The rollback of reforms in Minnesota
Published 8:54 am Friday, April 15, 2011
Column: Jeanne Poppe, Guest Column
Many Minnesotans believe in bipartisanship and smart reforms. Sometimes the Legislature even gets both in one package. Even among the partisan bickering during the Gov. Tim Pawlenty years, some good health care reforms became law and were supported by DFLers and Republicans.
This session we have observed attempts to roll back some of these bipartisan reforms including the State Health Improvement Program, Medicaid early enrollment and Health Care Homes. We all know that laws are not static and political winds shift between elections, but repealing good policies that help many of us live healthy lives is not wise.
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Minnesota made a concerted effort several years ago to combat obesity. Why? The state spends an estimated $1.3 billion annually to treat obesity and related disease. For the first time in history, our kids’ life expectancy is expected to be shorter than their parents.
To fix this, the state developed a plan that would use evidence-based methods to encourage healthy lifestyles. The State Health Improvement Program, known as SHIP, helps Minnesotans live longer, healthier lives by reducing the burdens of chronic disease.
Locally, Mower County and Fillmore County public health departments receive funding from the Department of Health to implement SHIP. The public health departments use SHIP policies and practices in schools, communities, worksites and health care settings.
In schools, the focus is on healthy nutrition and teaching healthy lifestyles. In communities, the goal is to increase non-motorized transportation (exercise) and involvement in community recreational activities and health facilities. At worksites, wellness initiatives including health assessments, coaching and health education are utilized. These strategies can keep workers healthier and more productive. In the health care setting, the SHIP goal is to create partnerships and collaborations which increase access to healthy foods, physical activity and tobacco cessation to patients.
SHIP is a preventive program that makes decisions based on data. It focuses limited state resources on high impact areas, leading to healthy lives. The Health and Human Services bill in the Minnesota House eliminates this program.
On his second day in office, Gov. Mark Dayton signed an order enrolling Minnesota in Early Medical Assistance. This act provided insurance for poor and uninsured Minnesotans. The HHS bill in the Minnesota House repeals this early enrollment thereby kicking 105,000 Minnesotans off health insurance. The bill cuts $1.3 billion in state and federal funds. This money would go directly to hospitals, doctor’s offices and local clinics.
The funding cuts also mean a loss of 20,000 private sector jobs across the state. These would have big impacts in rural areas. Closure of a hospital means a longer drive or ambulance ride to the emergency room. Shutting down a nursing home means dad or grandma are now farther away.
Health Care Homes is a program providing coordinated medical care for Minnesotans with chronic conditions. The results are beneficial on two levels, quality and cost. This treatment works with patients to improve the quality of care and the frequency it is delivered. Care for chronic diseases are expensive and Health Care Homes save the state money. The HHS bill dilutes the definition of Health Care Homes leading many in the health care sector to be concerned that they will become less focused, therefore less effective.
The health care industry tracks data which is used to assess patient care. This data tracks provider rates. Proposals in the HHS bill need this data to carry out the reforms it aims to make. One proposal aims to save money by tracking provider payments and finding which doctors cost less. However, the HHS bill restricts this data collection. If the goal is to get better outcomes from state resources it doesn’t make sense to get rid of the very tools needed to accomplish the goal.
Minnesota is known as a national leader for quality health care. The state has made wise choices implementing bipartisan reforms that improve outcomes in people’s health while ensuring prudent use of state dollars. The HHS bill makes poor choices with these new policies. Stronger emphasis needs to be made to move forward, build on past success and reconsider efforts that repeal good policy.
Please continue to let me know what you consider to be the priorities of the state and the solutions you recommend at the state legislature. If you would like to be on my email update list, please send your email address to firstname.lastname@example.org. I also hope you will continue to contact me with your questions or suggestions regarding our state budget. I can be reached by email, or at 1-888-682-3180 or 1-651-296-4193, and by mail at 291 State Office Building, 100 Martin Luther King Blvd., St. Paul, MN 55155.
Jeanne Poppe, DFL-Austin, is the state representative for House District 27B.