Ask just about any Minnesotan if our health care system needs work. Doctors, insurance agents, nurses, lawyers, politicians, and patients will probably not only say ‘yes,’ but have some sort of medical horror story to tell you too.

 

Where it gets difficult is in trying to articulate exactly what should be done. Most people will have suggestions for improvements in areas with which they have had personal experience, but system-wide changes that will work for everyone are elusive.

 

There tend to be two generalizations when it comes to health care reform discussions. On one side, there are those who expect the government to take control and provide “universal health care.” On the other, we hear about “free market solutions.” To be frank, most people spouting these media-driven catch phrases don’t know what either notion actually means, but they have the right sound bites to mesh with one personal political philosophy or the other.

 

Most discussion of health care reform ideas is limited to making claims of presumed benefits or advocating a bumper-sticker health care solution. The news media is often ruthless in its simplification of the issues, so this article attempts to explain some of the details of useful health care reform ideas.

 

Under current statutes, it is actually illegal to purchase medical insurance from outside the state. Minnesota has a closed market, with the largest number of government-imposed insurance policy mandates in the nation. Introducing more competition and reducing government mandates will expand quality and choices while reducing costs.

 

Providing tax credits for the purchase of individual health plans would help offset the disparity between employer-sponsored group plans paid for with tax-free dollars and privately purchased plans without the same tax break. People struggling to continue coverage between jobs through COBRA and employees who do not receive health insurance through their work would benefit from such tax credits.

 

Expanding Health Savings Accounts (HSA) coupled with high-deductible insurance plans would put more consumers in-charge of their health care dollars. Partially removing the third party pay model will result in more fiscal discipline on the part of the consumer, reducing over-use of our health care system. This will in turn drive down the price of insurance policies while allowing the consumer to keep unused health care dollars for education, retirement savings or other uses of their direction.

 

Tort reform would reign-in the costs of frivolous lawsuits and could have an immediate impact on the cost of medical treatment by reducing the doctor’s overhead cost of malpractice insurance that is ultimately passed on to the consumer.

 

Reforming Medical Assistance and MinnesotaCare to resemble an HSA model has the potential to significantly reduce overuse of subsidized plans. Recipients would be rewarded for exercising fiscal responsibility by being able to rollover the unused cash balances within their HSA account. 

 

While contemplating various methods of health care reform, it’s important to keep the rights of patients in mind. Protections for patient privacy are essential. Private medical records should never be transferred without the explicit consent of the patient.

 

The health care reform bill that’s now being debated in conference committee will be on the way to the governor’s desk soon, but the governor has expressed misgivings about the details, which are very different from the ideas expressed here. The goals set out by the governor’s commission, various committees, legislators and special interests that crafted the bill are laudable: Controlling health care costs and increasing access to treatment. The end product doesn’t live up to its promise, though.

 

The 114 page health care bill as it now stands actually increases costs and could very well have the effect of reducing access by closing rural hospitals and clinics.

 

Governor Pawlenty wanted a bill he could sign to improve Minnesota’s health care. Unfortunately, he didn’t get one and it’s reported that he’s been meeting with conference committee members to see if changes can be made that bring the bill closer to the original vision for it. Failing that, the governor may very well veto legislation he had hoped to be able to support. In that case, health care reform will not happen this session and legislators will go back to the drawing board when they reconvene next winter.