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Rosenmeier forum addresses health care

Tackling the complex issues of cost efficiency and accountability in Minnesota’s health care delivery system in a two-hour session is a daunting task, but that was agenda for Monday night’s public forum at Central Lakes College.

The Gordon Rosenmeier Center for State and Local Government sponsored the session bringing four speakers — each with their own particular vantage point on the health care system. Each presenter was given 15 minutes to make a presentation. Those presentations were followed by questions from the panelists to each other and then questions from the audience.

The four speakers were:

• Dane Smith, a 30-year journalist with the Pioneer Press and Star Tribune, who is president of Growth and Justice, a progressive think tank committed to making Minnesota’s economy more prosperous and fair. Smith presented the Lewin Group study on the cost savings of a unified, universal one-payer health care delivery system.

• David Feinwachs, a former chief counsel for the Minnesota Hospital Association. Feinwachs urged accountability for HMO contractors administering state health programs.

• Dr. Chuck Sawyer, with Minnesota Physicians for a National Health Program, a member of the Health Care for All Minnesota board and senior vice president of Northwestern Health Sciences University.

• Phil Griffin, a lobbyist for Preferred One, is with the Minnesota Council of Health Plans, a nonprofit trade association which advocates for Minnesota’s current HMO-dominated system.

Answering a question from the audience, Smith said he thought the U.S. Supreme Court would not throw out the Affordable Care Act (ACA) but might inflict damage on the legislation. Sawyer said he hoped it would be struck down so health care could be revisited.

“I think the current insurance model has failed,” Sawyer said.

Griffin predicted the ACA would not be completely struck down by the Supreme Court. He bemoaned the uncertainty that the 7,000 page bill has created in the health care industry, particularly since so many details remain unresolved.

For the sake of simplicity, Sawyer suggested that Medicare, a good government program, simply be extended by gradually lowering the age.

Smith said one encouraging aspect of the ACA was that 30 million people who were not formerly covered would be covered. The former journalist said that while the market system works well for many products and services it is not used for education, sewage lines or toll roads. Many items are best served by being part of the public sector, Smith said.

“I think health care is one of those things,” he said.

Smith, in his presentation, said the U.S. health care system is the most expensive system and has glaring and growing inequalities in income and race. It is characterized, he said, by fragmentation, administrative complexity and creates constant bewilderment.

He said the unified, universal health care system his organization is calling for (often called a single payer system) would be difficult for politicians to implement.

“We know it’s a heavy lift, politically,” Smith said.

Feinwachs decried the lack of accountability in the current system, in which the HMOs provide the data to the Department of Human Services.

“We can’t tell where the money’s going,” he said.

He noted there are only four predominate HMOs in Minnesota.

“We don’t have a free functioning market,” he said.

In our society, he said, we don’t allow people to starve or to freeze to death and we shouldn’t allow them to go without health coverage.

Sawyer agreed the current insurance model, which is tied to employability, makes no sense. He said 9.1 percent of Americans were uninsured in 2011, with that number including 70,000 children. Health care is something everyone needs, he said. There is no need for the current HMO costs of underwriting, marketing, advertising and the excessive salaries, benefits and bonuses for HMO executives.

Sawyer suggested creating one risk pool with universal access where resources are merged to fund privately delivered health care.

Griffin said much of the administrative expense is there because of government regulation.

“Administrative complexity is there because it’s a very complex system,” Griffin said.

Smith theorized the objections to the public option system is because America is a uniquely individualistic society.

“I think Americans will favor choice, even if it kills them,” he said.

MIKE O’ROURKE, associate editor, may be reached at 855-5860 or He may be followed on Twitter at

Mike O'Rourke
Mike O'Rourke began his career at the Brainerd Dispatch in 1978 as a general assignment reporter. He was named city editor in 1981 and associate editor in 1999. He covers politics and writes features and editorials.
(218) 855-5860