So much going on. Winding up the 2025 farm year. Medicare open enrollment. What medical insurance to choose if you are under 65 and do not get health insurance from an employer. Who is hosting Thanksgiving and Christmas. The list can go on but I think we all recognize both the urgency to get things done as well as the potential for enjoyment in the holiday season.
On November 20, I attended a meeting for the Center for Healthcare Affordability, which has been established by the Minnesota legislature because, in the Center’s words, “Everyone in Minnesota should be able to afford the health care they need. But health care costs are high and growing faster than what Minnesotans earn.”
Those who pay directly for their own health insurance recognize the truth of that statement. If you are a regular reader of this column, you will have seen some of my prior observations on healthcare finance. The average per person per year cost of healthcare in the United States is around $14,000. The second most expensive country in the world for healthcare is Switzerland where the per person per year cost is about $10,000. Australia is about $7,000.
If money grew on trees, this would not be a problem. As money does not grow on trees, the high cost of Minnesota healthcare means we have less money to spend on housing, education, etc. because our healthcare costs are so high. One would think our high healthcare spending would give us great health, but it does not. The United States is about 49th in the world for life expectancy. Our infant and maternal mortality figures are worse than the other modern, prosperous countries. I think we all agree that paying a premium price for an inferior product is a bad deal.
Although I wish Minnesota had looked at this issue 20 years ago, it is good that it is being looked at now. The Center for Health Care Affordability says, “The Center is committed to making health care more affordable for all Minnesotans by fostering collaboration, sparking innovation and advancing evidence-based solutions throughout our health care system.”
What does that mean in practical terms? The Center will have meetings around the state to get input from many Minnesotans. Consider participating if you can. The work the Center is doing can help generate the understanding Minnesotans need to improve healthcare. A key to successful improvement is to look at “evidence-based solutions.”
What does that mean? For starters, it should mean we will carefully study the healthcare finance systems in other modern, prosperous countries. Our goal should be to learn from what others have done and adopt the best ideas.
People have lots of opinions, as opposed to factual knowledge. When it comes to solving a complex problem such as we have in healthcare, it is important to take the time to learn about the issue. Studies done in the United States and other countries show that in addition to lower costs and better outcomes, the people in those countries are more satisfied with their healthcare than we in Minnesota are with our healthcare.
Let’s look at some major challenges with fixing healthcare. Inertia. We have become used to the current state of affairs and change can be unsettling. Many businesses find the current mess to be an easy situation in which to profit. For example, if the insurance company makes R% on their gross revenues, they do not really care if premiums go up, as R% on bigger revenues is better for them.
Another example: There is currently no entity big enough to effectively negotiate drug prices so drug prices are the highest in the world by a large margin.
And another example: Aetna, Blue Cross Blue Shield, United Healthcare and the other insurers all sell similar products. The fact that their advertising, high executive salaries and profits for shareholders (for the for-profit companies) create much higher administrative costs than in other countries is not a problem they want to address. Much of the healthcare industry will oppose change.
You do not have to be an expert in healthcare finance to advocate for yourself and your community. You can keep it simple. Ask for:
1) Good insurance for everyone so financial disaster will not be added to the misfortune of illness.
2) Elimination of excess administrative costs to reduce the cost of healthcare for the individual and the community.
3) The creation of a true healthcare system for the state so we can get great healthcare outcomes in all parts of the state at a cost which is affordable. Healthcare should not be allowed to stay a free-for-all, allowing the most aggressive to extract the maximum profits from the healthcare dollar. Healthcare should be somewhat like an electrical utility, managed for the benefit of the community.
If you want to engage with this work, search for “Minnesota Department of Health, Center for Health Care Affordability” or go to https://www.health.state.mn.us/data/affordability/index.html
Wishing you a fine and healthy holiday season!!!
Mark Brakke is a retired family practice physician. He cared for patients in Coon Rapids, Minn. for 41 years during which time he was on the boards of directors of two health insurance companies. He currently is on the board of the educational non profit Health Care for All Minnesota (HCA-MN.org).
link