Senator Linda Berglin has long differed on health policy issues with many other Democrats, including the two state representatives from her senate district. For the past 16 years Berglin has been the state’s leading proponent of HMOs as the solution to the health care crisis and one of the state’s most influential opponents of the single-payer movement. In the 1990s she opposed single-payer legislation authored by Rep. Karen Clark, a Democrat from within her own district. Today Berglin opposes legislation to remove HMOs from MinnesotaCare and Medical Assistance, authored by Rep. Neva Walker, who represents the other half of Berglin’s constituents.
Berglin’s opposition to single-payer and her support for “managed care” (which refers to the tactics HMOs pioneered to keep health care costs down) also puts her at odds with public opinion. Polling data indicate the public has never been happy with managed care, and surveys and focus group research indicate substantial majorities support a single-payer system.
Berglin’s efforts to improve access to health care are well known. She played a leading role in enacting MinnesotaCare, the program that offers subsidized health insurance to working families who don’t qualify for Medical Assistance. In 2005 she led the fight to defeat Gov. Tim Pawlenty’s proposal to cut 40,000 people from MinnesotaCare. But Berglin’s role in promoting HMOs and opposing single-payer legislation has received very little media attention.
One of the exceptions was a report in the Star Tribune on Feb. 12, 1993, about a press conference held the day before by a half-dozen legislators including Rep. Karen Clark. The press conference was called by Clark and Sen. Sandy Pappas (DFL-St. Paul) to announce that they were introducing single-payer legislation. They were joined by several other legislators who supported single-payer and opposed the pro-managed-care bill that Senator Berglin was carrying.
The 1993 Star Tribune article quoted Senator Pappas stating that single-payer was “the only way to get at … administrative cost,” and Senator Doug Johnson (formerly DFL-Cook and chairman of the Senate Tax Committee) criticizing Berglin’s managed-care bill for not containing “strong, tough cost containment.” Berglin, who did not sign on to the single-payer bill, was quoted saying she thought her bill would contain cost. She was also quoted saying the Legislature had already decided to go down the managed care “road” and could not switch to single-payer now (“Single-payer health system proposed,” Star Tribune, 1B).
An article in the August 1995 edition of the Southside Pride also reported on the split between Berglin and some of her Minneapolis DFL colleagues. Under the headline, “Exactly what health care issues did Sen. Berglin support?” the article explored the conflict between Berglin and the single-payer movement that had sharpened due to Berglin’s hostility to the Clark-Pappas single-payer bill and several other bills introduced at the request of the Health Care Campaign of Minnesota (HCCM), a coalition of 30 organizations that led the campaign for single-payer in the 1990s.
Although Berglin had made numerous statements in the Senate indicating she opposed single-payer, her comments to the Southside Pride revealed how reluctant she was to state to a newspaper that she opposed Karen Clark’s single-payer bill. She stated, for example, “It is true that I have chosen not to push single payer the way Paul Wellstone has at the federal level … The reason is because it is not feasible to get it through [the Legislature] and get it signed [by the governor] … If you want to criticize me for not being a champion of the single-payer bill, that would be a correct criticism.” The implication of this remark is that Berglin did support single-payer, but simply chose not to give it a high priority. That was not the case.
Berglin’s opposition to single-payer and her support of HMOs has not diminished over the years. In the recently completed 2006 legislative session she opposed a bill to remove HMOs from MinnesotaCare, Medical Assistance and General Assistance Medical Care. (Under Berglin’s leadership, those three programs had been gradually privatized, that is, turned over to HMOs, during the 1990s.) Single-payer systems save great sums of money by cutting out the administrative costs generated by insurance companies. Cutting the HMOs out of the three state programs will cut the costs of these programs (by at least 10 percent) in the identical fashion. It is hard to understand how someone who promoted the takeover of the state’s health insurance programs by HMOs, and who now opposes removing HMOs from those programs, can claim to be a single-payer supporter.
Berglin’s opposition to single-payer is beginning to upset some of her constituents. At the Senate District 61 convention earlier this year, Berglin was not the only candidate nominated. A second candidate, Brian Harmon, was nominated for the sole purpose of delivering a message to Berglin. In his acceptance speech, Mr. Harmon praised Berglin for the progressive legislation she has supported over the years, but criticized her for her opposition to single-payer. Then he withdrew from the race and sat down. The message was clear. Democrats in Berglin’s district will no longer ignore her role in obstructing debate about single-payer in the Minnesota Senate.
Kip Sullivan is a member of the steering committee of the Minnesota Universal Health Care Coalition, which represents 13 organizations. He is the author of more than 100 articles about health policy, and of a new book entitled The Health Care Mess, available at Amazon Books, Mayday Books and Orr Books in Minneapolis, and from authorhouse.com. From 1980 to 2000, he was an organizer with Minnesota COACT (Citizens Organized Acting Together).