Senator Berglin responds—says she supports Single Payer System

BY LINDA BERGLIN

I believe that every Minnesotan should have affordable health care, which is why I was so appalled to read Kip Sullivan’s recent commentary piece stating that I oppose single payer health care. Mr. Sullivan needs to get his facts straight.
As a state senator, I have strongly supported legislation to provide affordable, accessible health care to all Minnesotans. I coauthored S.F. 979 in 2004 and S.F. 723 in 2005. Both of these bills were single payer health care proposals. Senate hearings were held on single payer bills S.F. 339 and S.F. 979 in 2004 and S.F. 2468 in 2006 and I voted for them as a member of the Health and Human Services committee.

Until there is enough support to pass a single payer system in the legislature, I will continue to work hard to get health coverage for more Minnesotans. For instance, in 2003, I was able to reduce the number of people Governor Pawlenty proposed to lose coverage and voted against the remaining cuts. Last year, I was successful in preventing all of the 37,000 Minnesotan’s proposed by Governor Pawlenty to lose coverage from doing so.

This year, we saw that money—or lack of it—was not the problem in providing health care coverage to more Minnesotans. Republican lawmakers are not interested in providing health care to the uninsured, even though there is an extra $120 million available in the Healthcare Access Fund. But, because House Republicans and the governor did not want to restore the health care cuts of the past two years, the money was not spent and more Minnesotans are without health care coverage.

I proposed legislation this year that would expand coverage to allow 15,000 more people to be covered and to restore MinnesotaCare benefits like physical therapy, optometric and dental care. Although we were not successful with this effort during 2006, I hope to see this coverage restored next year.
I also disagree with Mr. Sullivan that a single payer plan for health care cannot include managed care or integrated care.

Minnesota’s public program option for people to be in managed care has had many successes. For elderly and disabled patients enrolled in Medicare, the financing of Medicaid is blended with Medicare, creating a true single payer system where the patient is not confused about which plan will pay and what they are left to pay. We also find better outcomes in integrated care settings for diseases like diabetes where more patients are getting the screening they need to keep the disease under control. Some of the managed care plans the state contracts with are owned by the county government. We have high satisfaction rates with these plans. Surveys conducted in 2005 by the Minnesota Department of Human Services (DHS) found that 91 percent of Minnesota Disability Health Options (MnDHO) members rated their satisfaction as greater than non-MnDHO members with the health care services they received in a year. Seniors and their families overall were also more satisfied (85 percent/ 83.8 percent) with the services and health plan through Minnesota Seniors Health Options (MSHO) than through other plans.

The Mental Health Action Group, a broad working group made up of mental health advocates like National Association of Mental Illness (NAMI) and the Minnesota Association of Community Mental Health Programs have recommended to the state that we integrate mental health services and physical health services through a “managed care approach.” They believe that better coordination between medications for mental health and medications for diabetes or heart disease will result in better outcomes for persons with serious and persistent mental illness.

Through the contracts the state has with HMOs, we can get better health care performance. For example, HMOs can provide early testing for lead poisoning, a leading cause of mental retardation in young children. Once we put a requirement in health plan contracts that they increase the number of children ages 9 months to 30 months receiving a lead test as well as appropriate follow-up, we saw the numbers of tests go up from 23 percent in 2001 to 35 percent in 2005.

In my opinion, it is also essential to have the choice of integrated or managed care so that each health care provider is working with full knowledge of every treatment prescribed to patients by other providers. Without this, the outcomes can be tragic.

Most important, however, is to make sure that all people in Minnesota have access to affordable health care in a clinic setting. Last year, an average of $350 per family was being added to insurance bills to pay for unnecessary emergency room use by the uninsured. Not only is it the most expensive kind of care, but it is often sought out so late in the illness that permanent disability or premature death is the result. It is because of unnecessary misfortunes such as this that I will continue to press to make affordable health care available to all Minnesotans. Until there is enough support to pass a single payer system in the legislature, I will continue to work hard to get health coverage for more Minnesotans.