Advocating universal, single-payer health care in Minnesota

By Lisa Peterson-de la Cueva
Twin Cities Daily Planet, July 8, 2011

Senator John Marty contacted the TC Daily Planet after he read our June coverage of health care, specifically a Q&A with Senator Dave Durenberger on his support for federal health care legislation. Senator Marty let us know that he respectfully disagreed with Senator Durenberger’s view of solutions for our health care system. This is to be expected, since he’s the chief author of the Minnesota Health Plan, the only proposal for universal, single-payer coverage in Minnesota.

The TC Daily Planet had conducted a series of community conversations on health care, so we decided to ask Senator Marty questions that participants in our conversations had raised about what a universal, single-payer system would look like.

In a nutshell, what is the MN Health Plan and why do we need it?

The MN Health Plan is a single-payer health plan and it would cover all Minnesotans for all their medical needs. It’s a health care system instead of a health insurance system. The bottom line is if you need to go to the doctor or the dentist or the chiropractor and you get the care you need.

There are some people with the constitutional right to health care right now, like prisoners. But I happen to think that every Minnesota deserves the same health care that inmates might get. So why should some people have health insurance and some people don’t? The Minnesota Health Plan is the only proposal out there, period, that covers everybody and everything.

Why do universal, single-payer advocates think the Affordable Care Act is not good enough?

Federal health care reform takes a huge step in terms of covering more people. But at the end of a decade, if it works the way that proponents hope it’ll work, there will still be 23 million Americans with no health insurance. And there will still be people who have health insurance but they can’t go to the dentist because, oh, dental isn’t included. Or they’ve got a $10,000 deductible and they can’t get the MRI they need because they can’t afford the deductible. So in the long run, all the talk of what we’re going to do with insurance exchanges and the expansion of medical assistance— from a broader scale, all those things look like tinkering because it still leaves so many people in the dust.

If we know all the problems with the health care system, and we see the solutions in other countries, why is it so hard for people to talk about universal, single-payer?

I don’t use the word single-payer very often, though I don’t object to it. It’s just not very helpful. A lot of people love or hate “single-payer.” But the term’s not very descriptive. Yes, the MN Health Plan is a single-payer system, but it’s a universal health care system that provides care to all Minnesotans.

The bottom line is in our campaign finance system, and I really hate to say it, but the reality is money talks. If there’s some interest that has all the money behind it, you’re going to have a perspective that’s going to be heard. There’s no big, well-funded advocacy group doing this. It’s the political difficulty in passing this without money. How do you get the message out there? How do you take on the insurance system?

If we don't have a system of competing insurers, how can we ensure that we keep health care costs down?

When people have a choice of what doctors and clinics and hospitals they go to it will create more competition among providers than the current system. Right now people say, “Oh, I can’t go to that doctor, it’s not in my plan." That's not competition. People should be spending their time looking for the best doctor or chiropractor or nurse or care, not spending their time sifting through insurance plans, which is what people do now.

The current competition between health plans isn’t a logical competition in any way. And it’s simply not keeping costs down. Our system shifts the competition from the insurance companies to the providers.

What would happen to all the people who work in various insurance companies now?

That’s a really good question. And it’s actually a little bit bigger than that, because there are a lot of hospitals that wouldn’t need administrators who deal with all the different insurance companies, too. At some hospitals we have billing departments with hundreds of people. There are plenty of other of things that hospitals could use these people for if they had retraining.

Not to be flippant about it, because the serious thing about this is that any kind of change is tough, and people don’t want to lose their jobs. But the MN Health Plan includes dislocated worker benefits, retraining, and so on for the people who are working in the health insurance industry. And that’s not cheap, but it’s our responsibility and I think you have to take it very seriously and that’s why we included it in the health plan.

One more thing, dislocated workers would have one advantage over people who have lost their jobs in other eras—they would all be covered with health care…every one of them. But, that’s why we’re going to have a major cost study done to look at all the costs of things like this.

Some say, “I like the idea of universal, single-payer, but it'll never pass so why push it?" What’ll it take to push this through?

It’s going to take 45,000 Americans dying every year because of lack of health care. It’s the number one cause of bankruptcy: There are more people who go bankrupt from health care costs even though they already have insurance, than go bankrupt from every other cause in the country…combined! I think 52 percent of bankruptcies of in this country are caused by health care and three-fourths of those people had insurance. And it’s getting worse!

I’m very critical of politicians who say, well this might be the best way we can do this, but it’s never going to pass. Where is your democracy if you never think anything can pass? Why don’t we define what we want, and then move forward with that?

So what’s it going to take? People dying should be enough, and frankly that’s why I’m confident that we’ll be able to pass it; not with this legislature, but hopefully in the next few years.

Lisa Peterson-de la Cueva is the project manager for the New Normal project at the Twin Cities Daily Planet.