Editorial: Search for GAMC fix needs guv's help

A health care problem -- the rising cost of care for Minnesota's poorest and sickest people -- became an impending crisis last May, when Gov. Tim Pawlenty used his veto power and, later, unallotment to defund General Assistance Medical Care as of March 1, 2010.

Pawlenty said at the time that he was leaving the Legislature time to find another way to care for, and pay for, the 70,000 low- or no-income sick people whose medical bills GAMC covers in the course of a year.

Finding an alternative is crucial, and not just for the people in the program. Hennepin County Medical Center, Regions Hospital and other health care providers that serve the poor, including numerous group homes, face serious financial difficulty and downsizing without GAMC. The entire state loses if those services shrink.

To their credit, several of the Legislature's DFL health policy masters -- Sen. Linda Berglin and Reps. Tom Huntley, Paul Thissen and Erin Murphy, to name four -- have taken Pawlenty's challenge to heart.

On Thursday they unveiled the framework for an alternative funding mechanism for a scaled-down version of the program. Described as a work in progress, it involves a crimp in eligibility, more county contributions, a surcharge on hospitals, the capture of federal dollars that will no longer flow to the state if GAMC dies, and a welcome dose of reform. It would invite more counties to do what PrimeWest, a 13-county consortium of rural counties, do now -- restructure payments to reward cost-effective medical practice.

Pawlenty would have done well to encourage the legislators' efforts. Instead, in remarks Thursday from his trade mission in Chile, he took a hasty shot at one element of the plan, the hospital surcharge. He did not acknowledge that his veto stands to do damage to some of the state's largest and most critical hospitals. For them, the proposed surcharge would be a lesser blow.

Having steered GAMC toward a crisis, the governor should feel obliged to help avert it. We hope he brought a problem-solving spirit home to Minnesota this week.