Time is overdue for public health reform

Published 9:09 am Wednesday, May 4, 2011

Column: Mike Bromelkamp, Guest Column

Spending reform and government redesign continue to drive the Minnesota Chamber initiatives as the 2011 Legislature heads toward adjournment. Public health programs are receiving a great deal of scrutiny as policymakers seek to close the projected $5.1 billion shortfall in the general fund for fiscal year 2012-2013.

Mike Bromelkamp

We must confront the challenges head-on and find ways to build a budget based on the available revenues for the next two years. The current approach to government programs and providing services is simply unsustainable.

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The Minnesota Budget Trends Study Commission report is among the latest to issue warnings on the need to restructure government. The Minnesota Bottom Line report, also issued in 2009, offered recommendations on how to provide government services but spend less during a time of severe budget shortfall.

The red flags are not new. The Weber-Brandl report issued in the mid-1990s forecast the changing demographics and their impact on the long-term stability of state and local governments. State economist Tom Stinson and state demographer Tom Gillaspy have delivered a similar message to numerous audiences in recent years.

Specific attention to the structure and delivery of public health programs is a common theme among all the bulletins, and for good reason. The pressure on the health and human services budget is documented and daunting. Left unaltered, that single sector of the state budget is projected to increase by 42 percent over the next two years.

The Minnesota Chamber advocates a variety of measures to improve the quality of service and control costs. One of our key initiatives is seeking a global federal Medicaid waiver. The specific proposal at the Legislature — Consumer Health Opportunities and Innovative Care Excellence, aka CHOICE — would allow Minnesota to negotiate a block grant with the federal government and be exempt from the federal mandates.

Minnesotans are not served well by a one-size-fits-all system. The waiver would give the state flexibility to design programs that best address our health care needs. The optimal results will be both improved health-care outcomes and significant financial savings.

To that end, Minnesota recently received good news. Under a new initiative funded by the federal Affordable Care Act, it is one of 15 states that will receive up to $1 million each to develop new ways to meet the often complex needs of individuals eligible for both Medicare and Medicaid programs.

Federal waivers are not new to the state. Minnesota has several health care waivers including one for MinnesotaCare and programs serving the aging and disabled populations.

The Minnesota Budget Trends Study Commission identified growth in health care as the most important factor in controlling rising state expenditures. It’s time for policymakers to act on those reform recommendations that improve the way we care for our most vulnerable citizens while developing a system that is sustainable and effective.

Mike Bromelkamp is a principal at Olsen Thielen & Co., St. Paul, and chairman of the Minnesota Chamber of Commerce Health Policy Committee.