On MinnesotaCare Buy-In Option, Legislators Must Put Patients Over Lobbyists

Why can’t the Minnesota Legislature give consumers a MinnesotaCare buy-in option so that they have a guaranteed health insurance coverage option, more doctor choices, and much better price competition?  An army of corporate lobbyists say it’s because reimbursements to the health care industry would be lower under that approach, an argument that froze legislators into inaction during the 2019 legislative session. 

To be clear, if that argument prevails, Minnesota lawmakers will never contain health care costs.

To contain costs, policymakers have to lower the amount of money going to the major cost drivers — insurance overhead, doctors, nurses, medical devices and pharmaceuticals.  If politicians reject a reform every time lobbyists for those cost-drivers object about getting lower reimbursements, they will never contain consumer costs.

Let’s look at one of those cost-drivers, physicians.  Politicians like to complain about insurance overhead and pharmaceuticals, for very good reasons, but that’s too easy.  Let’s look at the most sacred of health care’s sacred cows.  Doctors have an abundance of fans, campaign donating power, and lobbyists, so politicians are especially afraid to direct cost-control efforts at them. 

When you look at the long list of developed nations where physicians are paid less than in the U.S., paying less for doctors seems reasonable and doable.  For example, the average specialist in the U.S. earns $230,000 per year, while the average specialist in other industrialized nations receives less than half that amount, $107,000 per year. 

Remember that the next time you hear physicians and their lobbyists complaining about reimbursements being too low.

Oh and by the way, the health outcomes in those developed countries with modestly paid physicians are better than in the U.S. So don’t buy the claim or inference that better pay automatically leads to better care.  It doesn’t.

And about those pharmaceuticals.  American patients pay much more for pharmaceuticals than patients in many other developed nations around the world.  Remember that the next time you hear lobbyists complaining about Medicare and Medicaid reimbursements being too low.

(On this front, the Minnesota Legislature needs to pass legislation to allow importation of Canadian pharmaceuticals, as I argued a while back.  Florida recently passed such a bill, but Minnesota politicians remain frozen by health care lobbyists.)

A Minnesota Care buy-in option — branded as “ONECare” in Minnesota by Governor Tim “One Minnesota™” Walz — would ensure that every Minnesotan always has at least one health insurance option available to them, which is particularly important in remote rural areas.  It would give them broader networks of caregivers, which again is important to Greater Minnesota residents.  It would provide comprehensive benefits and a service that gets good consumer reviews. It would bring better price competition to hold down the health insurance costs.  Those all would be huge benefits for hundreds of thousands of Minnesotans.

But not if Minnesota politicians get cowed into inaction every time corporate health care industry lobbyists complain about receiving lower reimbursement rates. If this group of legislators won’t do the right thing on a MinnesotaCare buy-in option, we should elect a new group who will.

MN DFL Should Champion Importation of Canadian Medications

Here’s a political idea for the DFL: Find a massively expensive thing that enrages voters.  Then make it dramatically cheaper. Oh, and do it without increasing government spending or taxes.

I understand the skepticism.  It does sound akin to the classic Student Council President campaign promise to reduce the cost of cafeteria soda — a crowd-pleaser but infeasible.

But there actually is such an issue available to Minnesota state leaders –empowering Minnesotans to purchase cheaper prescription medications from Canada.

According to drugwatch.com, prescription drugs are on average 65 percent cheaper in the Canada than they are in the United States. This is because Canada has huge government controlled health care plans using their purchasing power to negotiate lower prices from the pharmaceutical industry, and the U.S. doesn’t. Minnesota state lawmakers can’t change the underlying problem driving high drug prices in the U.S., but they could at least allow U.S. citizens to benefit from the more sane Canadian system.

After all, the Vermont Legislature just did it. Why not Minnesota?

In the upcoming 2018 elections, this should be the top issue Minnesota DFL state legislative candidates stress. Making more affordable Canadian medications available to Minnesotans would improve the lives of ordinary Minnesotans, and it’s a huge selling point with voters. Just ask Mark Dayton, who in 2004 made a lot of political hay by financing busloads of senior citizens going to Canada on medication shopping trips.  This proposal is similar, but it eliminates the long bus rides.

Nearly two-thirds of Americans like this idea. By an overwhelming two-to-one margin, a Kaiser Family Foundation survey found Americans support “allowing Americans to buy prescription drugs from online pharmacies based in Canada.”

This is an easy-to-understand issue to explain the difference between Republicans and DFLers to swing voters, and it especially appeals to seniors, who are the most likely to show up to vote.

This issue communicates important messages:  DFLers hear voters who are struggling to pay their medical bills; Republicans don’t. DFLers are proposing something real and tangible to control health care costs; Republicans won’t. DFLers will put the interests of ordinary Minnesotans over special interest lobbyists; Republicans won’t.

Coupled with the DFL’s MinnesotaCare for All buy-in option, offering cheaper Canadian medications would give Democrats the upper hand on perhaps the number one issue in the 2018 elections.

I can already hear overthinking DFL wonks explaining why they shouldn’t do this. President Trump won’t allow it to happen, they’ll say. I say force Trump’s hand. Though Trump’s HHS Secretary, a former pharmaceutical company executive, calls it a “gimmick,” Trump enthusiastically proposed this very idea during the campaign.

“…the last provision of his new seven-point plan is: “Remove barriers to entry into free markets for drug providers that offer safe, reliable, and cheaper products.”

“Congress will need the courage to step away from the special interests and do what is right for America,” the plan says. “Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe, and dependable drugs from overseas will bring more options to consumers.”

So, either make an honest man of Trump or expose him and his congressional Republican enablers for flip-flopping and being the cause of outrageously high drug prices.

This is the right thing to do, and it’s an extremely popular thing to do.  Empowering Minnesotans to benefit from more affordable Canadian medications should be one of the centerpieces of Minnesota DFLers’ 2018 campaigns.