The following is from Minnesota COACTS's Spring newsletter. COACT http://coact.org has been working on and organizing for single payer medical insurance for years. They deserve lots of credit for their vision and persistence. -- Tim
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| COACT members demonstrating for single payer in January 2018 |
Single-payer’s popularity being used to promote health
care proposals, some of which may need a closer look.
Beware of proposals that funnel tax dollars through insurance companies in disguise.
By setting uniform prices, single-payer removes the
incentive for clinics and hospitals to merge into large
chains; whereas, under provider groups , health care
will further consolidate into a few huge corporations.
Because health care is the top campaign issue and
because proposals are called single-payer , voters
deserve to know which ones are genuine. Therefore,
COACT and Health Care for All MN (HCAMN) are
clarifying the differences by explaining the principles of
single-payer, which define the Minnesota Health Plan.
Expanding MinnesotaCare to everyone may be the
first step to get there, if it is administered directly by
state government without HMO-provider groups .
Note: Don Pylkannen of COACT sent me the following note regarding Gov. Daytons position:
"Gov. Dayton has publicly supported single-payer since 2010 when he first ran for Governor, although he hasn’t specified Sen. Marty’s Minnesota Health Plan. In 2016, he budgeted $500,000 to fund a study to compare the cost savings of a state single-payer system vs. free-market insurers. Although the DFL-majority Senate passed the budget proposal, it was not voted on in Conference Committee (of both DFLers and Rs), possibly due to pressure from the HMO lobby for fear of the results."
Beware of proposals that funnel tax dollars through insurance companies in disguise.
Capitalizing on single-payer s popularity, some
gubernatorial and legislative candidates are proposing
a one-government payer to pay for universal health
care with tax dollars. This may sound like single-payer,
but voters should be wary of who gets those dollars.
If our tax dollars directly pay doctors and hospitals of our choice, this may be single-payer. Otherwise, if tax dollars are first funneled through organizations not called insurance companies, but which function the same as insurance companies, this is not single-payer.
Therefore, watch out for proposals that pay these insurance companies in disguise which are called “provider groups” (hospital-clinic chains) with such names as Accountable Care Organizations (ACOs), Integrated Health Partnerships (IHPs), or Integrated Delivery Systems. These are still HMO-run groups that need to make a profit off the tax dollars they get.
Type of insurance risk distinguishes true single-payer from false single-payer
These HMO-provider groups (ACOs, IHPs, etc.) bear the kind of insurance risk in which they stand to make money if they can stay below a target level of annual spending, and they stand to lose money if they go over it. Therefore, they must micro-manage their doctors to ensure medical care abides to the group s profit margin. Furthermore, they incur the same wasteful expenditures of insurance companies such as advertising and marketing, and exorbitant CEO and management salaries, so less goes to patient care.
On the other hand, a true single-payer bears the kind of insurance risk which is spread throughout a single statewide pool that includes the healthy and less healthy. And everyone- rich and not rich- pays into it, according to income, which lowers cost and saves money, so everyone gets the care they need when they need it. Patients health is primary, not profit.
Under a true single-payer system, such as the Minnesota Health Plan, the one-government payer bears all insurance risk; it does not offload that risk on to the HMO-provider groups of ACOs or IHPs.
The one-government payer does not attempt to control costs by shifting risk off itself. Rather, it saves money by cutting administrative waste and negotiating fair, uniform reimbursement rates for hospitals, clinics, and medical device and drug companies.
If our tax dollars directly pay doctors and hospitals of our choice, this may be single-payer. Otherwise, if tax dollars are first funneled through organizations not called insurance companies, but which function the same as insurance companies, this is not single-payer.
Therefore, watch out for proposals that pay these insurance companies in disguise which are called “provider groups” (hospital-clinic chains) with such names as Accountable Care Organizations (ACOs), Integrated Health Partnerships (IHPs), or Integrated Delivery Systems. These are still HMO-run groups that need to make a profit off the tax dollars they get.
Type of insurance risk distinguishes true single-payer from false single-payer
These HMO-provider groups (ACOs, IHPs, etc.) bear the kind of insurance risk in which they stand to make money if they can stay below a target level of annual spending, and they stand to lose money if they go over it. Therefore, they must micro-manage their doctors to ensure medical care abides to the group s profit margin. Furthermore, they incur the same wasteful expenditures of insurance companies such as advertising and marketing, and exorbitant CEO and management salaries, so less goes to patient care.
