Minnesota Can Lead the Way


I really don’t like the health care bill that the House of Representatives passed and sent to the Senate for conference. Really. Do. Not. Like. And it’s not just the Stupak Amendment, a cruel bit of pernicion foisted on the Democrats in order to gain Catholic Church acceptance and support for passage. No, it’s much more than that. It doesn’t spread the risk and pool of insured enough to make a dent in rising health care payment costs. If the bill were to be effective, it would create a single pool of insureds with a membership of 330 million people. One pool, all risks covered.

Five years ago I was working for a small business. I have to carry insurance for the kids as part of my divorce decree. My boss’s health insurance agent calculated the increase in premiums over the prior year, and one of the factors involved is what the carrier’s outlay had been before for doing the job we were paying them to do.

I was working in a body shop, and we dealt with insurance carriers, as they are the third-party payer in accident claims. We would sell the service to the customer but our estimates to the insurance companies, and had to justify every expense for each repair. Often adjusters would arbitrarily cut our estimates in order to bring their claims costs down to a level they had budgeted for the year. In body shops, there is no protocol to go back to a customer and bill for the difference once the claim had been settled (unless the customer had requested repairs to damage unrelated to the service). Body shops take the loss on such adjustments. Insurance companies also controlled the rates they paid to us, claiming comparisons to the local market. Funny thing is, they were the ones that set the rates for the local market. I could see a conflict of interest.

The customers were not concerned with the total cost of the repair as long as they got their cars back in pre-collision condition. For the insurers, it is a sweetheart deal because they control the repair. I also depended on total billings for each month to determine bonuses, and I was not happy when an insurance company adjusted a final bill because it affected me. It was a battle with them, and we had only a few insurance companies to deal with because for each state each insurance company has only one pool: all the drivers in the state who buy their coverage.

Auto insurance and health insurance are completely separate classes of commodities, but I learned from my experience not to trust either to have the customer’s interests at heart. I learned to trust them not to have the shop’s best interests at heart. I learned that they have their stockholders’ best interests at heart. Insurance companies have to be careful to serve their property and casualty customers’ needs, because it is relatively easy to change carriers. Want to rate shop on insurance? Call a number and if you find a rate you like, pay for it and switch. For those of us who rely on group coverage through our employers, there is a different story.

We are limited to specific benefits enrollment periods, and we can’t change our insurance outside of those periods unless we have a “major qualifying event.” If an insurance company does something in January that a customer doesn’t like, then it’s something to keep in mind until the next November when the enrollment period begins again. The company will still get the premiums over the next 11 months. It’s a sweetheart deal for the insurance companies, and in the meantime, the customer may be fighting collections from the health care provider because they are jumping through hoops to prove that a procedure was a necessary and proper step in healing you.

What that meant for me and my co-workers was that because the spouse of one of the employers had been through treatments for brain cancer, our premiums were jumping 75%. The insurance company had done what it was paid to do, and then told my boss that they were getting a raise. They can do that. It really made things tight for me, because in addition to child support I was also paying a significant portion of my family’s health coverage. Our pool was small, and like all small business pools was overwhelmed by the needs of the insurance company.

The bill that passed through Congress does not address that. It doesn’t address the issue of small pools. In fact, it seems to make the problem even worse, because now it mandates that people carry insurance and I haven’t heard of anything that prevents them from determining how they determine the pools. It excludes denial of coverage but doesn’t address whether or not insurance companies can place such risk into separate actuarial tables and charge whatever premiums they choose.

No, it is not a cost-savings measure for those of us who live in the country that pays more than any other country in the world for health care insurance and still has millions uninsured. It does serve the insurance companies very well. I was supposed to celebrate that the House had passed a bill, but was in fact rather disgusted that we are still working with a monstrosity with an amendment that excludes payments for abortion services while allowing coverage for ED treatments (which is a good thing for many people, but it is inequitable treatment which targets a specific class of people). We are supposed to accept reassurances that this amendment will be struck before the president signs it, but I am not feeling so secure.

