Access to affordable health care is a right, not a privilege, and Minnesotans should vote to include that in the State Constitution, says Sen. Linda Berglin.
"Ninety-one percent of Minnesotans believe that health care should be available to all citizens regardless of their income or their employment," Berglin, DFL-Minneapolis, said earlier this week in a telephone interview.
"We also know that the problem is just going to get worse if we don't address it in a comprehensive way," she said of rising health care costs, and in citing another survey showing 52 percent of Minnesotans fear losing their current health insurance.
Berglin, chairwoman of the Senate Health and Human Services Budget Division, isn't happy at the way the Legislature has been dragging its feet over meaningful health care reform, but believes she has the answer.
By having voters this fall approve a State Constitution amendment question, lawmakers would be forced to come to grips with the issue.
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Berglin's bill would have the Constitution amended that "every resident of Minnesota has the right to health care." But it would also provide that "it is the responsibility of the governor and the Legislature to implement all necessary legislation to ensure affordable health care."
Debate may hinge on what might be considered "affordable," but Berglin estimates that for most poor and low-moderate income Minnesotans, affordable means 1 to 10 percent of family income.
The bill has the support of about two dozen organizations, such as the Minnesota Hospital Association, Children's Defense Fund, Minnesota AFL-CIO, Minnesota Nurses Association and a host of other unions.
The groups believe that "the growing problem of health care costs is starting to drain the system," said Tara Garman of the Minnesotans for Affordable Health Care, the umbrella group pushing for the ballot question.
"It should be a basic right," she said of health care. "People should be able to have affordable health care and preventative care. ... It's something we take very seriously and we think that because of the depths of our problem, the solution has to be as dramatic as the problem."
Serious health care reform won't happen unless Minnesotans speak out, and they can do that by making health care a constitutional right, Berglin believes.
"I really believe it's not going to happen unless the citizens speak out that they want this in our Constitution, and then we will see a coming together of various ideas and various proposals and very strategies within the Legislature to get us to a reformed health care system," Berglin said.
A Families USA survey of health care costs in 2005 showed that families with private or employer-sponsored care are paying an average $386 more in higher premiums just for the health care of the uninsured through uncompensated care in hospitals, Berglin said.
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And that will grow by 2010 to $650 per family, she said.
"Emergency room care in hospitals is one of the most expensive ways to access the system that there is," Berglin said. Typically, uninsured people will wait until a serious health problem sends them to the emergency room, demanding high cost care.
"It's also one of the least successful in terms of outcome for the patient," she added. "Oftentimes people arrive at the emergency room just too late in the stage of an illness to recover fully from that health care encounter."
North Country Regional Hospital could be a poster child, says Jim Hanko, North Country Health Services CEO.
"A significant proportion of our ER traffic are people who, for whatever reason, choose the emergency room," Hanko said. "For many, it's become the primary source for their primary care -- maybe the only source for their primary care."
ER visits at North Country have risen from 17,000 in 1998 to estimates of more than 22,000 this year, he said. And, with that, the hospital's share of uncompensated costs is rising at nearly the same rate, "a pretty scary rate," he added.
"It's just hugely expensive to provide care in the emergency room for the system, when an office visit would be more preventive and much less expensive," Hanko said.
A constitutionally guaranteed right to health care also needs incentives, Hanko argues.
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"We need to build incentives into this right to health care that makes people accountable for using the right health care resources at the right time," he said. "That means primary care for primary care problems, and not the emergency room for primary care problems."
The system suffers when high-cost care for the uninsured is cost-shifted to those who do pay, forcing health care costs up for everyone, both Berglin and Hanko said.
"When you try to cost shift," Hanko said, "it cost shifts to you and me who have health insurance through employment, but we also spend an awful lot of time knee to knee and toe to toe and eyeball to eyeball with Blue Cross just trying to make sure we get a good deal from them in terms of our contract. And we always haven't."
Prospects of the bill in the House are unsure. The House Policy and Finance Committee last week was to consider a similar measure, but it was withdrawn by the DFL.
"In this tightly scheduled session, we gave the DFL the opportunity to present their major health care proposals," says the panel's chairman, Rep. Fran Bradley, R-Rochester. "The committee does not plan to revisit these issues."
But Berglin said the bill which was pulled, authored by Rep. Neva Walker, DFL-Minneapolis, provided the constitutional question of making health care a right but also would require developing a single-payer, universal health care system in Minnesota by 2010.
Rep. Tom Huntley, DFL-Duluth, will carry Berglin's version, which requires lawmakers to "ensure affordable health care." The hope is to scan a variety of systems to find the best mix for Minnesota, she said, not require a single-payer system.
"It's a different bill than the one they heard," Berglin said, "and I hope they would give it a shot at a fair hearing."
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Huntley's bill has bipartisan support as it may find Rep. Larry Howes, R-Walker, as a co-author.
"I'm very interested in it as a second author," Howes said. "It is something to look at."
Howes says the constitutional right to health care would help ensure that all Minnesota children have coverage.
"I want to know how we can ensure that my grandchildren and Carl Pohlad's grandchildren are covered," he said of a right which is blind to family income. "I want the amendment framed to take care of the kids."
"Health care is a topic of discussion at the Legislature, but we don't get very far," Berglin said. "We discuss how to gain back what we've lost, how to keep from going backwards."
Hopefully, that will change with making health care a constitutional right, allowing people to seek preventive care before straining the system with high-cost emergency care, Garman said.
"The only way we can actually contain costs is to make sure that people get preventative care at the beginning of illnesses," she said, "before it becomes so expensive when they are in the emergency rooms or in hospital stays where they can't afford their bills."
