Is this Healthcare change… or just rhetoric?
The flurry of healthcare related activity in St. Paul over the past month has not really cleared up where the state will land on the accountability issue.
A number of bipartisan bills targeted at fiscal accountability for the HMOs serving state funded healthcare programs did not meet committee deadlines. This doesn’t mean that they are gone for the year, but the road ahead is much more difficult if these bills are to be brought to a vote in the MN Legislature.
An aide to Sen. Sean Nienow, author of a number of health reform accountability bills, said that even if those bills don’t get a committee hearing before the deadline that doesn’t mean they are dead. It means that there could be plans to submit bills through the Rules Committee or even have them included in the Omnibus bill.
Adding a bit to the confusing state of legislation is the continuing push by Gov. Dayton to add his pieces into any healthcare reform this year. Those pieces include, but are not limited to, competitive bidding by HMOs for the right to service state funded healthcare programs and limiting the profitability by HMOs to a 1% maximum limit every year. Both of those moves, although laudable, offer substantial wiggle room for the HMOs who currently provide insurance for all of the state funded programs. The wiggle room comes in the form of non-standardized accounting practices that the HMOs are allowed to offer up as proof of their own accountability. These self-funded and self-reported audits are done by agencies hired by the HMOs, not by external sources. The reporting requirements are uniquely determined, in large part, by the HMOs themselves, giving strong reason to question the overall accountability for the $3 billion tax dollars funneled into these companies each biennium.
At stake in all of the healthcare reform talk and/or actions, are a couple of things:
First, there is the overriding issue of reforming an increasingly expensive and increasingly exclusive system whose cost seems to be running out of control. More and more people are excluded from the current system every day, as costs continue to soar. HMOs have taken to attributing those rising costs to the care providers themselves thereby deflecting any and all inferences that the HMOs themselves could have waste or unwarranted expenses.
Secondly, there is the political issue of who is being a “good watchdog” of the tax dollars collected and spent on healthcare in Minnesota. The tag of being labeled the “fiscally responsible” group is much coveted and seems to, in many cases, outstrip the concern for improving the accessibility and quality of the healthcare system. The jockeying for achieving most-favored status, in the eyes of the MN electorate concerned about health reform, has turned into a real heavyweight bout.
The HMOs, the MN legislature, the governor and the MN Council of Health Plans (the trade group representing all MN HMO providers) are all slugging it out to protect their turf, their image and their (our) tax dollars.
Advocates allied and working together for healthcare reform like *GMHCC, **MUHCC and Take Action-MN, have all played a significant role in getting the debate going, aided in large part by the November 2010 firing of whistleblower Dr. David Feinwachs, the 30-year general counsel to the MN Hospital Association. Feinwachs was terminated from his position after pressure was applied by the HMOs in Minnesota. They were upset with a video, produced by Feinwachs, which highlighted the lack of accountability for healthcare spending of tax dollars in the state, which directly and indirectly pointed out the culpability of the HMOs.
Seven County and GMHCC will be in St. Paul to work to make sure your tax dollars are spent wisely.
*Greater MN Health Care Coalition ** MN Universal Health Care Coalition