Health care changes spur access worries

By WARREN WOLFE, Star Tribune

Last update: April 17, 2008 - 7:40 PM

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re "I'm just guessing you've never been on MN Care"

I haven't, but I have 4 [that I know of] relatives who have been and are on MinnCare and have had no complaints about coverage that I've … read more heard. For starters: one had knee replacements, one had a hip replacement, and a niece's father-in-law had the SAME operation on the SAME day in the SAME hospital by the SAME doctor that King Hussein had. It cost the King a big bundle, but MinnCare covered my niece's uncle's bill. FURTHERMORE, those relatives on MinnCare had the luxury of being treated by doctors in the world-renowned Mayo Clinic. Of all the insurance I've had through employers for many years the Mayo Clinic has been excluded from coverage (unless I want to pay a hefty chunk of the bill). Only since I've retired have I had insurance which will cover Mayo doctors.

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Several physicians and Republican legislators said Thursday that bills to create massive changes in Minnesota's health care system could drive small hospitals and clinics out of business and harm patient care.

"As a patient, you don't want to see the doctor holding a calculator to figure out if the right kind of care you need is just going to cost too much," said Dr. Jim Young, a family practice physician in Rosemount.

Chief among the concerns of doctors and small or independent clinics is a proposal in House and Senate health care bills that would require them to set a single price to treat patients with some chronic conditions -- at least for public employees and those on Medicaid and other state health programs.

"It's the status quo, only worse," said retired urologist Dr. Bob Geist of St. Paul. "It's managed care with teeth."

Reps. Laura Brod, R-New Prague, and Matt Dean, R-Dellwood, also spoke at the briefing Thursday.

But the Minnesota Medical Association's president said his group continues to support a scaled-back House version of the changes, despite misgivings of some of its members.

"We need to reform the system -- everybody agrees with that," said Dr. James J. Dehen Jr., a surgeon at the Brainerd Medical Center. "We can disagree about bits and pieces of the bill, but it would allow patients to compare costs and quality of care, and allow clinics to become 'health care homes' that give comprehensive and coordinated care. That's good."

On Monday, House and Senate conferees will begin work trying to meld the bills that each house passed this month.

A major contention will be whether to expand MinnesotaCare to cover 47,000 additional lower-income people. Republicans argue that would be too expensive. The $400 million or so to fund that would come from the Health Care Access Fund. Gov. Tim Pawlenty wants to take $250 million from the $500 million in the fund to help offset a projected $934 million deficit.

Warren Wolfe • 612-673-7253

Governor: Tim Pawlenty
One of only a few prominent Republicans to win a competitive re-election contest in the Democratic sweep of 2006, Tim Pawlenty is widely seen as politically shrewd and naturally likable.

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