The solution to the Minnesota Legislature's ongoing paralysis over Real ID ("Real ID bill rejected by Minnesota Senate," March 7) is appallingly simple. Don't do anything. Let the deadline run out. Don't get an extension. Everybody flying in this state must then travel with birth certificates or passports clutched in their sweaty hands.
Forget about the inconvenience to ordinary schlubs like me. We may be many, but we don't count for much. However, once this state's high-profile executives and traveling sales forces start screaming about the inconvenience they are subjected to, it is safe to say the needed reforms will pass very rapidly. Especially if their wailing is accompanied by threatened cessation of campaign contributions.
Easy-peasy.
Bruce Downing, St. Cloud
HEALTH CARE POLICY, FEDERAL
Home care is but one of the tangles in the repeal bill
The impact of this new Republican plan for replacing the Affordable Care Act leaves out some very important issues. One of these is home care. Home care is undervalued through financing. This leads to a paucity of home care providers and services. The result is that people go home and do not receive care, or a family member reduces or quits employment to provide the care, or the person stays in the hospital. In pediatrics, the latter two are the typical path. Children with special needs sit in intensive-care units for months waiting for home care to become available.
Bills going through the Minnesota Legislature have attempted to change reimbursement policies so that qualified professionals can be obtained and retained, but so far this has gone nowhere. Inadequate home care leads to higher costs because the hospitals pick up the slack, and hospital care is one of the faster-growing expenditures in health spending.
While the ACA didn't go far enough to recognize this connection, the new repeal bill greatly reduces this. What will happen then is that children will sit in ICUs, adults will sit in hospitals waiting for home care, or family members will disengage from economic participation to provide the care. In the worst case, home care will collapse, and this will increase utilization of hospitals. Either way, patients and families lose; we all lose either by increased expenditures or reduced economic participation.
Ian Wolfe, Minneapolis
The writer is an RN.
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