MMA News
Pawlenty Continues To Target Health Care
Gov. Tim Pawlenty continues to use the current budget crisis to dismantle Minnesota’s health care safety net.
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MMA Statement on Gov. Pawlenty’s Supplemental Budget Proposal
While recognizing the difficult budget circumstances facing the state, the MMA is disappointed that the Governor continues to show such disregard for the health care needs of hard-working, low-income Minnesotans by pulling their health care safety net out from under them. The MMA repeats its call for a more balanced approach to solving the budget problem—through a combination of both cuts and increased revenue.
This proposal is bad policy. It will result in higher uninsured rates in Minnesota and higher costs for the rest of us. The working Minnesotans slated to lose their coverage will not stop needing health care; rather they will be forced to forgo treating preventable conditions that will get worse and land them in the emergency department.
The proposal also runs counter to Minnesota’s long-term goal of helping people stay off of welfare by allowing them to remain employed, pay taxes, and access low-cost health care coverage. Now, a single adult considering taking a minimum wage job will have to choose between the job or keeping her health care coverage.
Hard decisions will need to be made in the weeks to come, and there are no easy solutions. But if the Governor can’t support a program that keeps Minnesotans healthy, employed, and paying taxes, the decisions are going to be that much harder.
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His latest target is MinnesotaCare. In February, he presented a plan for erasing a $1.2 billion state budget deficit by reducing the income eligibility guidelines for single adults from 250 percent of poverty ($27,084 a year) to 75 percent of poverty ($8,124 a year). Under the proposal, the state would save about $120 million during the next 16 months.
The change would result in about 21,500 low-income working adults losing their health coverage. MinnesotaCare is a premium-based program for working Minnesotans that provides subsidies for health insurance on a sliding scale. If passed, the only adults without children who would qualify for MinnesotaCare would be those who in previous years qualified for the General Assistance Medical Care program.
In addition to this change, Pawlenty also proposed cutting long-term care payments by 2.5 percent and undercutting the state’s efforts at improving public health. His budget proposal included a $10 million cut in funds for the State Health Improvement Program, a statewide effort to reduce tobacco use and obesity by making communities healthier. Finally, his plan relied on the state securing nearly $400 million in uncertain federal funds.
The MMA responded immediately to Pawlenty’s supplemental budget proposal in a statement to the media. The MMA’s opposition to cuts in MinnesotaCare was included in news stories that appeared in the Albert Lea Tribune, Duluth News Tribune, Brainerd Daily Dispatch, Winona Daily News, and St. Paul Pioneer Press, and on WCCO.com and local blogs. MMA President Benjamin Whitten, M.D., also did an interview with the Minnesota News Network, which provides news for 80 commercial radio stations in Minnesota.
Clinic Comparison Project Is Off Track
In February, the MMA worked with lawmakers to introduce a bill (H.F. 3056) that would change the state’s approach to peer-grouping, a component of the 2008 Health Care Reform Act. The bill calls for three significant changes in the state’s approach to comparing quality and cost among hospitals and clinics. Those changes include adding a quality-improvement program that would help physicians and clinics improve their performance; extending by one year the public release of the data; and repealing language that precludes providers who score in the bottom 10 percent on the quality and cost measures from treating patients covered by state health insurance programs.
“The data the state is collecting could be a powerful tool for improving care; but the state’s current approach has an unrealistic timeline and is based on untested methods that could result in unintended, negative consequences,” says MMA President Benjamin Whitten, M.D.
Peer grouping is designed to strengthen incentives for consumers to choose high-quality, low-cost health care providers by allowing them to compare the cost and quality of the care provided by hospitals and clinics. Clinics and hospitals will be ranked on performance measures related to care for six conditions or procedures.
Under the current timeline, hospitals and clinics would get their first look at their scores in June; the state would publicly report scores in September. The state employee health plan, public insurance programs, local governments, and health plan companies would start using the data in January. “That leaves virtually no time to determine the accuracy of those scores,” Whitten says.
Delaying the public release of the data by a year would give hospitals and clinics a chance to better understand their scores, verify the validity of the data, and improve the way they deliver care. “Given the unknowns about the data’s quality, the MMA is urging the state to slow down, abandon the punitive approach, and use the data in a way we know works—for quality improvement,” Whitten says.
MMA Says Lawmakers Should Stay Out of Lyme Disease Debate
The MMA is opposing a bill that has embroiled the Minnesota Legislature in a debate about Lyme disease. The bill, which passed the Committee on Senate Health, Housing, and Family Security in February, would prohibit the Minnesota Board of Medical Practice (BMP) from disciplining doctors who prescribe long-term antibiotics for the disease.
Sen. John Marty, DFL-Roseville, introduced the bill last year at the urging of physicians concerned about being sanctioned by the BMP for prescribing long-term antibiotic treatment for Lyme disease. The BMP has not disciplined any doctors for this issue, but boards in Connecticut and other states have. Doctors long have argued about whether “chronic” Lyme disease exists and whether long-term antibiotic treatment is appropriate for patients whose symptoms persist following standard antibiotic therapy.
The MMA opposes this bill because it attempts to define a standard of care in law. Dave Renner, MMA director of state and federal legislation, testified against the bill and was quoted in the St. Paul Pioneer Press saying that its passage would set the bad precedent of the Legislature dictating practice standards for specific conditions.
MMA Offers Personal Day at the Capitol
Although the MMA’s annual Day at the Capitol event was canceled because of bad weather, it doesn’t mean that physician voices won’t be heard by lawmakers. With the health care safety net under attack, it’s especially important that physicians talk with their representatives. The MMA offers a number of ways to make that happen.
Your Personal Day at the Capitol
Schedule your own personalized visit while the Legislature is in session. You’ll have the chance to meet with your local legislators at a time that is convenient for you, and view hearings and floor sessions.
Your Clinic/Specialty Group Day at the Capitol
Get all the benefits of a personal visit in addition to spending time with your colleagues. By being part of a larger group, you can have an even greater impact on legislators. The MMA Medical Student Section and the Mayo Pediatric Residents used this option in 2009 with great success. MMA staff will brief your group to get you started.
In-District Meeting
Many physicians may not have the time to travel to the Capitol to meet with their elected officials but still wish to have a face-to-face discussion with them during the session. The MMA will set up a meeting before or after work close to your home.
To take part, contact Dennis Gerhardstein, MMA manager of physician outreach, at dgerhardstein@mnmed.org or at 612/362-3745.