[Winona Online Democracy]

Medical savings accounts, tort reform to protect doctors and hospitals and
getting 3rd party payers out, except for catastrophic coverage, are the only
long term solution.   Example:  Laser eye surgery, cosmetic plastic surgery,
which are always paid for by individuals have actually come down in cost.
Personal responsibility will solve allot.  Tom Severson

Box 736
Winona, Mn. 55987
507 452 3402 ext 214

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Behalf Of terri hyle
Sent: Tuesday, November 30, 2004 10:36 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: RE: [Winona] Health Care Happenings: Houston and the Governor

[Winona Online Democracy]

Interesting proposal. I'd like more details.   If MN can enact legislation,
regulation or simply garner the clout to streamline paperwork, that alone
would generate significant savings.  What I find interesting is that when
the governor was in Winona earlier, I spoke very briefly with him about
legislation which would allow school districts and cities and other local
government entities to participate in the same state health plan that state
employees are able to use. I wasn't advocating that any school district or
other governing body be forced to choose from among that set of plans,
merely that they be allowed to participate.  Since a large portion of the
pricing of health insurance is based upon risk spread out among a group, the
larger the group, the smaller the risk, generally, and the lower the price.
The governor was absolutely not interested because it would " only save
about 1 to 1 1/2%--which actually is pretty big bucks, even for our school
district, not to mention state wide.

Although I wasn't pleased with the response I got from the governor, I want
to say that one of the most wonderful things about living in Minnesota is
that I, as simply an average citizen, was actually able to speak directly
with the governor in city council chambers.  I rarely agree with our
Governor, but I do respect the fact that he, as well as Minnesota governors
past, was willing to travel around the state, to listen to the concerns of
other governing bodies and ordinary citizens such as myself.  I hope that
all of us in Minnesota never take for granted our open access to elected
officials at all levels in the state.



Quote from the Pioneer Press article posted by Dwayne:

� Using "best in class" certification programs as one measure of health
care quality and then using it to chose providers and encouraging patients
to select the best providers.

� Requiring health care providers to adopt the latest administrative
technology, thereby reducing waste and duplication, particularly in claims
processing.

� Timely submission of claims and eliminating the requirement that "zero
balance" bills be mailed to consumers.

� Enhancing anti-fraud and anti-kickback enforcement, which could save up
to 3 percent in health care costs annually.

End Quote

As I look at some of the features of the Governor's plan, it strikes me that
there is an underlying presumption that health care providers are somehow
holding up the claims processing.  In my experience, this is not the case,
but rather, that some insurance companies routinely delay payment on claims,
requiring multiple submissions of claims by providers and/or patients, and
generally, generate a lot of paperwork, which in turn, generates a lot of
cost not directly related to providing health care to patients.


Quote from the Pioneer Press article posted by Dwayne:

Under the GM system, the company asks health plans to document their best
care for patients with diabetes, heart disease and other conditions and
then rates each plan before presenting all the data to employees.

Employees then select plans according to their health needs. To encourage
efficiency and quality, the company pays more for employees who go to
better plans

End Quote

My problem with this is that someone other than the patient receiving the
care decides who is the 'better' provider.  At least two key issues in
patients deciding who is the better provider for their health care needs
are:  accessibility and trust.  What if your insurance plan favors a
provider that takes a 2 hr drive to reach  or that has a waiting list for
appointments a month or more long?  No matter how good that provider's
ratings, according to, and here's the good part, the INSURANCE industry's
ratings, if you can't see the provider when you need to, without a hardship
of a long wait or a long trip, this is not the 'better' provider.  And, of
course, if you don't know or like or trust the provider your insurance
company prefers, why should you pay a penalty?  And those of us who live
outstate need to keep in mind that as these rules and best practices are
being drawn up, the model that will be used is what works best for suburban
metro, not for rural areas.

I would much rather see proposals come from health care providers, at least
for a compare and contrast.

