Readers Write: Medicaid middlemen, red tape, gratitude, fraud scandals, climate change

Opinion editor’s note: Strib Voices publishes letters from readers online and in print each day. To contribute, click here.

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In response to Jill Burcum’s thought-provoking piece on Dec. 29 (“Any Medicaid changes require care, not haste,” Strib Voices), there is one change to Minnesota’s Medicaid program that could be made quickly without any negative consequences. That change would be to eliminate the private insurance company middlemen from our Medicaid program. During the past two legislative sessions, legislation that would have allowed Medicaid patients to opt out of managed care into traditional fee-for-service Medicaid has been killed by hospitals and insurance companies. Even though this proposal would save Minnesota taxpayers tens of millions of dollars (according to the state’s own estimates) and provide Medicaid patients better care of their own choosing, it has and will be blocked by avaricious hospitals and insurance companies concerned with their own profits and continued manipulation of the health care system.

Even though the Minnesota Legislature will never allow this desperately needed, commonsense solution, the federal government can bypass Minnesota’s legislative recalcitrance. The federal government just needs to withdraw or modify Minnesota’s 1115 Medicaid waiver. It is this waiver from traditional federal Medicaid law that allows the use of private insurance companies as middlemen in our Medicaid program. It is this waiver that allows our Medicaid patients to be forced into managed care programs they don’t want to be in. It is this waiver that allows our experimental, pilot or demonstration project in Minnesota Medicaid, which has been ongoing for more than 39 years, to continue to the detriment of patients and taxpayers alike. That is a long time with no benefit to anyone except the insurance middlemen. Fortunately, this could all change if the federal government withdraws the 1115 waiver or, at the very least, gives Medicaid patients the freedom to choose traditional fee-for-service Medicaid. Since the Minnesota Legislature won’t do this, the federal government should, thereby achieving both cost savings and better-quality care.

David Feinwachs, St. Paul

The writer is an attorney and former general counsel for the Minnesota Hospital Association.

In the Sunday edition of the Minnesota Star Tribune, Karen Tolkkinen wrote an article on small towns having trouble accessing state funds (“Small towns struggle for aid,” Dec. 29). What Leslie Lee went through very much parallels what I, as clerk of Wilmont Township in southwest Minnesota, went through to get a Unique Entity Identifier from the federal government in order to get FEMA funds for the flooding our township experienced this past spring.

The red tape we have to go through is not fair to every one of us out here that do not deal with this on a daily basis. I finally did get the UEI number after many hours of reading lengthy directions, making phone calls and filling out online forms. Now, in addition, we have to renew that number every year to keep it, so it is another task we have to remember to do.

Thank you for the article, Karen. It helped many of us know we are not the only ones dealing with impossible government websites and rules.

Audrey Brake, Wilmont, Minn.

I enjoyed reading “There’s no place like Minnesota” by Ka Vang (Strib Voices, Dec. 29). Wouldn’t you know, it was by a first-generation immigrant to Minnesota with a last name like Vang rather than Johnson or Olson who so beautifully articulated what there is to love about Minnesota. Those of us who are descendants of earlier immigrants to the state may take for granted our arts scene, sports teams, lakes and the “good people” that make Minnesota unique. Immigrants or newly arrived Minnesotans are often the spark plugs who open our eyes to what we have to be thankful for.

Carol Torgerson, Leonard, Minn.

How refreshing to read the “This happened on your watch” letter published in the Dec. 29 paper. Over the many years that I have been a constant Minnesota Star Tribune reader I have both strongly agreed and strongly disagreed with the letter writer’s erudite correspondences to this newspaper. Sunday’s contribution, I have to say, hits the proverbial nail on the head. The inattentiveness, arrogance and downright laziness that the Walz administration has offered in response to the outright fraud being perpetrated in Minnesota’s government-regulated programs (Feeding Our Future, autism support centers, charter schools and their success/failure ratios) deserves, well, to get the attention of a conscientious prosecutor. Oh, that would be Andy Luger.

Thank you to the writer for bringing such a cogent summary of how our state’s government and politics have gone so alarmingly awry to the attention of this paper’s readers. And to the Star Tribune for publishing his letter.

Paul Liemandt, Backus, Minn.

The reprinted Associated Press article by Steven Grattan, “Drought, fires and more battered the Amazon” (Dec. 29) did not underscore two underlying contributing factors. Namely, the burning and clearing of forest for soybean and beef production that has been going on for decades that has now changed the climate in this bioregion, putting the entire ecosystem in danger. Countries knowingly importing soybeans and beef over the years have contributed to this global calamity.

In 2022 the top importers of soybeans were China ($54.1 billion), Mexico ($4.08 billion), Japan ($2.47 billion), Spain ($2.43 billion) and Germany ($2.35 billion), and much of it comes from Brazil, the world’s largest exporter of the crop. The U.S. imported $438 million worth of soybeans in 2022. And, in 2022, China imported nearly $8 billion worth of beef from Brazil, accounting for more than two-thirds of Brazil’s total beef exports. The U.S. imported about 100,000 tons of beef from Brazil, making it the second-largest importer.

All these importing countries should be held accountable, and free and fair-trade agreements should be based on environmental impact and social justice determinations.

Michael W. Fox, Golden Valley

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Forty degrees, rain, drizzle, fog and all our snow melted? This is not the Minnesota winter I have come to know and love. It’s very much like the Dayton, Ohio, winters I grew up with. Now it’s cold again, but we’re left without our lovely snow to play in. No wonder it’s becoming more difficult to maintain outdoor rinks and ski trails. This is what climate change looks like — brown and icy!

Most of us are quite aware of the damage climate change is causing but feel helpless to do anything about it. Small changes can add up, though, if enough of us take action. Anybody can use refillable water bottles instead of buying bottles of water. Anybody can compost their food waste instead of sending it to a landfill. Anybody can buy vintage (read: Goodwill) items instead of buying new. And anybody can talk to their friends and neighbors and build the will to make bigger changes as a community.

Please take action, encourage others to join you and work toward the bigger changes needed to avert even browner, icier winters.

Catharine Ruther, St. Paul