With Healthcare, We’re Patients, Not Consumers

Nurse Talking To PatientBy Rose Roach, MNA Executive DirectorRose photo

I was honored to serve on Governor Dayton’s Health Care Financing Task Force, which completed its work on January 15, 2016 with a package of recommendations to be forwarded to the Governor and the Legislature. On behalf of the nurses I represented on that task force, I proudly voted yes for the overall set of recommendations which included important steps in providing better access and in some instances, more affordable, healthcare options for patients including: extending MinnesotaCare to cover people up to 275% of Federal Poverty Level; repealing the sunsetting of the provider tax that is needed to continue MinnesotaCare; covering adult immigrants and their children, regardless of immigration status, up to 200% of the Federal Poverty level; and funding an economic study to determine the long-term financing for a healthcare system that puts people over profits. Even with those compassionate, patient-focused recommendations, I encouraged the task force to take a serious look at the long-term efficiency, or lack thereof, of our current, broken system. Instead of being distracted by more acronyms (as I say, HMOs, ACOs, EIEIOs) and complicated provider payment schemes, it’s long past time we focus on the real cost drivers in healthcare: lack of access to primary care and care coordination, administrative inefficiency within the system, and out-of-control prices.

The fact is we will never get serious about fixing what has become an exceedingly complex, costly, and, quite frankly, inhumane health care system until we recognize that health is not a consumable good. It’s a public good, and it’s in all our interest to keep each other healthy. We don’t go out and choose our type of cancer or chronic disease. Market competition is a misnomer in healthcare since no one is competitively bidding on who gets to cover the costs of the brain tumor or liver transplant. It’s literally ridiculous to think we should, or even can, compare prices when we’re inflicted with illness because number one—we’re sick so our focus is on getting healthy and surviving, as it should be. Secondly, the “prices” are shrouded in secrecy so even if you wanted to know the actual price you won’t be able to find it. To pretend we can actually shop for healthcare, basically shop for our very existence, so we can get the cheapest chemotherapy or coronary bypass surgery is a false premise. This is our health we’re talking about, it just doesn’t work that way.

The issues raised within the Healthcare Financing Task Force have made it very clear that we must deal with financing the system before we can really begin to deal with the care delivery issues. It’s long past time to have that debate, in earnest, going beyond top line ideology and getting serious about the real bottom line in healthcare, which is the health of the patient. When people are healthy , we impact the health of the community and save money for family’s bank accounts, businesses’ employee expenditures, and government budgets. It’s simple, everybody in, nobody out. One big pool with no more segregating and fragmenting us based on income, geography, employment, citizenship status, age, gender, etc. The healthy and young counterbalance the not-so-healthy and not-so-young.  People get the care they need when they need it. We save money overall while care is put back into the hands of doctors and nurses and healthcare professionals, which will absolutely improve quality.

There is more than enough money in this healthcare system. We just need to get serious about reallocating precious healthcare dollars to actual care and to those who provide it—by doing so we’ll all be healthier, in mind, body, spirit, and pocketbook. We can’t keep pretending that we will figure out a way to make private insurance markets work for everyone. We’ve already had more than a half century of that system, and it’s not working. Enough is enough. As we pass along some very good and much needed recommendations for expansion of access to care to the Governor and Legislature, let’s all make a commitment to our fellow Minnesotans, on behalf of our humanity, to finally elevate healthcare to its rightful place as a human right.