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Pioneer Editorial: Health care reform won't come cheap

Last week, plenty of ideas for health care reform were presented at a Bemidji forum on health care, hosted by state Sen. Mary Olson, DFL-Bemidji. Many of them made sense, and many should be considered nationally by President-elect Barack Obama when he takes office Jan. 20.

But while the high cost of health care -- which continues to rise at great leaps -- ranks near the top of everyone's priority list, the greatest priority is the economy. From the poor economy at the national level pushing us into a recession, to the $4.8 billion and growing state budget shortfall lawmakers will face when they convene Tuesday, we're simply out of money.

Rising health care costs no doubt play a role in the souring economy as well, but finding the money for true health care reform will prove daunting at both the national and state level.

After 3½ hours of testimony at Sen. Olson's forum, numerous ideas included paying rural hospitals and clinics a fair reimbursement for the public assistance patients they serve. In most cases they are reimbursed at less than 80 cents on every dollar of cost of health care delivery, forcing them to shift those costs to paying patients and therefore jacking up health insurance premiums.

There's shortage of both nurses and doctors in rural America, a problem underscored by the lower salaries that are offered in rural areas coupled with the mega-bucks urban specialists can make.

Others testified that all chronic illnesses need to be treated equally, meaning those seeking mental health treatment should receive the same health care coverage as those who have diabetes or other chronic medical disease. Bemidji's school nurse told of parents who have put off treatment for their kids because they are working poor and can't afford health coverage or refuse to seek public assistance coverage. Healthy children are healthy learners, and become productive citizens, therefore a goal is to insure all children.

All good ideas, but Dan Hess, who holds two jobs and was one of the final people to testify, hit the nail on the head. "We're already indebted more than what the federal budget is, so without anybody coming up here and saying yes, I can get by without half of what we have right now, I'm not hearing that." He alleged putting more expectations on a system that has no additional revenue will only serve to ration health care.

"I see nothing but a train wreck coming," says Hess. "I haven't really seen anything that would be a cut or an adjustment. Who can argue against not having better mental health or nurse training? But I have to be realistic ..."

There is hope that savings can come from cutting administrative costs, but how much remains a guess. Plus the move to a single-payer health care system would create a new bureaucracy which may or may not be better or worse than the ones it replaces.

Everyone wants health care reform, but how willing are people to pay for it in the hopes of seeing long-term results?