MMA Viewpoint
Toward a Better, Simpler System
The Minnesota Medical Association (MMA) has entered a new and possibly controversial stage in health care reform. As you know, last year the MMA introduced the Physicians’ Plan for a Healthy Minnesota, a blueprint for reform that was developed by the MMA Health Care Reform Task Force. Our plan generated a great deal of discussion and led to legislation that was introduced late in the 2005 session but failed to advance.
At that point, the questions we faced were: What next? And how do we build support and fill in the details? We didn’t want our plan to sit on the shelf gathering dust. On the other hand, we would have to relinquish control and bring in other stakeholders if we were to take it to the next level.
During this past year, we met with more than 70 health care leaders and other stakeholders in order to explain our ideas and gauge how much interest there was in forming a partnership to achieve reform. Our choice was whether to keep the relatively complex system we have now or think outside the box and develop a simpler system that works better.
We were very encouraged to find a high level of interest in implementing health care reform. As a result of this interest, the MMA convened Healthy Minnesota: A Partnership for Reform, led by a 26-member steering committee of leaders in health care, business, state government, labor, education, and consumer advocacy. Although the partnership will use the MMA plan as the starting point for discussion, ultimately, it will shape its own agenda and strategies. The MMA will be part of that process.
The steering committee is forming four workgroups to address key elements envisioned in the MMA plan: 1) a reformed insurance market with health coverage for all Minnesotans, 2) a reformed delivery system focused on value, 3) a strengthened public health system with an emphasis on disease prevention, and 4) systems that support high-quality health care.
A main feature of the MMA plan is universal coverage, a requirement that every person in Minnesota have health insurance for essential benefits. The insurance market workgroup may consider this as well as other MMA ideas. If they do go down this road, there are bound to be a variety of opinions about the services that should be considered “essential” and the process that should be used to identify them. For example, should there be catastrophic coverage for costs above a certain level? Should there be coverage for preventive services such as immunizations and physical exams? Should treatment for chronic diseases be included?
The workgroup on health care delivery may consider the MMA’s suggestion to create a system focused on value and greater consumer engagement. The MMA recommended that patients control health care spending and that both physicians and patients have more information about costs. This complex issue calls for an open, honest discussion.
The public health workgroup will likely discuss the MMA’s recommendation to strengthen public health, emphasize prevention and early detection, and reduce risk factors for disease.
The quality workgroup may discuss the MMA’s recommendation to provide useful quality information, develop payment systems that support quality practice, and increase safety and effectiveness of care.
Workgroups will report their ideas to the steering committee and then spend the rest of this year shaping reform proposals. Although the MMA plan was the starting point, the wisdom of our partners will shape the final outcome of Healthy Minnesota: A Partnership for Reform.