MEDICARE: Commission Visits Minnesota

      The National Bipartisan Commission on the Future of Medicare visited Minnesota's Twin Cities yesterday, the Minneapolis Star Tribune reports. Sen. John Breaux (D-LA), chair of the commission, "said Minnesota was chosen because of its reputation for innovative health care programs and technology and its mix of urban and rural population." The Star Tribune reports that the main theme that emerged during the commission's visit was that "[e]veryone wants to restore the long-term solvency of Medicare and no one wants to do it by cutting benefits or raising taxes." Eight of the commission's 17 members came to the Twin Cities, the panel's first meeting outside of Washington, DC. Created as part of last year's balanced budget agreement, the panel is charged with finding ways to improve the nation's Medicare system. Its report to Congress is due next March (Black, 7/14). "We have a lot to learn. We face a dual challenge -- not just affordability, but also quality," said Breaux.

Speak To Us
      The St. Paul Pioneer Press reports that commission members heard from Minnesota's Business Health Care Action Group, which bypasses HMOs and insurance plans to contract "directly with more than 20 provider networks." Steve Wetzell, head of the group, said, "[C]ompetition is controlling costs and driving up quality for the 135,000 beneficiaries covered by the unique health care system." Panel members also heard from the Employers Association, "which established a purchasing pool for the hundreds of smaller companies across the state that belong to the organization." Blue Cross and Blue Shield of Minnesota also testified before the commission, noting that 140,000 Minnesotans are enrolled in its Medicare HMO (Majeski, 7/14). About 85% of the state's residents are enrolled in HMOs or other forms of managed care, which has existed in the state longer than in other parts of the country.

How To Get More Bang For The Buck?
      The Washington Post reports that some commission members said "Medicare must evolve beyond its traditional role of paying medical bills and become part of budding movement within American health care to measure more stringently the quality and cost-effectiveness of what doctors do." Panel co-chair Rep. Bill Thomas (R-CA) asked, "[W]hen we have limited dollars ... how can we make sure they are spent on the highest and best use?" (Goldstein, 7/14). Minnesota's own Sen. Paul Wellstone (D), speaking at a rally yesterday, said, "We will not allow any politicians, Republican or Democrat, to dismantle or privatize Medicare, not now, not ever." Wellstone recommended that Medicare stay solvent by increasing preventive care and research. "The way to have healthy Medicare is to have healthy seniors," he said (Star Tribune, 7/14).

Not Quite A Utopia
      When asked by Rep. John Dingell (D-MI) if Minnesota's "highly refined health care system" could be duplicated in other parts of the country, HealthPartners' CEO George Halvorson said yes, after time. "Minnesota's special environment allows experimentation with programs. Once they are perfected, they could be transferred to any other parts of the nation" (Pioneer Press, 7/14). But the Washington Post reports that other HMO executives told the panel "federal reimbursement rates have been so low in many rural parts of the state that they no longer operate there" (7/14). Michael Scandrett, executive director of the Minnesota Council of Health Plans, told the commission that Minnesota seniors are penalized through higher Medicare premiums and fewer benefits due to the way the federal government allocates reimbursements. "Minnesotans are frustrated by being short-changed on Medicare. As a result of existing federal policies, Minnesota seniors have fewer Medicare choices, and more limited benefits, than seniors in other states," he said. According to HCFA figures, Minnesota rates are about 21% below the national average (MCHB release, 7/13). Medicare HMOs in New York City receive $783 per month per enrollee, but in Minnesota that amount is only $414 under current federal guidelines. Thomas "apologized for the continuing disparity and said Congress had a long-term goal of reducing it" (Star Tribune, 7/14).