Thousands of doctors across the state already face low reimbursement rates from government programs such as Medicare and Medicaid, forcing providers to raise consumer prices to stay afloat. A public option would expand these low reimbursement rates.


When the state of Washington tried to implement a similar public option starting in 2021, it experienced these problems firsthand. The results have included fewer health care providers participating in public-option plans and financial troubles for those involved. The Washington State Hospital Association reported that in the first quarter of 2022, “hospitals and health systems in Washington lost nearly $1 billion, with a negative 10% operating margin.” And by the end of 2022, five counties still lacked any provider coverage. Minnesota should look at these warning signs before enacting government-run insurance.

A majority of Americans prefer a health care system centered around private insurance, according to Gallup . Instead of looking to a government option, Minnesota should promote a system that empowers patient choice and removes barriers that drive up costs and reduce quality of care.

For example, we need to expand access to direct patient care, an approach where people pay a monthly fee for open access to primary care. Direct primary care has been shown to dramatically decrease emergency-department use, hospitalizations, and costs. Direct primary care typically efficiently uses telehealth to increase patient access. Widespread use of direct primary care could transform U.S. health care to a much more cost-effective primary care-centered medical care system.

A public option, such as the one the Minnesota Legislature is considering, would increase government control, creating a health care monopoly that would reduce choice and competition and drive up costs. That's not what Minnesota health consumers need or want. Minnesotans would instead benefit from the expansion of personal options, such as health savings accounts, individual coverage health reimbursement accounts, and other means yet to be developed — to put them in control of their medical care.

More autonomy for patients and more freedom for doctors to provide necessary care are critical. That would increase patient satisfaction and decrease physician burnout. A public option would harm doctors and patients alike.

Dr. Robert Koshnick of Detroit Lakes, Minnesota, is a retired primary care physician and the author of “ Empower-Patient Accounts, Empower Patients .” He wrote this exclusively for the News Tribune.

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Dr. Robert Koshnick

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