I did not want to resort to the most stereotypical of all Minnesota-Norwegian phrases, but it seems an appropriate and well-understood description of what happened with Minnesota’s public health care this weekend. Uff da!
The legislature and the Governor agreed on what can only be described as an incredibly bad deal when it was decided that Minnesota would not be expanding Medicaid/Medical Assistance eligibility to access federal health care dollars, while also providing a much more capable health care program. Instead, it was decided that the highly unpopular GAMC compromise reached previously this spring will in fact begin June 1. The DFL “victory” is that Minnesota will apply for the Medicaid expansion, but it will not be implemented unless Gov. Pawlenty or his successor decides to give it the stamp of approval before Jan 15, 2011.
For the Governor it was a clear win. He can walk away with a “clean” record of no new taxes. He can also say he has not embraced “Obamacare.” One of his reasons for resisting a Medicaid expansion was that the $188 million in increased expenditures, which would lead to a $1.4 billion federal match, would be raised through a surcharge on health care providers. Apparently, such a surcharge would of be unfair to the providers, but somehow saddling them with an underfunded program is not.
So now, the hospitals will need to provide care for some 30,000+ of Minnesota’s poorest and sickest through a brand new program, all without breaking the $101 million ceiling. If the patients do somehow end up costing them more – and if history is a guide, they will – those costs will have to be covered by the hospitals. It should be noted that most of the health care providers were in favor of the “unfair-to-them” Medicaid expansion rather than the GAMC compromise.
If I had $200,000 of debt, I would look for a second job to help me pay off my debt or ask my supervisor for a raise. In addition, I would try to cut my expenses. For instance, I might go in on a Costco membership with friends to purchase cheap, bulk size food. I would cut down on eating out, make my own coffee rather than get Caribou, etc. This balanced approach would likely help me manage my debt relatively fast, but without making me completely miserable. What the Governor pushed through the legislature was a cut-only approach, but rather than cutting “luxuries,” such as eating out, he cut health insurance, food, medication and books.
We can all understand the need to tighten the belt, but cutting our way out of trouble when there is nothing left to cut is not the right way. Particularly since health care costs do not go away just because we refuse to find a way to deal with them. MN2020 Fellow Jeff Van Wychen’s article from last week shows us that expenditures for our elderly and disabled makes up for 2/3 of all Health and Human Services expenditure growth from FY 2006/07 to FY 2012/13. With our aging population, we would be fools not to recognize that this trend will continue.