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Minnesota Opinion: Our health bills are high enough already

Aphysician who sees patients every day -- patients with health insurance -- Dr. Laura Dean of suburban St. Paul hears the complaint often. "I pay more and more and I get less and less," she said her patients are telling her. Can you relate? Most ...

Aphysician who sees patients every day - patients with health insurance - Dr. Laura Dean of suburban St. Paul hears the complaint often.

"I pay more and more and I get less and less," she said her patients are telling her.

Can you relate? Most Minnesotans would nod yes.

"So they come in to see me, and they have a problem, and I want to order an ultrasound. They say, 'I can't afford the ultrasound because my insurance won't cover the ultrasound until I've hit my cap,' which is now $10,000 or $15,000. So they're paying a big premium cost (and) they're not having everything covered until they've hit a huge cap. And so people are choosing not to have tests that they might need to diagnose or to treat their problems," Dr. Dean said in an interview this week with the Duluth News Tribune editorial board; she was traveling with her husband, Rep. Matt Dean, who was speaking in Duluth, which this editorial will get to in a bit.

"So while (many Minnesotans) may have coverage," she said, "what it affords them in the health care arena is very little."

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Against the grim backdrop of a health care reality where decisions are being made for financial considerations rather than medical reasons came the even more grim announcement on Thursday that individual insurance rates are expected to see at least a 25 percent increase in 2017 in Minnesota. That on top of a premium increase this year of 14 percent to as high as 49 percent.

What's happening with health care in Minnesota and around the country is as well-documented as it has been hotly debated. The high cost of prescription drugs is driving up costs. Millions fewer are signing up for health insurance under the federal Affordable Care Act than anticipated, even if it means being fined by the federal government. Many of those millions are younger, healthier people whose premiums were supposed to be covering the care demanded by older and sicker individuals.

So insurers are losing tens of millions of dollars a year and are pulling out of insurance markets created state-by-state under the federal Affordable Care Act. The insurance market in Minnesota is known as MNsure.

In Minnesota this summer, Blue Cross Blue Shield announced its withdrawal from the individual market, sending an estimated 100,000 customers in our state scrambling for other plans.

The problems are many. As frustratingly, proposed solutions can't find consensus.

"We can't maintain what we're doing now," Rep. Jennifer Schultz, DFL-Duluth, said at the same editorial board meeting attended by Dr. Dean and Rep. Dean, a Republican. "A report just came out that said if you want to retire today at 65, plan on spending close to $300,000 on health care. Just on health care. People only save, on average, $100,000 for their retirement. If they're lucky, they save that much. So what's happening now is just not sustainable."

Schultz supports opening the health insurance plan of state employees to the public. Government needs to step in with such a public option, she said, to restabilize the market. She also suggested more times to enroll in insurance plans, or an enrollment period earlier in the year, to capture more of those who are going without coverage.

Schultz further supports recommendations reached last year by a 29-member health care task force. She and others were appointed to the task force by the governor, who, yesterday, in response to the announcement of massive insurance rate increases in 2017, said he'd reconvene the group. Its continued work clearly is needed.

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"It was 29 bipartisan individuals getting together and actually voting on different recommendations, and most of them had full support," Schultz said. "These were individuals representing health insurance companies, health care providers, physicians, legislators, people who work for community health centers (and others). It was a really diverse group of people that are looking at the issues and spent a lot of time understanding what works and what isn't working."

The task force made 33 recommendations. They can be viewed at mn.gov/dhs/hcftf/final-materials/. None of them was able to gain traction, however, at a legislative session this year that failed to get much of anything done. Schultz has vowed to bring a handful of the recommendations back next year if she is re-elected.

But that won't be soon enough, said Rep. Dean, in Duluth to talk at a meeting of the far-right Northern Liberty Alliance about his proposal to do away with MNsure altogether and start from scratch.

"It's three and a half years old, it's broken, it's not paying for itself, and it's getting worse," Dean said of MNsure. "If what they're doing was being done by a private health insurance policy, people would be in jail. People would absolutely be in jail from the mismanagement of this and from mistreating people across the state of Minnesota. We can't allow another three years of that to continue. There is a great sense of urgency that we need to tackle this, (and that includes) not even waiting for the next session."

A sense of urgency doesn't seem to be the problem in any of this. Especially among the many Minnesotans burdened by double-digit annual increases in their health care costs, leaving them to make medical decisions based more on what their insurance company tells them than what their doctor says.

Dr. Laura Dean sees that grim reality every day.

"When you look at how (the health care situation) affects the quality of Minnesotans' lives and their health care, I'm seeing a big impact," she said. "We need to get together to find solutions."

Yes, and sooner rather than later, and with both Republicans and Democrats working together with medical professionals, health insurers, and other stakeholders.

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Such political cooperation may be a lot to ask, but the health of Minnesota depends on it.

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