On the other hand, a true single-payer bears the kind of insurance risk which is spread throughout a single statewide pool that includes the healthy and less healthy. And everyone- rich and not rich- pays into it, according to income, which lowers cost and saves money, so everyone gets the care they need when they need it. Patients health is primary, not profit.
Under a true single-payer system, such as the Minnesota Health Plan, the one-government payer bears all insurance risk; it does not offload that risk on to the HMO-provider groups of ACOs or IHPs.
The one-government payer does not attempt to control costs by shifting risk off itself. Rather, it saves money by cutting administrative waste and negotiating fair, uniform reimbursement rates for hospitals, clinics, and medical device and drug companies.
Differences between single-payer and
substitutes being clarified for citizens
Where the candidates stand on single-payer
At this point, the gubernatorial candidates positions range from support for the Minnesota Health Plan to expanding MinnesotaCare to provider groups .
State Auditor Rebecca Otto’s Healthy Minnesota
Plan proposes a one-government agency to pay
provider groups to which all insurance risk will be
shifted. The Plan is based on the unproven theory that
managed care insurers (HMOs) save money.
At this point, the gubernatorial candidates positions range from support for the Minnesota Health Plan to expanding MinnesotaCare to provider groups .
Rep. Tina Liebling supports the Minnesota Health
Plan by citing her continued support of the bill and
stating that a system that pays multiple health plans
to provide care is not a single-payer system. (Note: Rep. Libeling dropped out after the newsletter was published.)
Rep. Erin Murphy supports a single-payer system by first opening up MinnesotaCare to everyone and contracting directly with providers.
U.S. Rep. Tim Walz believes a single-payer type system is on Minnesota s horizon ; meanwhile he recommends expanding MinnesotaCare.
Rep. Erin Murphy supports a single-payer system by first opening up MinnesotaCare to everyone and contracting directly with providers.
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| Erin Murphy |
U.S. Rep. Tim Walz believes a single-payer type system is on Minnesota s horizon ; meanwhile he recommends expanding MinnesotaCare.
All DFL and GOP candidates for governor agree that
health care is the top priority in the 2018 election,
according to what voters are telling them (Star Tribune
12-3-17). But how can voters determine which
proposals will work for them and not more HMO profits?
Here are the Minnesota Health Plan’s principles that can be applied to any of the proposals (GOP or DFL) to see how well they will work.
Will the proposal 1. Eliminate the bureaucracy of multiple insurance companies?
2. Contain costs by cutting wasteful overhead, not by denying care?
3. Ensure everyone gets quality care?
4. Be affordable based on ability to pay?
5. Allow choice of doctors and hospitals?
6. Provide all types of medical care?
7. Focus on preventive care and early intervention?
8. Ensure enough providers to guarantee timely care?
9. Continue Minnesota s leadership in medical education and research?
10. Pay providers adequately and on time?
11. Use a simple funding and payment system?
Here are the Minnesota Health Plan’s principles that can be applied to any of the proposals (GOP or DFL) to see how well they will work.
Will the proposal 1. Eliminate the bureaucracy of multiple insurance companies?
2. Contain costs by cutting wasteful overhead, not by denying care?
3. Ensure everyone gets quality care?
4. Be affordable based on ability to pay?
5. Allow choice of doctors and hospitals?
6. Provide all types of medical care?
7. Focus on preventive care and early intervention?
8. Ensure enough providers to guarantee timely care?
9. Continue Minnesota s leadership in medical education and research?
10. Pay providers adequately and on time?
11. Use a simple funding and payment system?
Note: Don Pylkannen of COACT sent me the following note regarding Gov. Daytons position:
"Gov. Dayton has publicly supported single-payer since 2010 when he first ran for Governor, although he hasn’t specified Sen. Marty’s Minnesota Health Plan. In 2016, he budgeted $500,000 to fund a study to compare the cost savings of a state single-payer system vs. free-market insurers. Although the DFL-majority Senate passed the budget proposal, it was not voted on in Conference Committee (of both DFLers and Rs), possibly due to pressure from the HMO lobby for fear of the results."
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