Lori Sturdevant: Stepping up and swatting down the partisan divide

09/09/2007

A bipartisan, bicameral group with long-term vision might be useful on transportation and health care.


By Lori Sturdevant,
Star Tribune
September 09, 2007


ROCHESTER, MINN. - As frittering over the state's response to flood and bridge failure proceeded last week, a thought occurred: A bipartisan bunch of forward-looking, problem-solving legislators -- say, a "rump group" -- might be useful just now.

That's why I hung out Thursday with 13 members of the Legislature's 2020 Caucus in Rochester.

Their host was the Mayo Clinic, and their topic was health care. But my mind kept wandering back to transportation -- and judging from the between-session chitchat, so did their minds.

Transportation has been state political topic No. 1, post 8/1 -- but that's not the only reason the 2020 Caucus was talking about it. For a group whose raison d'être is a search for ways to preserve the Minnesota good life as its population ages, the topical leap from health care to transportation is not a long one.

Last year, I witnessed a pair of focus groups that contemplated the era that's forecast to dawn in 2020, when the state's past-age-65 elders outnumber the birth-to-18-year-old set for the first time. Those groups mentioned better, affordable health care within one minute, and better, affordable public transportation within two.

Transportation and health care ought to be meat-and-potatoes fare for a 2020 Caucus worthy of its name. But they are also topics fraught with partisan mistrust and worse at the Capitol. That may explain why the caucus lately has been, um, quiet.

Officially, after Thursday's Mayo session, the caucus remains mum. The session produced no official pronouncement from the group.

But I saw heads in both parties nod affirmatively as Mayo officials laid out a package of health policy reform proposals. Significantly, those proposals steer clear of a switch to a single-payer (read, government-payer) system of health insurance. "That would kill this place," whispered Senate GOP Minority Leader David Senjem, R-Rochester, a Mayo employee.

Rather, the Mayo idea is for states to follow Massachusetts' lead and mandate the purchase of individual, portable health insurance policies. Employers would be urged, and maybe induced, to contribute to those policies' costs. Low-income people would receive a government subsidy to help cover the cost.

The Mayo variation on those ideas involves changing the way medicine in most places is practiced and paid for. Medical care everywhere should be delivered by Mayo-like teams and be coordinated by primary care managers, they say. Outcomes and patient satisfaction should be weighed against cost to measure the value of care. Providers should be paid for delivering high value, not for the number of office visits or procedures they perform.

Those ideas are much in play by at least two other legislative panels' work on health care proposals this season. What the 2020 Caucus could add to the work those groups are doing is a road map to a bipartisan consensus that would meet long-term needs.

A road map of that sort may be even more valuable to the quest for a long-term transportation fix. It stalled -- again -- last week, judging from an exchange of correspondence between Gov. Tim Pawlenty and legislative leaders.

"There are a lot of ways to get things done across party lines, and I don't think an exchange of letters is one of them," sighed Sen. Geoff Michel, R-Edina, a 2020 Caucus founder.

Pawlenty said at a news conference Friday that the latest snag was over transit funding, not over a gas-tax increase.

Here's where the 2020 crowd -- particularly Republicans like Michel -- might put their understanding of this state's demographic future to good use. They can make an argument for more transit throughout the whole state, not just the metro area, to maximize elder mobility.

Then they can get bipartisanly creative about how to pay for it. Retailers balk at a half-cent sales-tax increase in the metro area? How about a 0.2-cent sales-tax increase statewide? How about dedicating the proceeds from HOV-toll lanes on metro freeways to transit, then adding a few more of those lanes? How about phasing in small, automatic funding increases, not just over one or two years, but five or 10?

Nate Garvis, Target Corp.'s governmental relations vice president, told a Rochester audience Thursday night that the 2020 Caucus is "doing phenomenally courageous things right now ...in the best tradition of Minnesota governing." It would be good to see them live up to that billing.