Durenberger puts spotlight on urgent health care issues at forum

02/22/2005

By JODIE TWEED, Brainard Dispatch, Staff Writer

When it comes to their health care coverage, Minnesotans want greater personal responsibility, universal participation, full disclosure of costs and the quality of services, as well as incentives for people who make a commitment to remaining healthy and active.

Those were some of the findings that the Citizens Forum on health care costs, chaired by former Republican U.S. Senator David Durenberger, released last year in its study titled, “Listening to Minnesotans: Transforming Minnesota’s Health Care System.”

Durenberger, a St. Paul resident who since 1997 also has a home in Crosslake, presented a public forum on the state of health care costs Saturday at Central Lakes College’s Chalberg Theater.

The free event was sponsored by The League of Women Voters Brainerd Lakes Area, the Brainerd Dispatch, The Rosenmeier Center for State and Local Government at CLC, the Brainerd Lakes Area Chambers of Commerce, Mille Lacs Band of Ojibwe, Mille Lacs Health System and St. Gabriel’s Hospital in Little Falls.

Durenberger served as senator from Minnesota from 1978-1995. He is now chair of the National Institute of Health Policy and serves as a senior health policy fellow at the College of St. Thomas in St. Paul. He also has authored two books on health care. He was appointed as chair of the Citizens Forum on health care costs by Gov. Tim Pawlenty in the fall of 2003 to study health care costs in the state and make recommendations. Eighteen people made up the panel and received input from around the state through public meetings, e-mails, written comments and testimony from citizens, providers, businesses and government.

Durenberger said health insurance premiums for families from 2000-2004 rose 59 percent while family income rose only about 15.70 percent. According to the study, 4 to 5 percent of Minnesotans are uninsured. Minnesota households pay an average of $11,000 annually through taxes, premiums and out-of-pocket expenses for health care. Experts believe that number will double to $22,000 by 2010, which is not affordable for most families.

Even with these high numbers, most households are paying less than one-third of their actual health care costs. Costs of health insurance has grown 3-1/2 times faster than the state’s economy and workers’ wages. This is four times faster than the rate of inflation.

In any given year, 20 percent of Minnesotans use no health care services while 1 percent use 27 percent of all health care dollars in the state.

Durenberger said what is contributing to the high costs of health care is the improved medical technology in the field. Medical professionals are making a great deal of money from specialty clinics and specialized services and many of these procedures, such as X-rays and imaging, may not be necessary, he said.

Durenberger said many health care systems could purchase these high-cost machines, like MRI and CT scanners, together in a collaborative and share them, rather than passing those costs onto health insurers and patients.

Durenberger pointed out that five specialized heart centers will soon compete in the Twin Cities. There will now be about 40 such specialized heart centers in Minnesota and Wisconsin, he said. In a 2.1-mile area of Fairview Southdale Hospital in the Twin Cities there are 21 CT scanners, he said.

“Somebody has to pay for this stuff, right?,” said Durenberger.

Durenberger said no one finds out the actual costs of health care services or prescription drugs because health care and drug companies don’t want that information released to the public. In California, where the law now requires hospitals to release information about actual health care costs, Durenberger showed a graph in which different procedures varied greatly in terms of cost, depending on which hospital you were at. A chest X-ray varied from $120-$1,519, depending on the city, and the same CT scan varied from $950 to $6,599.

Durenberger said that even if people learn the prices of procedures and drugs, it doesn’t tell us as consumers whether we are receiving quality care at the hospitals we choose to spend our healthcare dollars, which most medical institutions won’t release either. He said according to recent statistics, each year 44,000 to 98,000 American lives are lost due to medical mistakes. More people die each year from hospitals than from breast cancer or from automobile accidents. He said the culture of medicine produces these types of medical errors.

“We need a different way of thinking about our health care system,” said Durenberger.

There were several conclusions that the Citizens forum on health care costs recommended to Pawlenty.

Minnesotans must be in the driver’s seat, said Durenberger. The community and individuals must be informed about costs, programs available and quality of care. This is consumer-focused health care, he said.

Costs must be brought under control and the uniformity in quality of care be delivered. There should be universal participation with coverage and access for all with improved access and the prevention of cost-shifting.

They recommended that a partnership be made among all parties, including providers, payers, individuals, business and government. There should be a promotion and creation of new models for educating health care providers and a decreased cost of overhead and administration.

Durenberger said people want to be rewarded for good health habits and there should be a greater promotion of healthy living, especially in the area of obesity and the use of tobacco.

The study also concluded that Minnesota must provide leadership at state and local levels to deliver quality, affordable health care.