REGIONAL— The push for a universal, single-payer approach to health care has entered the gubernatorial debate in Minnesota with a proposal put forward this past week by state auditor and …
REGIONAL— The push for a universal, single-payer approach to health care has entered the gubernatorial debate in Minnesota with a proposal put forward this past week by state auditor and gubernatorial candidate Rebecca Otto.
Dubbed the Healthy Minnesota Plan, Otto said her proposal would cover all Minnesotans with no premiums or deductibles and would reduce health care costs by about 15 percent, primarly through reducing administrative overhead and changing the economic incentives for health care providers.
While Otto said she agrees that a national solution would likely be the best path forward, she said Minnesota can’t wait, or necessarily expect, that health care solutions will come from Washington. “If we have to go it alone as a state, we will,” she said.
Otto said the inefficiencies of the current system are creating crippling cost increases and forcing health care providers to spend far too much of their time dealing with administrative issues rather than patient care. “Doctors tell me they’re spending 60 percent on paperwork and only 40 percent on actual health care,” said Otto. “That should be at least 90 percent on patient care.”
According to Otto, her plan would pay doctors based on their ability to manage the health of patients, rather than on the traditional fee-for-service. Patients would be free to choose their doctors, similar to how Medicare currently operates. Providers would bill a health care trust fund that would be established under the plan.
Funding for the trust fund would come from a variety of sources, including a substantial portion from the federal resources that currently come to the state through the Affordable Care Act. While implementation of Otto’s plan would require a federal waiver, she’s confident that the plan would be allowed to go forward by Washington. The plan would also be funded by existing state resources as well as through unspecified tax increases. But Otto notes that any tax increases would be more than offset by the savings that individuals and businesses would accrue from no longer having to purchase health insurance privately. “Employers are already spending this money,” she said. “This merely takes existing resources and redirects them into the health care trust fund.”
Working through the details of such a proposal at the Legislature promises to be difficult, acknowledges Otto, particularly given the political power of the insurance and pharmaceutical industries. “It will require a careful and considerate conversation,” she said. “The prize is we’ll be able to spend less for a better outcome.”
Otto said the economic costs of health care are crippling small businesses in the state, which she believes stand to benefit significantly from her plan by making health coverage less expensive for employees. “It’s the small businesses that are really getting creamed,” she said. “I don’t want to lose our small businesses who are so frustrated already.” And Otto cites recent projections showing that health care spending in Minnesota is expected to jump from $55 billion this year to $85 billion annually by 2023. “Imagine, if we could reduce health care costs by 15 percent, what that would do to help us fund other priorities,” she said.
While other states have proposed universal, single-payer systems, without ultimately implementing them, Otto said she’s worked extensively with health care experts and economists to assess why such proposals didn’t move ahead and avoid those mistakes. “Every state is different,” she said.
And times have changed, said Otto, particularly with the problems inherent in the Affordable Care Act and GOP attempts to repeal the law.
“I think we’re at a watershed moment,” she said. “Minnesotans are scared to death about the possible repeal and what it means to them and their families.”
Otto’s health plan is the second part of a five-part “RenewMN” vision that she plans to issue as part of her gubernatorial campaign. She faces several other DFL hopefuls, including St. Paul Mayor Chris Coleman, House Minority Leader Paul Thissen, First District Congressman Tim Walz, and Minnesota Reps. Erin Murphy and Tina Liebling.