Wednesday, July 1, 2009


"With virtually no Republicans agreeing with their own constituents that a public option is the way to go, you can take any state in the Union (especially in the Old Confederacy) and find a disconnect between members of Congress following a lock-step anti-family ideology and average families wanting the reasonable health insurance like the rest of the industrialized world already has---and for far, far less money than the U.S. spends on health care."
- Howie Klein, in his june 26 post "Why Are So Many Members Of Congress Going Against Their Own Constituents' Demands For Health Care Reform?" on his superb blog "Down With Tyranny!" ( -

Here is another tremendously intriguing idea on reforming health care which appeared in the Sunday edition of the Minneapolis Star Tribune, June 28, 2009. Yes, we in Minnesota DO have brains and aren't all wacko eccentrics like Michele Bachmann and Jesse Ventura! FYI: "DFL" stands for Democratic-Farmer-Laborer, the Minnesota version of the Democratic Party.

The White House wants help, and state Rep. Tom Huntley gets the call. Here's why:


Last update: June 27, 2009 - 11:57 PM

You don't get a telephone call inviting you to the White House every day -- or ever -- even if you're a nine-term DFL state representative from Duluth.

Rep. Tom Huntley picked up the phone and heard "This is the White House calling" on June 13. He had to catch his breath before he could utter, "I'll be there."

Four days later, Huntley sat at 1600 Pennsylvania Av. with 21 other state legislators from around the country and Secretary of Health and Human Services Kathleen Sebelius, discussing the hottest national policy topic of the season, health care reform.

It may say something noteworthy about the Obama administration's policy focus that among all of Minnesota health-minded legislators, Huntley got the call.

It isn't surprising that the president would seek out someone with Huntley's expertise. The 71-year-old Ph.D. biochemist taught at medical schools for 40 years, most of them at the University of Minnesota-Duluth School of Medicine. At the Legislature, he has chaired the House's health care finance division since DFLers took control of the chamber in 2007.

What's interesting is that the White House tapped someone with Huntley's take on how to proceed with reform. More than any other DFLer in St. Paul, Huntley has been a champion of changing the way medicine is practiced and paid for, in order to control costs.

Huntley's stock line is, "You've got to fix the system for the 93 percent in order to have money to serve the 7 percent" -- that is, the share of the Minnesota population that lacks health insurance. For the nation, that share is closer to 16 percent.

He says that Minnesota's doctors, some of whom he trained, treat insured people in ways that are too often duplicative and ineffective. For that, he does not blame them. Rather, he faults a fee-for-service payment system that rewards doctors for the number of procedures they do, not for keeping patients healthy.

Only if the galloping growth in health care spending can be slowed can the state or the nation afford to insure the uninsured. "You have to get after the costs," he says.

Other DFL legislators who carry a health care portfolio -- Sens. Linda Berglin and John Marty, to name two -- have made themselves almost synonymous with expanding access to health insurance via government efforts. Their difference with Huntley is more one of emphasis than of substance. They too favor lower-cost, prevention-focused medical practices, and Huntley is not averse to a government-sponsored health insurance program.

But if you're President Obama, and you see the access expansion train beginning to move in Congress without cost-containment cars firmly attached, the Minnesotan whose advice you want is Tom Huntley.

And if you're Huntley, itching to change the way Minnesota doctors treat the big-ticket diseases -- diabetes, depression, asthma, heart and coronary artery disease -- you want the White House to bring a Medicare and Medicaid payment-reform pilot project to this state. That's what he pitched in D.C.

He explained: "If you have a clinic and 5 percent of your patients are in a special payment program, you're not going to change the way you deliver medicine. But if 60 percent of your patients are paid in a certain way, that will change your behavior. I want to be able to combine Medicare, Medicaid and private insurance to get that critical mass for change."

Huntley's 2008 bill started down that road. When fully implemented later this year, it will pay primary care doctors to coordinate the care of their patients with chronic conditions. That idea -- "medical homes," in Capitol shorthand -- is intended to minimize high-cost, duplicative treatment by medical specialists.

But without the big federal programs involved, there's only so far that Huntley's 2008 bill can go in saving money. "We're asking that Minnesota be allowed to change the way Medicare pays," he said.

If Huntley gets his pilot, Minnesota could find itself positioned as a make-or-break proving ground for President Obama's biggest domestic initiative. The pressure will be on a lot of Minnesotans - not least of them Huntley - to show that it's possible to rein in health care costs while still insuring more people.

Huntley acknowledges that changing the way medicine is practiced is "very difficult." But, he says, "it's what we have to do.

"If this doesn't work, then you really will have a system where government sets the cost of everything...I don't think that's good for anybody. That wouldn't do anything for quality improvement. That's the club that's hanging out there."

Lori Sturdevant is a Star Tribune editorial writer and columnist. She is at

Treat the disease: Change how health care is paid for. A novel idea indeed!


Vigilante said...

Single-Payer Universal Health Care. Period. Bring the troopshome fro Iraq and Afghanistan to help pay for it.

Jack Jodell said...

I'm with you, Vigilante. Or, should we still keep troops there for a while yet, let's mandate that Halliburton, Blackwater, and KBR fund universal single-payer health care all by themselves. They've been piggishly profiteering off the war for years now and have gotten tremendously fat feeding off the public trough!