MMA Viewpoint
A Year Dominated by Reform
As my year as president of the MMA draws to a close, I take pride in the way that our association has been able to constructively engage with major players and stakeholders during a turbulent period dominated by health care reform.
The national debate on health care reform culminated this spring, when the Patient Protection and Affordable Care Act was signed into law. That debate was similar to the one MMA members have been leading in our state for some time. Our Physicians Plan for a Healthy Minnesota was developed over several years and presented in 2005. To develop the principles set forth in that plan, the MMA brought together leaders from health care, business, state government, labor, education, and consumer advocacy organizations. This group helped the state develop and then pass health care reform legislation in 2008. As a result of these deliberations, physicians involved in the process agreed on a basic set of reform principles including supporting public health, focusing on disease prevention, improving quality and transparency, and achieving universal coverage through mandatory enrollment in a health insurance plan. Throughout this period, I would argue that MMA members have led from the center as we pushed for reforms in Minnesota and advocated for those parts of the federal proposals that aligned with our own reform principles.
Now the health care reform debate is being refocused at the state level: Massachusetts is struggling with its far-reaching version of health care reform while states such as Minnesota are scrambling to address the fiscal realities of meeting existing commitments. Meanwhile, other states are attempting to avoid commitments to or increased expenditures for health care altogether. As we grapple with these challenges, the key thing to remember is that the way that legislation, both federal and state, is interpreted and codified by our state regulatory offices is as important as the law itself.
Well over 100 years ago, the English poet Samuel Coleridge wrote, “Every reform, however necessary, will by weak minds be carried to an excess that itself will need reforming.” I think what he was getting at is that reform is an ongoing process subject to the usual human strengths and weaknesses. With regard to health care reform, the MMA’s role is to continue informing policy makers of the realities physicians and patients face in the state’s clinics and hospitals so we can avoid excesses that could cause these reforms to fail. Thus, the MMA will continue to work with the Minnesota Department of Health, the state Legislature, health plans, and hospitals on health care reform.
Although I do not agree with all aspects of the Patient Protection and Affordable Care Act, I am convinced that Minnesota physicians and their patients are better positioned than ever to capitalize on its benefits and avoid some of its pitfalls because of the work that our MMA has already done. As Coleridge told us, this will be an ongoing process: Our most important work lies ahead.