No, I want to see a system that pays for health care for everyone who has a need and for those who don’t need it now to have the assurance that it will be there in case they need it. I want a plan that will increase the coverage risk pool to an entire population without dividing groups into isolated pools for which insurance companies can put the screws to employers. I want employers to be able to spend more on labor and wages than on insurance. I also want the self-employed and the unemployed to be able to have health care coverage. And I love that I live in a market-based economy, but I just don’t have the level of trust I should have in order to accept a new roll-out that doesn’t fix the basic problem.

This is not realistic. The idea of a single-payer system was slapped back by the White House and the congressional Democrats as “undoable.” It was considered to be only wanted by the “left of the left” in Rahm Emanuel’s words. I do have a wonderful surprise for you. Minnesota can lead the way on this, and it may happen far sooner than any of us expect.

Minnesota, our Minnesota can lead the way!

Last Wednesday at the District 51 DFL monthly meeting, at which I am the Affirmative Action Officer because I am “the atheist,” a volunteer who is working for State Senator John Marty’s Minnesota Health Plan bill came to speak to us and gave us the wonderful news that a plan that will work for health care coverage is making great progress through both the Senate and the Legislature. And it does just those things that I ask. Here is a brief rundown:

The MN Health Plan (MnHP) would be a single, statewide plan that would cover all Minnesotans for all their medical needs. Under the plan, patients would be able to see the medical providers of their choice when they need care, and their coverage by the health plan would not end when they lose their job or switch to a new employer. Consumers would use the same doctors and medical professionals, the same hospitals and clinics, but all the payments, covering all of the costs, would be made by the MnHP, and everyone would be covered.

The plan would be funded by all Minnesotans, based on the ability to pay, and would cover all health care costs, replacing all premiums currently paid by employees and employers, as well as all co-payments, deductibles, all payments for care by the uninsured or under-insured, and all costs of government health care programs.

Although the MN Health Plan is not cheap, it is significantly less expensive than our current system, and it would provide a full range of health care services to everyone, greatly improving the health of the population.

I’ll repeat this so that you get my emphasis: This is a real health plan that is making its way through the House and the Senate and has broad support. This is a list of the coauthors in both the Minnesota House and Senate. There are Democrats and Republicans on this list of coauthors. The plan has to make it through a few more committees before it will make it to the floor, and they will need some phone calls down at the capitol in order to get it there. Even though the 2010 session will be short, there will be time to work on it and get it further before the mandated end of session in May. Call your legislators and tell them that you support them if they are on the list, or tell them that you want them to coauthor this bill. I’ll work on Tim Mahoney, you work on the rest.

The bill will not pass this next session for this main reason: They know that the current governor is running for president, and we also know that Pawlenty is not likely to screw up his conservative bona fides by passing any sort of “socialized ObamaCare plan.” He would lose millions in campaign funds from his ultra-conservative base of donors. So, it needs to pass in the 2011 session, which seems a long ways away. There is something very important that you need to consider as well. None of the Republican senators and legislators running for governor are on the list of coauthors.

In order to get this done, we must have a DFL governor by January of 2011. We must have a governor who will put Minnesotans over national aspirations and will do the right thing. Do your volunteer work for a DFL gubernatorial candidate of your choosing, concentrate as much time and money as you have on this in the next year, and don’t let the Republicans win this one again.

Caucus in February and get active and involved.

I always hate one thing at political rallies. Some candidate will stand up and say “This is the most important election of our lives!” Every year. Is the 2010 election as important as all the rest? I’ll let our readers decide, and then pass this around to everyone you know who wants workable single-payer health insurance.  Those lovely Canadians started province by province when they moved into what they now have, and this is the way that I have thought it should be done.  If we prove in Minnesota that it works, then the rest of the country will follow suit.

I think we can do it. Change my mind, okay? Change me from “think” to “know.” We can do it!

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