Thursday, March 01, 2007

Is Norm Coleman going Gutknecht or Wellstone on the Health Care Issue ?

I am an independent voter with no allegiance to any political party. I vote on the issues and the number one issue to me is Health Care. So when Norm Coleman issued a number of press releases in February announcing new proposals that he touts as a “comprehensive rural health legislative agenda”, I am naturally interested.

Coleman states “The quality of your healthcare should not be a reflection your zipcode, and my rural healthcare agenda seeks to efficiently enhance the quality, affordability, and accessibility of healthcare in rural Minnesota.”

His comment sounds more like a campaign speech then an actionable comprehensive solution to the health care problem. His attention to this issue admirable, yet somehow I sense that these are the issues that Paul Wellstone would have been pushing harder and longer than in the year prior to re-election. I thought that based on Coleman complaints about Wellstone's performance, that Coleman would have been pushing these legislative ideas earlier. Coleman said "People should be angry and they should be angry that nothing's been done. The senator's been on the health committee for 12 years and you know I think people are tired of pointing fingers and saying we didn't get it done because of this and because of this."
Well, it's only been four years, but Norm, why has it taken so long for you address this issue ? ? ? Remember, that for the first four years of your term, the Republican Party had both chambers of Congress and the Presidency.

Hence, I ask the question is Coleman, “Gutkencht-ing” the issue ? What is “Gutkencht-ing”?
Simple stated it is when a politician realizes that there is an issue that will appeal to his constituents and that he can talk endlessly, while realizing that the full Congress will not adopt it. I coined the term based former Congressman Gil Gutknecht’s 10/10 Ethanol plan (10 % ethanol by 2010). Gutknecht pandered to rural voters about his proposal, yet failed to get even get a hearing in Subcommittee on Energy and Air Quality. At every farm event, Gutknecht talked ad nauseam about the 10/10 plan while he should have been working his colleagues for legislative action. The 10/10 plan was an attempt to address America’s oil dependence problem, but it was ten years late and by itself would not solve the problem.

Reading the press release, Coleman is offering baby steps that address a portion of the health care problem. In some ways, it mirrors a standard mission statement from an insurance company :
Improve access,
Simplify the health care experience;
Promote quality;
and Make health care more affordable.
The cynic in me makes me wonder how much these proposals were created in concert with some of his political contributors, such as UnitedHealth Group which is the number 2 contributor to his campaign fund.

Health care is an important issue that affects every voter … heck, America spends more on health care than food. But the debate is being controlled by the insurance companies and pharmaceutical/medical device companies, with input from the medical community. The access and influence that those industry lobbyists have on legislation clearly impact politicians (and hence the government) in undertaking action, or inaction.

Last month, McKinsey and Company issued a report on the cost of Health Care in the United States. The analysis attributed some of the cost problems in that we spend $98 billion a year in excess administrative costs ( such as marketing – think of those commercials for Restless Leg Syndrome.) Further, McKinsey estimates excess drug costs to be $66 billion a year. Interestingly, the report estimates the cost of providing full medical care to all of America’s uninsured at $77 billion a year. Thus, if the Healthcare Industry could be squeezed of waste and excess spending, the uninsured problem could be solved. Resolving this issue is critical to all of us, as even Wal-Mart is forming a coalition dubbed "Better Health Care Together," pledged to convene a national summit by the end of May to recruit other leaders from business, labor, government and non-profits with the objective of providing universal health-care coverage for "every person in America.”

Since Coleman is the Ranking Republican on the Permanent Subcommittee on Investigations it would seem logical that he would want to review the claims reported by the McKinsey report.

So, while I applaud Coleman addressing the subject, it is with some skeptism. The most intrigueing legislation is to increase the nursing workforce. There is a simple supply-demand solution to this … provide free education to every person that passes a qualifying enterance exam … if our tax dollars can provide K-12 education, why not provide additional training for selected and needed occupations? On the other hand, his proposal for a hospital in Cass County is an example of earmark spending that if it was for any other state other than his home state would be riducled by fiscal conservatives.

Where will Coleman get the money for funding his legislation? How about CEO compensation … for example former UnitedHealth Group CEO William McGuire received a total compensation of $124.8 million last year. This outlandish amount is enough to fund many Rural Hospitals. Note : McGuire may seem to be a unique example, but consider others in the industry Wellpoint’s CEO Larry Glassrock received $25 million, Aetna’s CEO John Rowe received $22.2 million and Cigna’s CEO Edward Hanway received $13.3 million.

If Coleman is to be successful in taking this from a campaign speech to enacted legislation, we should see co-sponsors signing on and hearings being held. By this summer, if there is no action, then we’ll know it was a hallow effort.

As I recall in his 2002 campaign, a focal point was his little daughter telling us that when he promises Diary Queen, he keeps his promises. Well, Norm were waiting.


S.628 : A bill to provide grants for rural health information technology development activities.
S.629 : A bill to amend the Consolidated Farm and Rural Development Act to provide direct and guaranteed loans, loan guarantees, and grants to complete the construction and rehabilitation of rural critical access hospitals.
S.630 : A bill to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare program.
S.631 : A bill to amend title XVIII of the Social Security Act to provide for coverage of remote patient management services for chronic health care conditions under the Medicare Program.
S.632 : A bill to provide for a hospital in Cass County, Minnesota.
S.633 : A bill to provide assistance to rural schools, hospitals, and communities for the conduct of collaborative efforts to secure a progressive and innovative system to improve access to mental health care for youth, seniors and families.
S.646 : A bill to increase the nursing workforce.
S.716 : A bill to establish a Consortium on the Impact of Technology in Aging Health Services.

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