Readers Write (April 2): Managing dog waste, health care, transit funding

I just read the March 26 article "Who is left holding the bag?" — about managing pet waste — and favor an idea for making this less of an issue.

The story mentions that a woman who saw the issue on the Facebook page for the Hamline-Midway area of St. Paul developed a sticker that can be put on a garbage can if residents are willing to allow dog walkers to put their dog poop bags in their garbage. Such stickers could be distributed by the neighborhood councils.

Those of us who have dogs already have smelly garbage, so it would not be a great sacrifice to have a few more bags in our trash. Those who do not have dogs but are dog-friendly also might not mind. People could also recycle their newspaper bags by putting them out by their garbage cans for use by dog walkers. I have one neighbor who kindly ties the bags to the railing by her sidewalk stairs for our use. This makes it easier to pick up after your dog if you were unprepared for multiple potty breaks on one walk.

Rather than fight about something like this, let's all be good neighbors and make it easy for dog owners and walkers to do the right thing. I, for one, would far rather have the dog poop in a bag in my garbage than left on my lawn where I am likely to step in it.

So D.J. Tice says we can't have all we want in health care (March 26). I'm guessing he would not favor single-payer. I'd like him to say why we should keep letting insurance companies take health care dollars. I can't think of any reason, besides that it's the system we have and it would be tough to change.

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I respectfully disagree with Tice. We spend more than any other country in the world for health care and get far less than the best results for our investment. Our neighbors to the north offer health care to all their citizens, and it costs them only $4,300 per person. In the U.S. we spend $10,000 per person, and we have countless millions who don't have health care or face care that is financially out of reach. Though I have heard aspersions cast upon Canadian health care, the reports that Canadians are flocking to the U.S. for better health care is flatly unsubstantiated. With $10,000 per person available, it would suggest we could improve upon the quality of Canadian care more than twofold.

I look at excessive health care provider profit as a problem to balancing care and cost. With considerable support of our public tax dollar, we are creating a colossus medical destination in Rochester that resembles the Bloomington megamall or Disneyland. Our top Fortune 500 company in Minnesota, UnitedHealth Group, has paid handsome dividends virtually every quarter since 2010. Additionally, we have new hospitals and clinics popping up everywhere as if they were gas stations.

I think it is past time for universal health care. If the Canadians can do it, we should be able to do it better. The president was heard saying in his address to the nation that "we need to think big and dream bigger." I agree.

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The Mayo Clinic has brought to light the discrepancies in insurance company reimbursement rates. As difficult a discussion as this is, it is important, and I applaud Mayo for its bravery. As Tice mentioned, the insurance companies have become "inconsistent and inefficient" in their financing systems. Companies such as Medica reimburse mental health professionals, such as myself, at a lower rate than does Medicare. They also reimburse at 50 percent lower rates than do other major carriers such as Blue Cross Blue Shield, HealthPartners and Preferred One. Medica is one company that does not keep pace with industry standards. It has not raised reimbursement rates for psychology in at least 14 years. Inflation has increased; costs for a loaf of bread have increased, and the profit for Medica has increased, but not the payout to providers. That is what Mayo Clinic is bringing to light. We of course want to continue to service all clients, but we also need to hold insurance companies and their executives accountable. Bravo, Mayo!

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Tice's column was on-point and insightful. I would take his comments further by referring to the March 24 article "Income lags for rural hospitals." Both authors pointed out how the medical systems cannot provide services to patients at the reimbursement rates provided to them by public health plans. Medicare, Medicaid and MinnesotaCare all pay the providers of care at rates 40 percent to 50 percent less than the private payer rate. The CEO of Mayo also said as much. The medical community cannot meets its fiscal budget at those payments.

This fact points out a flaw in our current health care debate. The problem is not the cost of our private insurance. Rather, the cost of our private insurance is the canary in the coal mine. Fact: The major insurance companies in Minnesota pay out more than 90 percent of the collected premium back to the medical providers for our care. By law, they must pay out at least 85 percent of our premiums for that purpose. Fact: Under MinnesotaCare, the average paid claim per member is more than $5,600 per year.

The problem is the cost of medical care, period. To all those who think Medicare for all or opening up MinnesotaCare to the public to purchase will solve the problem, consider this: If we went this route, then the medical providers, medical-device manufactures, drugmakers and all industries with ties to the medical-industrial complex would see a significant drop in revenue — 30, 40, 50 percent. When an employer loses revenue, jobs are lost, benefits go away and stock values fall. All hospital systems and medical clinics would see a large revenue loss. All industries that make medical products would lose revenue. Can the medical providers absorb this kind of loss? Who will fight tooth-and-nail to preserve their place at the table? Are we as a nation ready to have this fight?

So far, I don't think we are.

The March 26 editorial on transit states that "Republicans defend their Metro Transit pinch as necessary to improved funding for Greater Minnesota roads."

One of my local legislators, one of the few outstate Democrats, said that the general view of outstate legislators is that they don't have a dog in the metro transit fight.

The actual fight seems to be between urban Democrats favoring mass transit and suburban Republicans for whom transit is confined to someone, usually alone, driving a 2-ton steel box on pavement with the expectation of a parking place at either end. Unfortunately, that is not sustainable, as other cities have discovered.

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There is no plausible link to the assertion that metro funding holds the state at risk of economic ruin. This is the Star Tribune propping up the Metropolitan Council, which has done a wonderful job of bullying local units of government. If business growth near light-rail lines shows a surge, it's because the businesses follow the potential economic benefit. Business would still expand if this modality didn't exist elsewhere. How much real economic benefit exists when the Met Council recovers only between 22 percent to 33 percent via "fare box" recovery? That term is "government speak" for paying your fare — which is frowned upon by transit advocates.

The simple fact is that the unelected Met Council is using state and federal moneys to attain its utopian nirvana of a euro-metropolitan existence. Now that a $122 million shortfall is looming in transit funding, it wants the Legislature to impose a 0.5 percent sales tax on metro-area residents. This episode, along with the fight over land use in Oak Grove in Anoka County, should become a motivation to end this regional debacle.

This height of arrogance should usher in a significant effort to gut the influence of a regional authority so arrogant it would make the old Minnesota Sports Facilities Authority blush with envy.