As senators and business association spokeswomen debated the merits of Sen. John Marty’s proposed Minnesota Health Care Act (SF 118/HF 135) last week, more U.S. companies were announcing tens of thousands of lay-offs. Mounting job losses were claimed as a talking point by both supporters and opponents of the plan.
The bill passed out of the Health, Housing and Family Security Committee, chaired by Marty, on an 8-5 vote. Its next hearing will be by the Committee on Commerce and Consumer Protection.
The universal single-payer plan would require a major shift in the administration and budgeting of health care. In order to pass, it must also inspire a shift in conventional thinking about the role of health care.
This bill, with 25 co-authors, is a more detailed and concrete iteration of the single-payer plan Marty introduced last year.
Tagging the current system “a patchwork mess,” Marty said the overhaul plan would cover everyone while controlling costs for businesses and individuals. Cost savings would come through the elimination of layers of for-profit and non-profit administrators including HMOs, insurance companies, in-house hospital and clinic staff devoted to billing and collections, marketing costs, and companies that exist solely to help individuals maneuver through the system. Further savings would come through a provision for buying drugs and medical supplies in bulk, at negotiated prices.
Together, these administrative costs are responsible for 31 cents of every dollar spent on health care, and they divert actual delivery of health care away from people, said Marty.
Under his bill, more resources would be funneled directly to people for quality care, preventative care, dental care, mental health care and prescriptions. There would be no more restrictions on pre-existing conditions and denial of claims would be a thing of the past. The new system would be under the authority of a 15-member board with representation from different regions of the state, chosen by county officials.
The plan “treats health care like a community good, like police, fire and schools,” said Marty.
That’s socialism, according to some business lobbyists who spoke in opposition.
Beth McMullen, health policy director for the Minnesota Business Partnership, said her organization’s members include the 10 largest companies in the state. The group is committed to a “market-based, patient-centered” system, she said, and would oppose a single payer system under “government control.”
Stacia Smith, director of workforce and health policy for the Minnesota Chamber of Commerce, said the Chamber opposes a “government–run” health system, but is committed to discussions on other health reform proposals.
Julie Brunner, executive director of the Minnesota Council of Health Plans, was more sympathetic to the senator’s plan but said a “public-private” reform approach is in everyone’s best interest.
Twila Brase, president of the Citizens’ Council on Health Care, a group that lobbies for “free markets” in health care, says the group “does not support socialized medicine” because it discourages innovation and “promises something it cannot provide.”
McMullin added “In this economy, when everyone is concerned about jobs, this would drive jobs away.”
Committee member Sen. David Hann raised the question of job losses under the plan.
Along with provisions for retraining dislocated workers, Marty said the bill would give dislocated health care workers something other laid-off workers haven’t had – health care.
Marty further defended the plan by saying the goal of reform is to “design a health care system to provide healthcare, not [give] jobs to people.”
But questions remain, primarily on financing, such as: What will premiums cost individuals? How much will businesses be taxed? Specific costs are unknown, said Marty, adding that researching and compiling a cost-analysis report would cost half a million dollars, something the state hasn’t authorized. A foundation is working on a report, said Marty.
All sides agree health care reform is urgently needed, but they are miles apart on how to change the system.
Advocates of the plan were elated when Sen. Linda Berglin, chair of the Senate’s powerful health finance division and a leading health care policy expert, recently signed on as a co-sponsor to the bill, something she didn’t do last year.
Another health measure re-introduced this session is the Minnesota Health Security Act. This bill takes a two-phase approach to expanding health insurance, according to Sen. Tony Lourey, the bill’s Senate sponsor. Based on the Children’s Health Security Act passed by the House in 2007, the act mandates affordable and comprehensive insurance coverage for all children by 2010, and extends insurance coverage to all adults in 2012.
Under this plan, adults would pay no more than 5 percent of their household income on health care coverage. Marty’s committee heard the Health Security Act bill on Wednesday, January. 28.
Berglin last week also introduced the “Cover all Kids” health insurance bill. The bill allows children of families whose parents have access, but can’t afford private insurance, to become eligible for MinnesotaCare.
[Correction 8:30 a.m. 2/2/09: Committee member Sen. John Doll” changed to “Committee member Senator David Hann.”]