You're sick. Achy. You've got a nagging feeling that maybe this is a recurrence of that bug you picked up a few months ago.

Imagine logging on to your secured personal medical Web profile, checking results of previous lab tests, doing a few quick price comparisons on treatment options, then using your flexible spending account debit card to pay for eligible out-of-pocket costs.

That's what could soon be in store for all Minnesotans and what will be reality for the state's 50,000 employees as early as next year, Gov. Tim Pawlenty said Tuesday in a major health-care rollout that he said puts Minnesota in the forefront of consumer-friendly medicine.

Speaking to a health care alliance group at the Minnesota History Center in St. Paul, Pawlenty said his goal is to give all Minnesotans access to online personal health portfolios by 2011.

"We need to put consumers in charge," he said. "We need to give them the tools so they can make good decisions. ... This would be a significant breakthrough in the way we maintain information in this state," and could serve to lower prices, ease paperwork and give consumers control over their medical histories.

Pawlenty said he also will establish health-reimbursement accounts for state employees that would allow them to load the money on a debit card; they could use it to tap pre-tax money put away for out-of-pocket expenses without collecting receipts and submitting claims.

"The efforts we have made so far are a good start, but they are not enough," Pawlenty said.

With few resources, because he has been unwilling to raise taxes to help revamp the existing system, Pawlenty nevertheless has been slowly building what he considers a new model for health care, first creating a website that allowed Minnesotans to price-shop prescriptions and even order them from Canadian pharmacies. Other phases have adopted uniform insurance claims, created nursing home report cards and better equating payments to outcomes.

Pawlenty also created the Smart Buy Alliance, a group of employers, union groups and others that looked for ways to standardize health-care purchasing and drive down prices. It was to that group that he unveiled Tuesday's proposal.

Reaction is muted

Rep. Paul Thissen, DFL-Minneapolis, who heads the House health and human services committee, said that Pawlenty's proposals were "worth exploring," but that more is needed to achieve genuine health-care reform.

"Minnesotans across the state are continuing to struggle with skyrocketing health-care costs and shrinking access," Thissen said. "We will work with the governor on pilot programs, but we also encourage him to focus on the everyday problems facing Minnesota in the area of health care and join us in pursuing the fundamental innovations we need. The time for test runs is past."

Pawlenty and others involved in formulating the proposal say the changes they seek are fundamental.

"What if you were in an ambulance ... had an injured person and could pull up their records instantly on the way to the hospital?" Pawlenty said. "Think of the power of that."

He said the state's major private health plans have already agreed to put pricing and quality data on a single website, which will be under construction and should be ready next year. Pawlenty said that in addition to state employees, the Carlson Companies will be offering a version to their employees.

Once the general public is able to create portfolios, he said, parents could access immunization records for their children, check insurance information, prescription histories and even possible drug interactions. A sample screen shot shows personalized graphs on blood pressure, cholesterol and glucose readings.

Dr. James Mault, director of the Health Solutions Group at Microsoft Corp., said that the technology for such secured portfolios already exists and that hospitals, providers and insurers have already signed up. Minnesota, he said, is the first state to do so.

Pawlenty, who has a personal antipathy for last-century methods of paperwork and receipts, said he looks forward to a time when everyone can use debit cards for out-of-pocket expenses.

He confessed to at one point dropping out of his own flex-spending option, offered through the state, because "I sat down and thought about the amount of paperwork I have to collect, track, enter. ... It's not worth it. In the world of 2008 we don't want people collecting receipts, pile 'em up, fill out some form, interact three times with an administrator. We're moving that to a debit program. Zip your card through and move on. That's the world we live in today."

Privacy questions

Privacy issues remain a concern, and Jay Cline, president of Minnesota Privacy Consultants, who is advising the state, cautioned that no system is perfect. "There are always risks," he said. The key, he said, is having a detailed system that can tell you when information has been breached and track it. "Minnesota's the first state to put its name on the line," he said. "I'll sign up for it."

The proposal remains in the formulation stage, Pawlenty said, and he expects to conduct town hall forums across the state to gather suggestions from Minnesotans. But, he said, the existing system, in which consumers remain detached from costs cannot be sustained, no matter how much money is poured into it.

Patricia Lopez • 651-222-1288