Terri Hyle

>From: [EMAIL PROTECTED] (Dwayne Voegeli)
>To: [EMAIL PROTECTED]
>Subject: [Winona] Health Care Happenings: Houston and the Governor
>Date: Tue, 30 Nov 2004 20:04:33 -0600
>
>[Winona Online Democracy]
>
>Last week there was a news story that the Houston School District had
>dropped it's health care insurance because it's simply to expensive to
>continue.
>
>An anomaly or a sign of things to come?
>
>What do you think?
>
>Below is an article from today's Pioneer Press about a new health care
>proposal from Governor Pawlenty.
>
>What do others think about it?
>
>Dwayne Voegeli
>
>Nov. 30, 2004
>
>------
>
>Novemeber 30, 2004
>
>Major health care proposal launched
>
>Governor announces 'Smart Buy' alliance to slash costs, improve care
>
>BY TOM MAJESKI
>
>Pioneer Press
>
>------
>
>Gov. Tim Pawlenty on Monday announced a major health care initiative
that
>combines the clout of the state and private industry in a
first-of-its-kind
>purchasing alliance designed to hold down soaring costs and improve
quality
>of care.
>
>The proposal, which was developed by the governor's "Health
Cabinet," calls
>for improving administrative technology and streamlining paperwork and
>regulations. It also supports tax incentives for health savings accounts
>and targets fraud and kickback schemes.
>
>Pawlenty said the "Smart Buy" purchasing alliance was formed
as a response
>to health care cost increases that are "unsustainable." In
Minnesota, he
>added, those costs are increasing at the rate of $300,000 an hour, or
$80 a
>second. Health care now costs the average family about $14,000 a year.
>
>"It will devour the budgets of individuals, families and the state
in the
>future. It needs to be addressed significantly, boldly and
promptly," said
>Pawlenty, who estimated the alliance plan could generate savings
>approaching $12 billion, or 43 percent of the $27.5 billion Minnesotans
>will spend on health care this year.
>
>Peter Benner, special assistant to the director of AFSCME Council 5,
said
>parts of the governor's initiative are extremely important, but he
warned
>that it doesn't go far enough.
>
>"We want to buy for quality, we want to buy for good price,"
said Benner,
>whose group represents some 40,000 public employees, one of the state's
>largest unions. "Messages like that need to be sent by everybody,
whether
>they are private employees or public employees," he added.
>
>"It's an OK place to start, but we are not going to transform
health care
>in Minnesota with general statements, like we want to buy on
quality,"
>Benner said. "This is not a tight-knit group, to put it mildly. We
have a
>long, long way to go here. While it's an important step, it won't mean a
>hill of beans in 2005 and 2006 unless more is done. It's simply not
enough."
>
>Pawlenty said the "Smart Buy" alliance represents three-fifths
of the
>state's population, or about 3 million Minnesotans, making it a force
>health plans cannot ignore when negotiating contracts. "This brings
the
>thundering three-fifths of the marketplace to bear," he said.
>
>Besides the state, other participants in the alliance include the Buyers
>Health Care Action Group, Minnesota Business Partnership, Minnesota
Chamber
>of Commerce, Labor/Management Health Care Coalition of the Upper
Midwest,
>Minnesota Association of Professional Employees, Employers Association
and
>the Advocates for Market Place Options for Mainstreet.
>
>"It's not a government bureaucracy, it's an alliance,"
Pawlenty explained.
>"It's not an attempt to nickel-and-dime health care providers, it's
an
>attempt to get better value. We have one simple goal: to buy health care
>better. It preserves the marketplace but says we're going to stop buying
>stupid."
>
>Carolyn Pare, CEO of the Buyers Health Care Action Group, a coalition of
>employers, said negotiators will be using a common purchase order
patterned
>after the one developed decades ago by General Motors.
>
>Under the GM system, the company asks health plans to document their
best
>care for patients with diabetes, heart disease and other conditions and
>then rates each plan before presenting all the data to employees.
>
>Employees then select plans according to their health needs. To
encourage
>efficiency and quality, the company pays more for employees who go to
>better plans.
>
>"This isn't about benefit design," Pare said. "It's not
about moving the
>money around, it's about digging into what's being provided.
>
>"This isn't about a pool that is going to improve cost by squeezing
>discounts out of providers. This is about improving care for
everybody," he
>said.
>
>Karl Oestreich, a spokesman for Blue Cross and Blue Shield of Minnesota,
>said the state's largest health insurer supports the governor's plan.
>
>"It's a good cross section of health care buyers in the
state," he said.
>"If they can come together and speak as one voice and move some of
these
>things forward, it's a positive."
>
>Carolyn Jones, director of health care policy for the Minnesota Chamber,
>said the governor's initiative is not a drive for collective purchasing
of
>health care but rather a drive to bring buyers together to create a
market
>where customers are in charge and providers are rewarded for providing
the
>best care at the lowest price.
>
>"Individually, we will not be able to change the system,"
Jones said. "But
>if we start to send the same message at the same time and use our
combined
>purchasing power to reward those responding to the message, the
marketplace
>will change."
>
>GLANCE: THE ALLIANCE
>
>Among its ideas, the "Smart Buy" alliance calls for:
>
>� Using "best in class" certification programs as one measure
of health
>care quality and then using it to chose providers and encouraging
patients
>to select the best providers.
>
>� Requiring health care providers to adopt the latest administrative
>technology, thereby reducing waste and duplication, particularly in
claims
>processing.
>
>� Timely submission of claims and eliminating the requirement that
"zero
>balance" bills be mailed to consumers.
>
>� Enhancing anti-fraud and anti-kickback enforcement, which could save
up
>to 3 percent in health care costs annually.
>
>------------
>
>Dwayne Voegeli
>
>Winona County Commissioner
>
>(507) 453-9012
>
>[EMAIL PROTECTED]
>
>359 Pleasant Hill Dr.
>Winona, MN  55987
>
>------------
>
>
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