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Health Care: A Line not Crossed

A political standoff in Minnesota over health care funding has resulted in a short-term retreat that may cool things down for a little bit.  It also might be a sign of how things will go nationally as the debate moves on from “bait and hook” to a real engagement.  If that is the case, there may be an opening for Democrats to push their advantage and achieve something very important and lasting.

Minnesota has faced a terrible budget shortfall, like nearly all states.  Governor Pawlenty tried to fix the holes in part last year by vetoing funding for General Assistance Medical Care (GAMC), a program that covered the costs of emergency room visits and so on by people with no money at all.  It was devastating for hospitals across the state.  This session, the DFL legislature attempted to restore funding, but was quickly vetoed by the Governor again.  The outcry was swift and strong, coming from both our hospitals and leaders of faith who made it clear that a just society doesn’t do something like this.

Last Friday, after many closed-door meeting, the Governor blinked.  A plan was announced to restore GAMC funding temporarily while a long-term solution was found.  It seems simple enough, but like everything in the health care debate the politics complicate things greatly.

The Republican plan all along was to move people from GAMC to MinnesotaCare, a system that we have to provide coverage to people who cannot afford it through a 2% tax on all health insurance.  It has been in place for 15 years and shown to be successful in controlling costs by keeping people out of expensive emergency rooms and taking care of problems in a doctor’s office before they are bad.  It’s worth noting that it was originally proposed and pushed by current candidate for Governor Sen. John Marty.

The proposal to move towards MinnesotaCare seems like a good idea on the surface, but there was a hitch.  Gov. Pawlenty didn’t include any additional funding for the people moved off of GAMC, meaning that it would almost certainly bankrupt MinnesotaCare in the future.  That may not have concerned Governor Patches and his crazy quilt of quick-fixes to the budget, but everyone else knew it was a problem.  The need for more time before GAMC is cut is nothing more than a search for a more stable fix.

This could be a major change in the battle over health care in Minnesota.  The Governor was forced to admit that his proposal went too far and that it was unacceptable to allow MinnesotaCare to break.  We know now just how far things can go.  I think it’s time for the DFL to press their advantage and finish this battle once and for all.

We have established that MinnesotaCare works and is vital to our state.  This system, as it now stands, covers people who cannot get insurance any other way, but has built into it all of the trappings that a regular health insurance plan should have.  Finding a way to include GAMC into the system would not only increase its population of users, it would put in one agency the proper incentives for moving people to what is called “managed care” – taking care of health before it gets terribly bad.

Expanding this system to anyone who is willing to pay for it as an alternative form of insurance would not cost the state anything while providing a floor of basic health insurance for everyone.  It is, by default, a public option.  It could even be expanded into other areas such as supplemental Medicare and a certified Veteran’s Administration provider with some cooperation with the Obama Administration.  Naturally, these grand plans require it to fit into the final form that is decided in Washington, but that should not be too terribly difficult.

Expanding the coalition that relies on MinnesotaCare through all government supported or managed systems would cement our public option firmly in Minnesota.  It would end the debate, at least for us, over a public option that competes in the marketplace.  We have established that it is vital, so now is the time to move it ahead.

This may seem like a strange thing to start in an election year, but this is a critical wedge issue that the voters frankly should decide.  Marty Siefert, Republican candidate for governor, voted to restore GAMC but then switched to sustain the Governor’s veto before the latest deal.  He should be forced to make it clear where he stands on this issue, whether it alienates his party base or the general public, one way or the other.

A small agreement in the middle of a larger battle may not seem like much, but we now know just how the nay-saying side is willing to go.  That is a very important development that might play out in other places.  Let’s press the advantage while we have it.

15 thoughts on “Health Care: A Line not Crossed

  1. An excellent analysis and I hope everyone is watching this carefully. We have a good system in Minnesota or at least the start of one. I think everyone, even Republicans, know it. If they want to be a part of making it better then they can be part of it, but if they just want to hack and slash they should just get out of the way.

