Those present: President Lee Beecher, Bob Geist, Dave Racer, Hannelore Brucker, Carl Burkland, Lye Swenson, Don Gehrig, Wayne Zuehlke, Mike Ainslie, Dave Feinwachs, Jason Flohrs, Tim Herman, Doug Smith, and Rick Morris.
1. Minutes of the February 21, 2017 meeting had been circulated to all before the meeting and were not discussed further.
2. Book Review. Lee Beecher and Dave Racer gave us a book report on their collaborative effort, Passion for Patients. It has received positive reviews; high praise came for Greg Scandlen, himself a high quality and prolific author on health care issues. This review of a fine book by our own MPPA president proved to be excellent background for our discussions. Lee generously gave a copy to each of us in attendance. [Available at Amazon—hard cover or Kindle] 3. Legislature activities 2017. The discussion was to be led by Scott Jensen, but at 10:17 PM, well after our meeting closed, he was still sitting in the Senate chamber! Dave Feinwachs, Jason Flohrs, and Dave Racer led the discussion helped by the observations and opinions from our talented membership many of whom are still involved in grass root policy activities and/or at the state level with the legislature.
During the discussion, the issues in Peter Nelson’s Memorandum regarding Congressional actions on risk pools proved to be good background: we noted the demise of MN’s successful MCHA program, the promise of consumer-directed health insurance, and the necessity of real market prices (for services and insurance)—Peter’s analysis is again attached,
We discussed: “shoveling” money to the HMOs [one view of the re-insurance bill]; the demise of the fair-care bill, which would have made the HMOs recognize payment of deductibles outside Plan networks (killed by the HMOs); the demise of the AGs bill for oversight of sale of non-profit HMOs to the for-profits during which the enormous assets (some MN State Medicaid reserves) might be pocketed by the officers and Board members (killed by the HMOs)—possibly analogous to the Soviet apparatchik millionaires created with demise of the government and “redistribution” of its assests; and the failed attempt of the HMOs to regulate balance billing outside their networks.
The issues identified with Medicaid were future federal cuts; federal block grants; the problem of waste and expanded eligibility swelling Medicaid ranks and increasing costs; the public theology that insurance = medical care access; the drift toward single payer or a two-tiered medical system; the failure of government (socialized) care [tax props, false reported low costs hidden in government agencies and queues for the ill—RWG]; the drift to health care as a “right” instead of a privilege; and the difficulty of repealing welfare benefits; and the politics of pandering to voters with “free” care using other people’s (tax-payer) money. It was noted that if system goals were choice, prices, and a personal physician, the FMA bill, which we have been following, could fulfil these goals for Medicaid enrollees—HF 1552 and SF 1302 will hopefully be heard in the next session.
The consensus of the legislative discussion, if there was one, seemed to be that the Republicans (national and local) by actions and non-actions are in the process of committing political 2018 suicide, that the HMO tail continues to wag MN health legislation, and that the “Plans” are to still able to grade their own homework—as in trust us; everything is just fine.
Pertinent background: before the meeting Lee Beecher had circulated to all a NYT article regarding UHG scamming through trolling patient charts and upgrading codes—the US DOJ has joined the whistle-blower law suit! https://www.nytimes.com/2017/05/15/business/dealbook/a-whistle-blower-tells-of-health-insurers-bilking-medicare.html?mwrsm=Email Read on…
4. Medicare for all. The lively discussion was led by Dave Feinwachs; he said that we should let younger people buy-in (not free like after age 65). He said the premium would be a small fraction of what seniors now pay for Medicare A and B, as the employer-based subsidy is re-directed to Medicare. Unfortunately, we lacked time to hear how he thought this would function or what Medicare regulations would apply.
Critics noted that: Medicare price fixing had broken the back of medical practices; socialized systems abroad were becoming unaffordable despite overt rationing of access (queues); NHS “reforms” are endemic when queues eventually affect increasing numbers of voters; fixed global national budgets would mean bureaucratic rationing [unlike the flexible aggregate of millions of family budgets governing all other microeconomic sectors—RWG]; and we would likely evolve into a two-tiered UK-like system. Other suggestions included having the government create a stop-loss [re-insurance] system for insurance policies.
5. The meeting adjourned at 8 PM—with usual post meeting confabulations!
6. The next meeting will be sometime in the fall—Congressional bills/acts may determine the MN 2018 legislative session activities. During summer and fall, there will be continuous member activity regarding the next legislative session.
Robert W. Geist MD, Secretary pro-tem