Minnesota Health Care- A Model For Other States?

I had the opportunity to provide testimony to the Minnesota Health Care Reform Task Force last week. This group was convened to develop new ideas and solutions to improve the health care in the state. Minnesota has always been looked upon as one of the “innovators” in the country when it comes to health care. It is the home of the Mayo Clinic, Medtronic, United Health Group, HealthPartners, Red Brick Health, and many other business model and product innovations that have been used as examples for other states in developing a more effective health care system for themselves.

The Task Force was certainly handed a huge task and must now integrate the federal requirements of the Affordable Care Act into its work. Despite the health care system that has developed in Minnesota over the years, it is still too expensive, too confusing, and many times inefficient.

The Task Force was provided updates from several of the work groups: Access (defining the benefit structures and pricing models to increase the number of individuals “covered” under a private or public health care financing program). Workforce (making certain the health care workforce is prepared to meet the future demand of health care). Health Insurance Exchange (developing the tools to implement a health insurance exchange market in Minnesota).

The four hour meeting was filled with handouts and presentations from the different groups. It was obvious to most that what was being discussed was going to cost a lot of money. It was also fairly obvious of the continuing confusion regarding the “rules” that must be followed to meet the requirements of the Affordable Care Act. Health care is complex- but these discussions made it even more confusing. There was very little (if any) discussion about how the average individual was going to understand any of it.

My testimony tried to at least bring the consumer/individual back into the discussion. I hope they were listening.

As I said, Minnesota is viewed as an innovator when it comes to health care. But Minnesota also struggles with the same challenges as other states to get consumers and individuals engaged and involved. With the complexity we are continuing to create- it’s no wonder.

Until groups like these begin to accept the economic realities we are facing, develop approaches based on a set of quantifiable objectives not utopian dreams, simplify the entire process, and include the perspectives of the “average citizen” in all of their discussions and decisions, we will probably just end up with a nice set of recommendations we can’t afford, that cost a lot of time and money to put together, and that we’ll just put on the shelf. We may move forward a little- but not nearly as far as we need to. But at least we're doing something.

The Supreme Court Decision and GSK; Which Way Will We Go?

It was fun to watch the cable news channels trip over themselves as they initially incorrectly reported the outcome of the Supreme Court decision last week. In their quest to report first- they reported wrong. Such is the price we have to pay when we want the news instantaneously. We’re going to need to be even more cautious when we’re determining what to believe; especially when it comes to deciding what to believe about health care.


Since the decision was made- the pundits have been trying to figure out what it really means. For all practical purposes, the guts of the law were upheld. It’s just that what things are called, and how things will work are going to change pretty substantially.

Even with the decision finally made, the health care debate is going to continue. The country is still divided on it view of the law. But the intensity of the division has intensified. The rhetoric behind the discussion will get even uglier than before. Just like we should have learned as the cable channels first reported the decision, what is reported will not necessarily be the truth.

The fundamental question we will continue to grapple with is this: how much should the government organize the health care mess we have created this country versus how much can we really rely on the “free market” in its ability to fix it.

Today, pharmaceutical company GlaxoSmithKline (GSK) agreed to a $3 billion settlement essentially resulting from health care fraud. The company was selling pharmaceuticals to markets where the drugs were not intended, and for conditions that had not been tested. The general public was exposed to some very substantial risks. But the GSK sales folks, some physicians, and others made a lot of money in the process; just following the American Dream. The GSK annual report states the ultimate aim of GSK’s business strategy is “to deliver sustainable improved long-term value and returns to shareholders.” There is no mention of delivering quality products at an affordable price to their customers. These companies are big, and the focus is financial. In an article about the fraud for Forbes Mathew Harper writes, “Criminal fines for giant drug companies, no matter how big, are less a deterrent than a cost of doing business.”

The free market left on its own can be dangerous.

So, we are still left to decide between a bloated and expensive health care law generally administered by the federal government that few understand and many people still don’t like, and uncertainty as to whether it will work, and a free market approach that continuously struggles to put the patient, the individual, ahead of profits.

I’ve said all along the answer is somewhere in-between. We just don’t have the right leaders in place to put a middle-ground approach together. The debate will continue.