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State Representative David Dill
100 Rev. Dr. Martin Luther King Jr. Blvd.
651-296-2190
For more information contact: Sandy Connolly 651-296-8877
Column/LTE
Think it's bad now? Just wait There's a looming health care crisis for Greater Minnesota
There's trouble brewing for rural health care, and it's coming at us from several directions. First of all, under the administration's budget proposal, 18,000 working individuals in Greater Minnesota will lose their MinnesotaCare health care coverage. In fact, the cuts are so deep that a part-time worker earning the minimum wage of $5.15 per hour would make too much to qualify for that coverage.
The Governor's proposal will cut adults without children from MinnesotaCare. In St. Louis County there are almost 2,300, in Cook County there are 54 and in Lake County there are136 adults who fall into this category. Unless they make less than $580 a month or have health care expenses that bring their income down to that level, they will be cut. This isn't a free hand-out; these are working people who will no longer have the option of buying coverage under this proposal.
On top of that, only 38 percent of the employers in Greater Minnesota can afford to provide health benefits to their workers, something that is only going to get worse over the next few years as options for coverage vanish.
What happens when people lose their health insurance? First of all, they can't afford the costly visits to the doctor for routine or minor problems. Instead, health problems are ignored until they are so sick that they have no choice but to visit the local Emergency Room. Or, they go there for a problem that isn't an emergency but because it is the only option open to them. ER's don't turn people away for lack of coverage, the way a clinic might.
These uncovered visits to the Emergency Rooms of our rural hospitals turn into problems for all of us. Any business that performs a service and then doesn't get paid for it has to recoup the money somewhere. In most cases, the debt is passed along to those who can pay in the form of higher fees and insurance premiums.
These kinds of problems have caused 23 hospitals in Minnesota to close since 1991, which has resulted in a loss of 1,594 hospital beds, and more could be lost in the next couple of years. According to the Minnesota Department of Health, one-fourth of the 119 hospitals in Greater Minnesota are operating in financial distress—meaning they are either operating at a loss or they have such a small operating margin that they cannot afford to do routine capital improvements to the facility.
To add insult to injury, the administration is also proposing cuts of almost $56 million in payments to hospitals, resulting in the loss of another $40 million in matching Federal funds. Greater Minnesota hospitals alone will absorb roughly $37 million of the $96 million in total cuts.
There is a also a growing shortage of physicians, health care professionals and clinics in Rural Minnesota, giving us dwindling access to health care. In the Twin Cities, there is one physician for every 830 residents, while in Rural Minnesota the ratio is one for every 1,430 residents. Thirty counties and a portion of 20 additional counties in Greater Minnesota have been designated by the federal government as Health Professional Shortage Areas (HPSAs). (To qualify as an HPSA, an area must have less than one physician for every 3,500 residents.) Dentists are in even shorter supply than physicians (one for every 1,820 residents) and most clinics and hospitals are having a hard time finding nurses, lab technicians and other health care workers to fill openings.
So, let's look at this administration's budget proposal. It reduces the number of people eligible to buy MinnesotaCare coverage and cuts payments to hospitals to the tune of $96 million, $37 of that to rural hospitals. All, supposedly, to save money and trim the budget. But we have to ask what we're really saving here. Is a dollar saved today worth spending 10 dollars later on health problems that were deferred because of lack of coverage or ineligibility? I can’t help but remember the TV oil filter commercial, “you can pay me now or pay me later"! Even with its troubles, Minnesota's health care system is the envy of our neighbors. Dismantling it shouldn't be an acceptable way to fix our budget problems.
Instead, we need to be looking for ways to increase the number of Minnesotans with health care coverage, improve access to health care in rural areas and help strengthen the financial foundation at rural health care facilities. We need to have more options on the table than just budget cuts upon previous budget cuts.
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