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State Representative Paul Thissen
100 Rev. Dr. Martin Luther King Jr. Blvd.
651-296-5375
For more information contact: Sandy Connolly 651-296-8877
NEWS COLUMN
MEETING THE CHALLENGES OF HEALTH CARE IN RURAL MINNESOTA
The Minnesota House of Representatives Health and Human Services Policy Committee recently left the Capitol to visit communities in Greater Minnesota. We wanted to better understand the health care challenges faced by Minnesotans who live outside the metropolitan area. It was an incredibly valuable experience.
While the committee certainly heard about challenges facing rural residents and health care providers, I left extremely impressed with the creativity and commitment that communities have made to making sure that all Minnesotans have access to high quality health care. Those positive ideas will help the legislature craft a health care reform package that makes sense across the state.
First and foremost, reform must be built around the basic principle that no person in Minnesota should pay more for health care than he or she can afford. The need for such fundamental reform is evident in Greater Minnesota. More rural Minnesotans lack health insurance than those living in urban areas and Minnesotans outside the Twin Cities are more likely to rely on public programs to pay for health care. More alarming, a full 25% of rural Minnesotans who do have private health insurance spend themselves into medical debt because their coverage is too limited, or their deductibles too high, to provide meaningful coverage when it is needed. That should not be. Clearly, the work the legislature is now undertaking to make health care less costly will have a big impact all across the state.
But rural Minnesota also faces several unique health care challenges. Medical professionals are in short supply and the numbers of medical students choosing to enter primary care – the doctors who provide the vast majority of care in rural Minnesota -- is declining precipitously. A major reason is that primary care doctors are paid significantly less than their specialist counterparts.
The legislature will take steps next year to shift that equation. An essential part of our health care reform proposal is the idea that patient care should be centered on primary care providers who will have greater responsibility to coordinate care and keep people healthy. Primary care doctors will be paid more as a result, making primary medicine a more attractive option for new doctors.
Our committee also learned that cities like Hibbing involve the entire community in efforts to attract doctors to their area -- finding reduced cost space to set up shop, locating meaningful work for spouses. The state can be a partner in those efforts. We also heard that the Rural Physician Associate Program (RPAP) as well as such incentives as tuition reimbursement and loan forgiveness programs make a difference in getting medical students to choose to practice in rural settings. The legislature will look for ways to provide additional support for those successful tools. Finally, we are exploring ways to remove licensing and regulatory barriers so that nurse practitioners and physician assistants can use all of their skills to provide high quality care at less expense.
Another concern is the lack of mental health services in Greater Minnesota. The shortage is dangerous. For instance, nearly 20% of Hibbing 12th-grade girls reported that they have attempted suicide. A significant new investment by the 2007 legislature in mental health should make a difference, but more steps need to be taken.
One important part of the solution may be to replicate the Morrison County Healthy Communities Collaborative, a combined effort of the Morrison County Public Health department, local schools, churches, and other organizations and individuals. The Collaborative has successfully leveraged community resources through cooperation and joint planning to get early help to children with emerging mental health problems. Communities across Minnesota should be empowered to build on the strength of networks and partnerships like the one in Morrison County to help reach more Minnesotans through public health efforts.
The terrific ideas we heard on our tour will undoubtedly make the state's health care reform better and stronger. Together, we can make health care more affordable and available to all Minnesotans.
State Rep. Paul Thissen (Minneapolis)
Chair, House of Representatives Health and Human Services Committee
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