Bush Foundation president: Health care redesign neededby Cathy Wurzer, Minnesota Public Radio
St. Paul, Minn. — Two of the DFL gubernatorial candidates for governor want to save the state money by implementing changes to health and human services programs. Matt Entenza and Margaret Anderson Kelliher have said they'd draw ideas from a report published last year by a group of Minnesota foundations.
MPR's Morning Edition spoke with the president of one of those foundations about some of the ideas in the report about health care reform. Peter Hutchinson is president of the St. Paul-based Bush Foundation, one of five foundations that published the report. Hutchinson ran for governor four years ago with the Independence Party.
Cathy Wurzer: This report found $3.7 billion in savings on health care alone. About $1 billion comes from ending the tax exemption for employer-provided health insurance. What's the thinking behind that?
Peter Hutchinson: The thinking is real simple. The tax system in Minnesota is set up to raise a certain amount of money. And then about 40 percent is "spent" to give people incentives of one kind or another. This happens to be one of them. One of the questions we were raising is, is that spending the kind of spending we want and is it producing the outcome we want? So the question here is, is giving employers deductions and keeping employees safe from understanding the total cost of health care a good way to spend the state's resources?
Wurzer: Isn't a proposal like that political suicide? It's like talking about ending the home mortgage deduction.
Hutchinson: It may well be political suicide, but these are questions that need to be debated. One of the problems with the status quo is we don't actually ask much about the status quo, whether the things, the choices we're making that were made decades ago still make sense in the current situation.
We know that health care is one of the driving cost factors all across this state. And lots of proposals have been made to think about health care, but fundamental redesign of the health care system up until this year hadn't really taken place, and now the state has to think about what it's going to do. Health care is cutting into our education budget, our higher education budget, our transportation budget and on and on.
Wurzer: The other part of the savings would come from putting all public health insurance programs into a single health insurance pool. Then, you'd pay health providers a flat rate to care for each patient. Why is that a good idea?
Hutchinson: It was included in the federal health care reform. If we put together our state spending, our local government spending on health care, we would be one of the largest purchasers of health services in all of Minnesota. If we did it smart, we could get a better deal and we could drive the marketplace to produce a better kind of health care resource. In this case, the argument is we should be paying medical care providers to keep people healthy, not providing a fee for service for every time somebody gets sick.
Wurzer: This report came out before the federal health care reform bill was passed. How has that bill changed the situation?
Hutchinson: It started the trail, it started the process of creating health reform. One of the challenges that we in Minnesota need to consider is whether or not we want to wait until 2014 when all of the pieces of the federal change take place, or if we ought to be moving now to make additional changes to make our own health care system more efficient and more effective for our citizens.
All of this is under the umbrella of redesign, a very important idea right now. We're faced with a huge budget shortfall, but the question is what should you do? We're always told there's only these two choices. On the one hand, we can cut, cut, cut, which is really spending the money we've got but getting less for it. And the other choice is raising taxes, which is really about getting more money but not really getting more or better services. Redesign asks the third question, which is can't we get more for the money we're currently spending?
(Interview transcribed and edited by MPR reporter Elizabeth Dunbar.)
- Morning Edition, 07/21/2010, 7:40 a.m.