  2. I was surprised how Pawlenty reacted to being labeled “mean” by cutting GAMC. This may be about nothing more than his campaign for President which is probably what everything is about. But if it works, I agree that we should use it. I do not know if it applies everywhere.

    A public option that does not cost anything is a good idea. If Washington will not do it, I agree that Saint Paul can. We already have to some extent.

  3. Having spent Saturday at our local DFL Convention, I have to say that the sense of urgency among the DFL is pretty strong. It’s been 20 years since we had a DFL Governor and that point was driven home many times.

    Finally, after all these years, we really do miss Rudy Perpich.

    If that sense of urgency has real weight behind it we can and should press our advantage now. This is clearly an issue that is in our territory and is calling out for something to be done. If the Republicans agree that managed care is better than emergency care, and that we’re going to be stuck with the tab one way or the other, we have an agreement that we can build on.

    It’s not much, but it’s time to move it ahead, IMHO. We know how far the Republicans will go, which means it’s time to either defeat them once and for all or join up and make it work together. I hope it’s the latter, but have no fear of the former.

  4. I sincerely hope that a suitable compromise can be found. For all the faults of the NHS system in the UK it is something that we all take for granted, critisce and malign, but as soon as their is any real hint of placing significant areas of health care back into the private sector there is an outcry of outrage. I fear though that the UK is heading more towards the American medical care system as it is and ever further away from the universal health care for all. It will not be until we forsake our current system will we truly value and appreciate a health care system which is accessible to all and affordable to all.

  5. I certainly hope the democrats can use this issue to their advantage because the Republican plan to bankrupt MNCare is short-sighted and a public health risk. It’s incredible how much of this type of cutting Gov “Patches” has gotten away with in his tenure and it’s reassuring that he’s been stopped for a change!

  6. In order for this state, or any other state for that matter, to pass progressive health care reform, we need to elect a leader (a Governor) that believes in health care as a basic human right. I agree that the DFL needs to push while they have the advantage, but we also need to elect a Governor who pushes this issue already, like Senator John Marty. He not only created Minnesota Care, but he also created and advocates for universal coverage, the Minnesota Health Plan. Without him in the Minnesota Governor’s seat, I fear that we will face the will of the policitcal forces in the form of special interest money. Pharmaceutical companies and health insurance companies have more money then the general public, and they will stop the movement of any progressive health reform, unless we have a leader who stands up for the general public and turns their back to special interest money. That person is Senator John Marty!

  7. Sen. John Marty is a good guy, no doubt about it. If he became Governor, I’d be happy.

    I happen to support Margaret Anderson Kelliher because I believe she has more skill and experience on a wide range of issues. I was happy to caucus for her at the SD65 DFL Convention last Saturday.

    That doesn’t mean I don’t like Sen. Marty. I heard him speak, and I have to say that at the very least I wish he was Senate Majority Leader right now!

    My best wishes to all DFL activists and candidates. Let’s keep fighting for what we believe in, and after the convention picks one from among us unite behind that person for a Minnesota that works!

  8. Bob, don’t doubt that for a second. In fact, I’m sure it’s all about him one way or another because it always is.

    But I don’t care why at this point – what we know is that there’s a line he knows he can’t cross. We finally have him pinned down. That’s the advantage we gained.

  9. Wish we had that in Ill. Insurance rates just went up 25 percent for me, as much as 60 percent for others. At 25 percent rates would double in 3 years (rule of 72).

  10. Its time for republicans and conservatives to get out of the way and stop protecting the insurance industry. Its obvious this is what they are doing at the expense of all Americans. We all need access to affordable health coverage and we all need it before the whole healthcare industry collapses under its own weight of people and businesses dropping coverage. We have had this problem for a long time and its time to fix it. Its true we have the best healthcare in the world but only if you can afford it. As soon as you cant afford it it becomes the worst system in the world.

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  12. Things have gotten pretty quiet on the health care front since the big law was passed. I wonder how this will play out in our state and others now.

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