Showing posts with label HMO. Show all posts
Showing posts with label HMO. Show all posts

Sunday, August 14, 2011

Onward to Health Care Reform V


In an earlier Blog I wrote about a bill introduced by DFL Sen. John Marty in the Minnesota legislature to address concerns about the high cost of state public plans that use HMOs for administration.  A similar bill was introduced by Republican Sen. Sean Nienow.  Neither bill was included in the final bills passed by the legislature.  The Minnesota Universal Health Care Coalition (MUHCC) then encouraged people to contact the Center for Medicare and Medicaid Services (CMS) at the federal level to not approve a waiver to continue using HMOs for processing Medicaid payments.  Unfortunately CMS approved the waiver, but they now require the HMOs to submit financial reports quarterly and annually along with additional reporting requirements.  We'll see whether this bears any fruit in cost containment.
 
Joan and I traveled recently to the city of Tracy in SW Minnesota for a Health Care Forum.  The forum had local community leaders discuss our current health care system and possible reforms that can increase access and lower cost.  Dr. Michael DeBrule of Marshall, MN moderated the discussion and gave an excellent talk on what is wrong with our health care system and why the Minnesota Health Plan (MHP) would solve the cost problems, and provides high quality coverage for all Minnesotans.  Approximately 40 people attended the event, asked many questions and showed interest in the plan.  Several people have stepped up to build a regional team to educate in the SW Minnesota region.  We are finding that Greater MN is very receptive to changes in how we pay for our health care.
 
The Minnesota Universal Health Care Coalition (MUHCC) in May hosted an event at the Park Square Theater in St. Paul, titled "Artists on Stage for Health Care".  The event is part of the "Campaign for the Minnesota Health Plan".  The event was a combination of health care stories, artists performing, and information on why and how to reform health care in Minnesota.    
 
 
 Those of you  who have access to the Northfield Public Television (NTV) cable channel 12 can view the event on Tuesday, 8/16/2011. at 9pm and on Sunday, 8/21/2011, at 8:30pm.  The show is entertaining and informative.  I have a DVD copy of the show and can make it available for public showing.  Give me a call or email if your interested; 507-645-0094, sjanusz@charter.net.

Wednesday, February 16, 2011

Onward to Health Care Reform


We, Joan and Steve Janusz, have been invited to contribute to the SD 25 web site. For the past three years we have educated ourselves on our health care system focusing on accessibility and payment. It’s been quite a roller coaster ride!

There are four major conclusions we believe:
1. Health care is an issue of justice; everybody has a “right” to quality health care

2. Our present health care payment systems are very costly and we can’t sustain the increasing costs

3. To rein in the costs and pay for health care everybody must contribute to a fund, based on their ability to pay

4. To change how we pay for health care requires a grass roots movement similar to how woman’s suffrage and civil rights were won; not something for the faint of heart!

We will use the Senate District 25 DFL web site to pass on information about happenings at the State and Federal levels regarding health care reform, with an occasional dose of our own thoughts and insights.

To get started: last week we attended two state house legislative health committee meetings. Both meetings focused on Medical Assistance (MA) and Minnesota Care (MN Care) which are public plans paid by the State. The administration of these plans is primarily contracted with insurance companies (HMO’s). It was interesting to observe a less contentious setting than last year’s session.

Before the first meeting there was a mini rally in support for better transparency between the public plans and the HMO’s. This was triggered by the statements made by David Feinwachs, former General Counsel of the MN Hospital Association. David dared to point out that the $3 billion given to the HMO’s remains unaudited.

The Health and Human Services Finance committee meeting had a full room of observers which surprised the chairperson. Presentations were made by the Minnesota Medical Association (MMA), MN Department of Human Services, David Feinwachs, and a representative from the Minnesota Council of Health Plans (Blue Cross, Ucare, etc.). The committee was striving to understand the costs of the public plans to the state. It was interesting how the legislators looked to David Feinwachs several times to help interpret things being said by the other presenters. Our overall impression was the legislators were not fully accepting what the HMO’s were presenting.

The Health and Human Services Reform committee meeting followed. This meeting focused on an overview of the public plans, implementation of the Expanded Medical Assistance program, and future changes that lie ahead with the Federal Affordable Care Act (ACA). The Expanded MA program is a result from provisions in the Federal ACA. At this point the plan is to enroll the approximately 95,000 people in the Expanded MA program through the State Dept. of Human Services (DHS). Then DHS would assign each of these people to an HMO. Thus, the insurance companies would end up with all 95,000 people. Because of expressed concerns and protests that question transparency and cost, it is hoped the DHS will reconsider this approach.

We realize from listening to these committees how complicated the rules are and procedures that exist with our public state health care plans.

Finally, there is a wonderful opportunity next Wednesday to learn more about health care reform. T.R. Reid, noted journalist, who produced the PBS Frontline documentary “Sick Around the World” and written the recent book “The Healing of America” is coming to Minnesota. See the below flyer for specifics on the event. Help spread the word about the event!


(c)2011 Senate District 25 DFL / Steve & Joan Janusz. All rights reserved.

Note:  Opinions expressed in this article are that of the authors and do not neccessarly reflect the views of the Senate District 25 DFL or DFL in general.