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That reform sure doesn't go very far

Perhaps Minnesota can take the lead by embracing truly universal care

By Nick Coleman
Minneapolis Star Tribune, March 27, 2010

After she was diagnosed with kidney cancer, my mother was given a prescription for a daily chemotherapy pill that has been shown to extend the lives of patients with that cancer. When I went to pick up the medicine, the pharmacist asked if I had received financial counseling. No, I said, wondering why we were talking finances, not health care. Just how much is this prescription?

I almost needed a doctor when she told me: The first 28 pills would cost my mother $4,607 -- a full 40 percent of her meager annual income from Social Security.

I ended up buying one week's worth -- seven pills -- giving me time to try to figure out how we could afford a month's supply of a medicine that is fully covered in England and France: Kidney cancer patients in those countries do not have to pay for the medicine my mom needed. Perhaps that's the kind of anti-American thing that Gov. Tim Pawlenty had in mind when he denounced the Obama administration's health care reform bill as a foreign measure built on a "European approach" -- you know, the funny idea that people shouldn't be bankrupted by their medical care.

My mother passed away before I had to go back to the pharmacy for more pills, dying days before the health care reform bill passed. But I doubt she would have been comforted to find out that the great reform effort would mean she would get a whopping $250 rebate on that $4,607 chemo bill, or that if she lived until 2020, the "donut hole" in her Medicare drug coverage would finally be eliminated.

If this is "reform," it is at a snail's pace, a mammoth effort to bring forth a mouse.

Give President Obama credit for getting the bill passed over the shouts of temper-tantrum Tea Partiers and their red-faced enablers in the GOP. But the final bill fell far short of what was first proposed, has gaping holes, leaves gluttonous insurance companies still in charge of health care (Minnesota-based UnitedHealth Group posted a $3.8 billion profit last year) and doesn't even require insurance companies to insure adults with preexisting medical conditions until 2014. If they're still alive.

Still, passage of the national measure, as limited as it may be, gives us a glimmer of an idea of what real reform might one day look like. And one promising part of that picture might emerge in Minnesota, where the Minnesota Universal Health Care Coalition (www.muhcc.org), an alliance of physicians, unions and reformers, is pushing for a single-payer system.

Minnesota could become the next Saskatchewan. And that would be good.

Saskatchewan was the first Canadian province to adopt a single-payer health care system, paving the way for Canada's universal Medicare system. The plan remains so popular that the man who led Saskatchewan's reform, Tommy Douglas, was voted greatest Canadian of all time in 2004 (Wayne Gretzky, the putative "Great One," finished 10th).

The hope of reformers here is that Minnesota can help blaze a path to universal health care in this country.

"We've lost sight of what we've been fighting for," says John Marty, a DFL state senator from Roseville who is chief author of legislation that would create something called the Minnesota Health Plan. Marty is running for governor on a strong health-care reform platform and criticizes DFLers who aren't fully committed to universal care. "If the country had approached slavery like we have approached health care," he says, "we'd still have slavery, but Democrats would be bragging that the slaves only work 40 hours a week now. We haven't fixed the problem. There will still be people dying from lack of health care, and going broke."

The Minnesota Health Plan would fully cover all Minnesotans with a single-payer system like Canada's. A similar plan has been approved by the California Legislature but was vetoed by Gov. Arnold Schwarzenegger. More than a third of Minnesota's legislators support the proposed plan. If he is elected governor, Marty says, he will make the Legislature stay in St. Paul until the bill is passed.

Minnesota used to be proud to lead the nation. Maybe it should take the lead again.

The plan passed by Congress "is not nearly good enough," says Elizabeth Frost, a Minneapolis doctor who is one of the leaders of Physicians for a National Health Program and who says the biggest beneficiary of the plan is the health insurance industry. "There will be 32 million more people with health insurance, but the real question is whether the insurance will be any good. If you have to pay too much out of pocket, people don't go to the doctor. The fight for reform isn't over.

"Last Sunday wasn't the end. It was the beginning."

Nick Coleman is a senior fellow at the Eugene J. McCarthy Center for Public Policy & Civic Engagement at the College of St. Benedict/St. John's University.

http://www.startribune.com/opinion/commentary/89301787.html