Comprehensive Reform

The growing number of uninsured and anxiety among those with insurance fueled a national debate and Congressional action this past year. Unfortunately, federal proposals focus on who pays for expanding health care coverage – without addressing the underlying issue, the rising cost of health care.

To improve overall health and control health care spending in the public- and private-sector, the Partnership advocates systemic reforms aimed at realigning the incentives to create a functioning health care market driven to provide the greatest overall value – an equation of cost and quality – to individuals.

In this respect, Minnesota provides a model for reform. With our “Business Plan for Health Care Reform” as a guide, the Partnership worked with lawmakers on both sides of the aisle to pass health reform in 2008, which was consistent with our Principals for Reform. (See below.) We continue to support public- and private-sector steps to implement that legislation and establish systems to evaluate the relative effectiveness of those reforms and all programs.

• Provide price and quality information that is relevant and useful to patients.   
• Pay for results and outcomes, not volume of procedures.
• Engage individuals in value purchasing decisions while maintaining appropriate insurance measures through the individual and group markets. 
• Expand and create incentives for healthy lifestyles and wellness through insurance products, health care providers, employers, schools, etc.
• Develop and implement appropriate infrastructure for health information sharing between providers that is portable for individual patients with appropriate information. 

Role of Government

Set standards: Within this framework, the role of government should be to set standards for the health care sector – and take down barriers to cost-effective health care. Appropriate state and federal regulations should be in place to protect consumers and reinforce the incentives in a functioning market-based, patient-centered system. Standards should address issues such as insurance underwriting, individual affordability, benefit coverage and provider quality.

Provide a safety net: State and federal health care programs, such as Medicare, Medicaid, MinnesotaCare and General Assistance Medical Care, play a distinct and important role as payers for a large portion of the population. These programs should be structured as part of a functioning market.

• Beneficiaries should be empowered to use providers/plans that deliver cost effective, quality care.
• Reimbursement systems and levels should include incentives for high-quality, cost-effective care without shifting cost to the private sector.
• The cost of uncompensated care should be addressed directly and transparently – not simply shifted to the private sector through higher private reimbursement rates.
• Revenue to fund public health care spending should rely on broad based, equitable sources.
• Revenue designated for health care should be used only for health care purposes.

Minnesota Impact from Federal Reform

Traditionally, the Partnership does not lobby at the federal level. However, the debate over national health care reform – with its potential impact on Partnership members and Minnesota – led the Partnership to work with members of Minnesota’s congressional delegation on the issue. As Congress debates health care reform, the Partnership will continue to work with our key congressional members and state policy leaders to address issues raised by any federal reform.

Innovation in the Private Sector

The state should enable plans, providers and employers to create a market-based, patient-centered system and to promote healthy lifestyle choices. Rather than attempt to restrict self-insured organizations, which are governed at the federal level by ERISA, the state should look to them as valuable vehicles for innovation and flexibility in health care.

For more information, contact Health Policy Director Beth McMullen.