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MNSure Has Bad Audit - So How About Finding The Fix?

Category: Health Care
Posted: 01/30/16 16:41

by Dave Mindeman

MNSure has become a MN GOP punching bag for some time now. The latest legislative audit didn't help matters much as numerous errors were found in regards to the state health programs.

But let's examine some of this from a real world perspective.

Health care has always been a complicated system - the beauty of single payer is its simplicity, but we don't have single payer. We have a myriad of eligibility rules, restrictions, reporting nightmares, and layers upon layers of bureaucracy.

And frankly, a portion of this is a problem that has nothing to do with MNSure. The basic problem for MNSure has been that they have tried to completely automate the system. Where the state programs have files and caseworkers working with clients to figure out where they fit, the exchange tries to shrink all that down into a few facts and figures. That can work for the bulk of health care recipients, but there are still a large number of people who don't fit into a nice neat category.

Yes, the ACA is complicated. It is a product of years of wrangling with insurance companies, health providers, government services, and the layers of vendors who provide that health care. Everybody added their opinion from their own perspective and the end result has layers upon layers of data and forms and rules that are difficult to navigate.

MNSure had no precedent to work with. A new law and new software and new requirements have proven to be inherently flawed. Some of that was to be expected, but obviously, MNSure has had more issues than it should have had.

Some of this is because of the early software failure. The timeline had to be stretched and corners had to be cut. Rules have been modified and major overhauls have improved things immensely, but there are still some basic problems that need to be ironed out.

Republicans want to ditch the whole system and just dump Minnesota into the Federal exchange....at least until the ACA is repealed in their minds. But there is advantages to having our own system. We can better adapt the exchange to meet state health care eligibility and rules. We can make quicker adjustments if the system is our own. We simply have more control. You would think that Republicans would prefer that idea.

The Audit report was pretty critical...and deservedly so. Change and adaptation has been slow, but we have to remember that this new entity is only a few years old. It has already had 3 chief operating officers. It has been wading through regulations that have been constantly shifting. The road to a mature operating entity is going to be slow and rocky.

And it wasn't like some of these problems were not always inherent in our health care system. Anyone who has tried to figure out an insurance bill knows how crazy it can get. The Minnesota state programs have always had eligibility problems to deal with. Even prior to MNSure, people have been placed in the wrong program because lower income people that are close to threshold income levels keep moving in and out of these programs.

And the paper work has been complex. As a pharmacist, I would be spending a lot of time checking on eligibility for patients. Many times they simply missed sending in some information to the state....the requests for data are constant and it is easy to miss those notices. MNSure has been an attempt to automate all of that, and frankly, there just may be too many variables to allow that. It may come to the old system of caseworkers following up with clients to keep up with all the changes.

Yes, the audit report reveals some serious problems, but the real issue is how do we deal with it. Republicans continue to avoid any responsibility to address these issues with fixes. They are great at joining in on the criticism, but in the end, Minnesotans need health care and we need to fix the problems that hinder our methods of providing it.

Audits are necessary and problems need to be identified. But addressing and fixing those problems is the job of our representatives.

The ACA has reduced the uninsured by a huge number. Isn't that what we want? Don't we want health care to work for everybody?

When Republicans have critiqued the audit for whatever political gain they think they can maximize, how about everybody gets to work and fix it.

That would seem to be the real job here.
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Paulsen Criticizing the ACA Without Reading His Own Facts

Category: Health Care
Posted: 12/09/15 18:17

by Dave Mindeman

The disinformation on healthcare that Republican officials keep disseminating is staggering. I was looking at my Twitter feed and saw this...

Rep. Erik Paulsen;@RepErikPaulsen
Skyrocketing premiums, less choice, and #CBO says 2 million fewer jobs in the workforce. Ocare problems continue: http://fxn.ws/1IFz2Y1

I realize that Paulsen is not a fan of the ACA....which he proves by trying to "defund" it via his Medical Device Tax repeal. He still has not provided any indication of how he would replace the revenue.

But let's get back to the subject at hand. Let's note that the link Paulsen points to is a Fox News Report (surprise, surprise) entitled...

ObamaCare to reduce workforce by 2 million jobs' worth of hours, CBO says

Sounds kind of ominous doesn't it? Then you start thinking...but gee, aren't we having 80 plus months of job growth? How can there be such job losses going on?

Well, I guess you have to actually deal with facts to get the right answer. Paulsen is not doing that.

So what does this mean? Well, let's take a look at Paulsen's link:

The nonpartisan CBO estimates that the decline will come primarily due to workers responding to changes made by the law to federal programs and tax policy.

Notice that? The statement says that the decline comes from the workers. Not the employer. They are not killing jobs because of Obamacare. It is the workers finally having some choices.

This is not actual jobs being lost, but a reduction in the number of hours that workers "choose" to work. It involves moving to part time (again by choice since health care is not such a prime consideration); they can retire (because health care is available outside of work); and they have the additional option of starting their own business - with the availability to get health care on an exchange.

Obamacare is not killing jobs - it is giving the workforce choices it never had before. Employers cannot lock in employees with essential benefits that have limited options. What employers are actually worried about is how to replace those hourly reductions as the work force shrinks.

We'll get into more of the healthcare disinformation later...but I just had to address the Paulsen distortion....well, because it is such a blatant distortion of the facts.

Typical Paulsen.
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Medtronic Continues Its Blarney Campaign

Category: Health Care
Posted: 12/04/15 18:25

by Dave Mindeman

Let's see....I have this $9.3 billion lying around. What should I do with it? Dilemma. Dilemma.

Yeah, believe it or not, somebody has that problem.


Now really, I'll say this again. Does this sound like a company that needs to get rid of an "onerous" tax? The hypocrites at Medtronic still are directing their lacky, Erik Paulsen, to get them that exemption from Obamacare taxes. And yet, they are still debating what to do with all this fricking cash.

You know, this is really absurd.

Medtronic is truly unAmerican. And I mean that in the literal sense because they are no longer an American company. They sold that citizenship for that $9.3 billion and ended up in Ireland.

And what is on the table....

"This just gives us financial flexibility," Ishrak said in an interview. "We'll have to look at future deployment of that in some way, and immediate deployment as well. ... Financial flexibility simply means we can keep the money to do what we need to do, including acquisitions, as well as more direct returns to shareholders."

Hmmmm....Rep. Paulsen. Why, exactly, does Medtronic need to be "relieved" of their fair share in paying for health care? Why should we be giving them yet another tax break when they have no interest in America as a home base and a fricking windfall in cash? Explain, Rep. Paulsen. Please do.

Here's more.

Medtronic has averaged one acquisition per month since it bought Covidien PLC for $49.9 billion in January, and company executives said they will continue to eye acquisition targets.

American taxpayers are paying for those acquisitions. They are buying up more American companies under their Irish umbrella and avoiding more and more taxes.

And still they would have us believe that they need an ACA tax exemption.


Can we be done with this Medtronic hoax? Please?
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