Health insurance: Choice and portability are the answers

Roughly 100,000 people living and working on Minnesota Main Streets recently learned that their health insurance is going to cost 50 to 100 percent more next year. And many don't know what they are going to do. They don't have that extra $1,000 per month it may take to pay their premiums, unless they quit taking family vacations, sell their second car, or quit buying gifts. "Merry Christmas" says the Grinch who stole their financial health.

Minnesota's families used to enjoy some of the best health care in the country, at low cost. That is being lost. Now those who purchase insurance on the individual market must decide to drop coverage altogether or struggle to find all the money it will take.

Gov. Mark Dayton has proposed a 25 percent insurance premium rebate for 2017 to soften the blow, which would help out these families a lot. It would cost $300 million and would solve the immediate part of the need.

But the other need is to show the world that Minnesota is open to health-insurance competition. We must make modest reforms to our insurance system now to make sure that next year will be better, with more plans, more choices, and more doctors.

Both the rebates and the reforms need to happen this year so counties, groups and insurance companies can act in time to make their plans available for 2018. Even early next year might be too late.

There are five reforms we can do this year, in a special legislative session after Thanksgiving.

First, let's help fraternal organizations, farm groups, co-ops and others to form their own insurance plans. This is already allowed as something called a Multiple Employer Welfare Association (MEWA). The Department of Commerce needs to make it easier to form one of these groups. The savings and satisfaction can be remarkable. Next year we can provide for a way to help them achieve fiscal solvency.

Third, allow for-profit HMOs to bid in our market. If only one or two put their toe in the water, it could have a revolutionary effect. We are home to huge United Health Care, but it is barred from offering plans in this its home state. It's time to give it and others a chance.

Fourth, allow purchasing across state lines. This has been discussed for more than a decade, and it is time to give customers the chance to shop. It works for car and homeowner's insurance, and it can be a way to give health-insurance shoppers some real choice. Buyers will need to shop wisely, but since so many now have only one very expensive, poor-quality choice, they really have no say at all. It is time for consumer choice.

Finally, let all doctors and clinics who will agree to the terms and conditions of a health plan's pricing and other standards participate in any health plan. The current very restricted networks are said to save a lot of money, but that comes in part by depriving necessary care. Patients have spent years developing a good relationship with their doctors, who actually know their cases and can offer cost-effective treatment. Going to a new clinic and unnecessarily repeating tests wastes money, and medical errors by a strange doctor can be fatal. Let people keep their physician.

It's time to put our faith back in our doctors and their patients to make our health care system enviable again.