|
Minnesota needs universal health coverage
By Mary Brainerd, HealthPartners President and CEO
From the Star Tribune, July 21, 2006
The doctor in charge of Regions Hospital Emergency Department keeps the plastic patient wristbands of patients whose stories he wants to "wear on his sleeve." One is a patient with high blood pressure and heart disease, neither of which he cared for because he lacks insurance, until he had a heart attack. He required emergency services, medical procedures and several days in the hospital. Another patient had a history of blood clots in his lungs, which were controlled by medications until he lost his job and his coverage and couldn't afford medication. He nearly lost his life from a pulmonary embolism, and had many days of intensive (and costly) treatment.Many of us know someone who doesn't have health insurance. It only takes one trip to the emergency room to understand the cost of being uninsured. Universal health insurance could improve the quality of life, and improve health in our state. You may be thinking, "hold on to your wallets." In reality, universal health insurance may not add costs to our system; we already pay for the costs of care for the uninsured in the most costly and sometimes least helpful settings.
I do not mean a government-run, single-payer system. Massachusetts recently created a landmark law to provide universal coverage to all its citizens through the private market. Massachusetts proposal combines individual responsibility through an individual mandate with new lower-cost insurance options and government subsidies, to ensure affordability. I applaud Massachusetts leadership. However, Minnesota is better poised to provide universal coverage than Massachusetts. We have the lowest rate of uninsured in the country. We have a sustainable government program in place through MinnesotaCare. And, we have employers that understand the value of providing health benefits for employees. We also have a better insurance market structure for smaller employers. So, what are we waiting for?
Universal coverage should be a priority. Health insurance reduces mortality rates by 10-15 percent; educational attainment and annual earnings increase significantly with health care access; and people with health insurance live longer and healthier lives. As costs increase, universal health care may even out the playing field in two ways. First, people who are uninsured often delay medical care until its an emergency. Care delivered in an emergency room costs everyone more. When uninsured individuals cannot afford the costs of emergency room visits or hospitalizations, they go into the system, increasing costs for everyone. Delays in treatments can result in more serious, less treatable health conditions or poorly managed chronic illnesses -- a tragic outcome for the individuals and another cost issue. More participants in the pool of people with health care coverage spreads costs across a larger population, stabilizing costs. Individuals are generally uninsured because they: 1) are eligible for government programs but unaware of it, 2) choose not to buy coverage, (typically young, healthy individuals who don't think it's worth it), 3) are ineligible for government programs because their incomes are too high, but are unable to afford private insurance. We can address these issues.
First, we need to identify those who are eligible for government programs and enroll them. Almost 60 percent of Minnesota's uninsured population is potentially eligible for an existing program, but doesn't know or hasn't enrolled. Like Massachusetts, we can enroll them by requiring that all individuals have health insurance. The requirement to have coverage must be enforced. We also need to offer affordable coverage for those who are ineligible for government programs. By creating more affordable and easily accessible insurance products, expanding eligibility for programs like MinnesotaCare, or a combination of the two, we can close the gap.
Without universal health coverage, we put our future at risk. A growing number of the uninsured in our state are children and a healthy start to life, together with a quality education is the foundation for the future health of our children and our community. We have the infrastructure to make universal coverage a reality. Let's take action.
|
|
