3:00 p.m. The Center for the Study of Politics and Governance is hosting a conference on health care, entitled: “Market-Based Reforms in Health Care: The Next Step?” The first presenter is Minnesota Governor Tim Pawlenty, with Larry Jacobs, Director of the Center, serving as moderator.
3:01 p.m. Pawlenty signed health care legislation in 2008, such as requiring all health care providers to use e-prescribing, creating patient-centered ‘health care homes’ to provide comprehensive primary care, and establishing payment reform based on financial incentives with the aim of improving quality and reducing cost.
3:05 p.m. The Governor makes his way into the auditoirium with a diet coke in hand “to help stay awake” he says as he shakes the hand of a member of the audience. Perhaps the budget crisis is forcing the Governor to keep some late hours these days. The topic of the day aside, it would be interesting to get Pawlenty’s perspective on yet another gubernatorial legal scandal that came to a head today in the state of Illinois (joining the former Ohio Governor Taft from a few years ago as Midwestern executives in hot water; not to mention the scandals involving Governors James McGreevey of New Jersey in 2004 and Eliot Spitzer of New York earlier this year).
3:15 p.m. Pawlenty begins his talk today on market-based reforms in the health care industry. The Governor discusses how access, quality, and cost of health care are in conflict, and that equal weighting must be given in order to improve the health care system.
3:22 p.m. Pawlenty talks about how the fee-for-service system of health care gave way to the HMO-ization of the marketplace in the early 1990s to innovate the health care delivery system in the Gopher State. The net result is that the state has 3 or 4 dominant providers that account for approximately 90 percent of the marketplace – for better or for worse.
3:25 p.m. Pawlenty says approximately 90 percent of Minnesotans are insured – noting the state has been “reasonably successful” in keeping the number of uninsured residents to a fairly low number, compared to other states nationwide. The Health and Human Services portion of the state’s budget went up 18 percent from the last biennium, says the Governor. The health care portion of that budget increases approximately 21 to 22 percent each budget cycle (with an economy that is barely growing). Over time, the Governor says this is mathematically unsustainable and will consume the majority of the state’s budget within twenty years (with the federal government on a similar trajectory with its health care budget).
3:32 p.m. Health care was not listed among the Governor’s top priorities in terms of his view of the state’s budgeting process. Last week, at his news conference, Pawlenty listed military and veteran’s as the top priority, followed by public safety and K-12 education).
3:33 p.m. Pawlenty projects the cost of health care for the state of Minnesota will be reduced by 12 percent (that is, 12 percent less than costs would have increased, not a net loss) based on the legislation Pawlenty signed as described above.
3:35 p.m. Pawlenty says consumers need to understand the price and the offering of health care services in readily understandable terms in order for market-based systems to work — price transparency in a user-friendly format. The Governor says consumers currently do not have incentives to know the price or quality of information of health care services under the current system.
3:42 p.m. The Governor is somehwat pessimistic as to the future of health care reform at the federal level, stating it will be like the Massachusetts Plan, perhaps without the mandate.
3:49 p.m. Pawlenty says one way to increase efficiency is to get all providers in the state to use the same billing code.
3:52 p.m. In a question and answer session, Pawlenty says the one silver lining to the “horrific” economic situation is that it will provide opportunities for reform in all budget areas – finding ways to do things better (and cheaper).
3:55 p.m. When asked about the wisdom of a single-payer system, Pawelnty flatly states that Minnesota is almost there now – with four major providers in the state.
4:01 p.m. When asked about the direction of health care at the federal level, Pawlenty jokes that he doesn’t want to relive the recent election as it was “Difficult for me enough as it is” (playfully referring to his non-sleection as VP nominee).
4:08 p.m. The second panel now convenes:
Tony Miller, CEO, Carol
Linda Berglin, Member, Minnesota Senate
Mary Brainerd, President and CEO, Health Partners
Lois Quam, Managing Director, Alternative Investments, Piper Jaffray Companies
The panel is moderated by Tom Forsythe, VP of Corporate Communications, General Mills.
4:11 p.m. State Senator Berglin says the next step for health care reform is to implement what was passed in the last legislative session – in the clinics, the hospitals, and other care-giving situations. She says the state has provided the menu and prepared the banquet, but the question remains ‘Will anyone come?’
4:13 p.m. Berglin says much more needs to be done in the area of primary care, whereas the current system drives people with even small ailments to specialists, as that is where the big money is.
4:17 p.m. Berglin says simply because one pays more for health care doesn’t mean one is getting a better quality of care – in fact, the opposite is likely.
4:19 p.m. Mary Brainerd says 25 percent of all health care costs revolve around “smoking, sitting, and supersizing.” Brainerd says there is too much waste and overuse of health care services, and these substantive issues need to be addressed if the reduction of health care costs is ever going to be achieved. The federal government must step in on efficacy issues, she adds, and that federal involvement is necessary, as, without it, the changes implemented by the state of Minnesota will not solve the big problems of health care for its residents.
4:26 p.m. Lois Quam says the issue of market-based reforms in health care is particularly of interest now, in light of the recent (mis)management of the nation’s financial markets. Quam says there has been an “impoverished conversation” in the cold war between those who want government involvement in health care and those who do not. Quam says the state of Minnesota has been resting on its laurels for too long – things the state used to do better and now does not (such as the rate of uninsured children – Minnesota used to lead the nation as having the lowest rate, and has now dropped behind states like Alabama, says Quam).
4:31 p.m. Tony Miller says the issue of health care should be deeply personal for every citizen. Miller says the list of what needs to be reformed about health care has looked the same for the past 20 years – and yet little has changed. Miller believes people should act as advocates and consumers, and not patients, and demand a high-quality system from their providers.
4:39 p.m. Quam says she is confident that Senator Tom Daschle will provide good leadership as Secretary of Health and Human Services in the new Obama administration.
4:43p.m. Miller says to think the country will move to a market-based only system or single-payer only system is ‘insane.’
4:56p.m. Forsythe concludes by characterizing the health care crisis thusly: “the wheels have come off the wagon.”