Physician Patient


Minnesota Physician-Patient Alliance, Inc. ("MPPA") is a not-for-profit organization committed to improving our health care system. We do this by communicating information to the public and within the industry about important health care issues.

MPPA believes that efficient, quality health care depends on strong doctor-patient relationships. Interference in the doctor-patient relationship by third parties such as health plans and the government, is widespread in today's health care system and often limits what doctors or patients are allowed to do, altering market-based reimbursement, and undermining the traditional ethics of the medical professions. While the intentions of the third parties in interfering with the relationship may be honorable (for example, to control costs or improve quality), ironically the cumulative effect of this interference is unnecessarily high costs and reduced quality. Efforts to reform health care, therefore, must first and foremost address the issue of strong doctor-patient relationships.

The MPPA board consists of physicians, health care consumers, and others who share these concerns and values. We seek to communicate our message by collaborating on research and publication, sharing information about market developments, and individually being active in a variety of health care and community organizations.

To see who belongs to MPPA, please visit our Who We Are page by clicking on the link to the right. To see some of our communications, click on one of the Publications links to the right. If you would like to learn more about MPPA or our positions, click on the Contact Us link to the right.

MPPA was established in 1997 as a Minnesota 501(c)3 charitable nonprofit organization. If you would like to be added to the MPPA listserv, the respected MPPA online discussion group, send us your contact information and we will add you.

Apr 5

Constituents are sending a drum beat of complaints to their legislators about escalating health care insurance premiums, gaping deductibles, and loss of access to doctors, hospitals and other “providers.” In response, the MN legislature (on a bipartisan basis) approved to spend more than $600 million (we have a budget surplus) as a bribe to keep at least some Minnesota Health Plans servicing the Minnesota (MNsure) individual insurance market. No guarantees, of course. Governor Dayton couldn’t even sign this legislation and it passed absent his signature.

Now we are told that the Plans are losing money, to be exact $687 million in 2016 according the Minnesota Council of Health Plans trade association.

However, the investment accounts held by the Plans are reportedly doing very well and some parts of their businesses are making money. Nice to know the details, but that’s a trade secret for these “nonprofit” organizations, right?

Minnesota taxpayers need to know how much money each of Minnesota’s nonprofit insurance companies put into their reserves in 2016. We want to know where our taxpayer money is going. Who will tell us?

Mar 18

Health Care Insurance “Reform” Passes House

The Minnesota Premium Security Plan (HF5): may be a security plan for Minnesota insurance companies. It creates a state-based reinsurance program. This bill passed the House on a bipartisan vote of 78-53. The goal is to stabilize and reduce premiums to consumers by mitigating the financial impact of high-risk individuals (those who are often the most sick) on MN insurance companies which provide individual health insurance. According to Minnesota Management and Budget (MOMB), the proposal will potentially reduce premiums by as much as 18 percent.

This legislation is designed to help to stabilize the Minnesota individual health care insurance market which has been devastated by Obamacare and MNsure. The bill will allow insurance companies to offload high risk individuals in their risk pools to MN taxpayers. The individual market risk pool includes about 5% of Minnesotans with health care insurance. These are people not on employer-based coverage, Medicaid, Minnesota Care, or Medicare. In 2017 the individual health care insurance pool is a third the size and contains twice the percentage of medically needy (expensive) enrollees than before the implementation of the Obamacare ACA law in 2010.

One of the realities facing any health care insurer is how the company apportions “risk” among its pool of enrollees. People who suffer extensive (expensive) illness (unless they die quickly without expensive medical interventions) often require expensive treatments and/or ongoing medical care which of course costs the “health care system” a lot of money. We know that 10% of an insurance plan’s enrollees generate 90% of its heath care expenses. That people are sick is usually not their fault, and clearly those with expensive conditions need health care insurance protections. However, unless costs for expensive enrollees can be covered by the insurers, they will withdraw from offering policies, as they have in Minnesota’s individual insurance market and MNsure insurance exchange.

Our legislators with HF 5 have offered a deal to the insurance companies with taxpayer money bribes to “stay in.” But to pass it taxpayers need assurances that legislation will actually result in lower health care insurance premiums and greater market choices for Minnesotans. I’m not convinced this legislation will do that.

This plan creates an internal reinsurance system using the legal framework of the Minnesota Comprehensive Insurance Association which was discontinued in 2013.

Health insurers would be partially compensated for taking on high cost customers so that MN health care insurance companies will not drop their individual policy offerings as they have in recent years. Customers dependent on individual insurance will have coverage options in a Minnesota individual policy market. This reinsurance will occur invisibly to patients. It will be administered by the Minnesota Comprehensive Health Association which since 1976 until 2013 ran our (successful) Minnesota high risk pool.

This legislation is projected to reduce premium costs, stabilize the market, and ensure that the sickest Minnesotans continue to have access to health care insurance.

Next, Minnesota and federal politicians need to propose and support reforms that will result in actual decreases in costs to consumers for health care services and health care insurance protections. This will mean price transparency, expanded choices of care “providers” and insurance products, and putting money under the control of patients and families as health care consumers.