President Obama will address health care today in a state that has long prided itself on the health of its citizens.
Minnesota has one of the healthiest populations and lowest rates of uninsured in the nation, is home to the world-famous Mayo Clinic and has introduced innovations in the cost, quality and access to health care.
When he arrives for his Minneapolis health care rally, the president also will land in a battleground state that has been friendly to him -- it gave him its 10 electoral votes in last year's election and hosted the rally where he announced he had clinched the Democratic nomination and gave his wife a notorious fist bump.
But Minnesota, which also hosted former President Bill Clinton for a health care rally in 1994 and former President George W. Bush in 2006 during a visit where he signed an executive order on health care, may not offer the nation a perfect model as the health care fight gears up.
Obama is likely to mention what Minnesota does right in his speech, but White House and congressional aides also cautioned against portraying the visit as an endorsement of Minnesota as the nation's reform ideal.
Despite its relatively low level of uninsured and a quality of care that is the envy of many states, Minnesota has struggled with escalating costs and has been forced to scale back its efforts.
The state also features health care debates that are nearly as bitter as those taking place nationwide. In recent years, much of the state's budget fight has centered on a drive, backed by Republican Gov. Tim Pawlenty, to trim the state's subsidized health care rolls. Legislative DFLers have largely fought to maintain or increase those rolls, and neither side has declared a truce.
With the president's visit today, the fights have only amplified. Pawlenty, a possible Obama rival in 2012, recently suggested on a GOP conference call that states might invoke the Constitution to sue over Obama's health care plans. Meanwhile, the state Republican Party is airing anti-Obama health care television ads to coincide with the president's visit and legislative Democrats accused Pawlenty's administration of failing to show results in some of the health care reforms in the state.
Useful tools
Still, Minnesota has developed some health care tools the nation would be wise to pick up, said Minnesota health care experts. The state has moved toward paying doctors for outcomes rather than for procedures. It has begun to provide integrated care for those with chronic diseases and requires hospitals to report errors. The Minnesota HealthScores website allows patients to compare cost and quality of care.
Adopting those could change the nation's attitude toward health care.
"Over time, use of the tools will change the culture," said former U.S. Sen. Dave Durenberger, a Republican now chairman of the not-for-profit National Institute of Health Policy.
While the White House has downplayed the story line of a Minnesota health model, some reform advocates in the state see an obvious connection.
"I don't think it's any coincidence that the president is making his first health care trip to Minnesota," said Lois Quam, a former UnitedHealth Group executive and wife of Democratic gubernatorial candidate Matt Entenza. "We have largely gotten it right in Minnesota."
But even the Mayo Clinic, which Obama has said has hit the mark with delivery of efficient, coordinated care, has criticized the White House and congressional Democratic leaders for sometimes getting health care wrong.
This summer, the clinic said the House Democrats' bill "misses the opportunity to help create higher quality, more affordable health care for patients."
Nevertheless, a Mayo official who attended Obama's health care address to Congress on Wednesday praised the president's leadership and direction.
"We really agree with a lot of the points the president made," said Jeffrey Korsmo, executive director of the Mayo Health Policy Center.
Korsmo also praised Obama's visit.
"Minnesota is a model overall for patient-centered care, so it's a good choice for him," he said.
But the conservative Freedom Foundation of Minnesota said this week that the reform proposals aren't focused enough on patients as consumers. The study concluded the health care proposals currently being floated in Congress could cost more than $4,400 for every Minnesotan.
Democratic members of Minnesota's congressional delegation have largely supported Obama's proposals for health care reform. The state's two U.S. senators -- Democrats Amy Klobuchar and Al Franken -- may have a chance to talk to the president more about that on his way here. Both are flying on Air Force One with Obama today.
Republican members have been much less supportive -- U.S. Rep. Michele Bachmann recently told NewsMax.com that Obama has advocated a "government takeover of health care" and said his plans are "antithetical" to what the American people want.
Delegation members from both parties have said Minnesota has been punished for doing things well -- the state's low cost and high quality for Medicare means the state gets shortchanged. They complain the current fee-for-service system has cost the state and that changing it should be a key focus of reform.
But policy is not the only consideration in the trip.
"My guess is he's choosing Minnesota because it's a high-quality, low-cost state," said Rep. Tim Walz, D-Minn. "But it's also a state that supported him fairly strongly in the last election."
