A Physician's View: We Must Have Legislators Supporting True Healthcare Reform

It is time to acknowledge that the private, profit-making “nonprofit” corporate model is failing nearly all of us.

Healthcare is a crisis for most people across the U.S., particularly in our rural areas. People delay going to the doctor because of $7,000 to $13,000 deductibles. Local newspapers announce benefit events to finance a child’s expensive cancer therapy. Beginning farmers limit their income growth to avoid losing MinnesotaCare, a public program for lower-income residents. Rural clinics and hospitals close because caring for our older neighbors is not “cost effective.” Maybe this is your story.

Ironically, people are hurting in a state like Minnesota, where there is an exceptional wealth of medical resources and a growing economy with full state coffers. But instead of using these resources to create reforms, which could provide everyone with quality care, legislative leaders are redirecting the public’s gaze to our neighbors and trying to scapegoat the poorest among us— those on Medical Assistance (MA). They imply that people on our public programs are getting something for nothing by not working, when in fact, most of the people on MA are working or in nursing homes. This scapegoating is a smokescreen.

We are told that healthcare is costing us too much. Yes, the U.S. spends a lot—about 50 percent more—than our peer countries in the Organization for Economic Cooperation and Development, according to an analysis conducted by the Kaiser Family Foundation. But we are not seeing the doctor as frequently, we have fewer doctors and hospital beds, and have worse outcomes with shorter life spans.

Most healthcare providers, especially those in rural areas, are not benefitting from these extra dollars spent. A study in the journal Mayo Clinic Proceedings found that more than half of the almost 7,000 U.S. physicians who responded to a survey reported professional “burnout.” Part of the problem is that doctors are increasingly buried under immense paperwork and harassment from insurance company pre-authorization requests. All that money flowing through the U.S. healthcare system is not helping this situation.

So where is this money going? In one year alone, medical billing paperwork and insurance-related red tape cost the U.S. economy approximately $471 billion, 80 percent of which is waste due to the inefficiency of the nation's complex, multi-payer way of financing care. One national study concluded that a simplified financing system in the U.S. could result in cost savings exceeding $350 billion annually, which would be nearly 15 percent of overall healthcare spending.

During the 2017 legislative session, Minnesota lawmakers spent over $540 million to “stabilize the individual market.” This money went to corporate insurers to protect them from the high costs of a few patients who need more healthcare without requiring anything in return, such as the auditing of how dollars would be spent or promises of lower premiums. Yet, we could have rolled all these patients into a cost effective long-standing public program, MinnesotaCare, for less than $50 million and used the extra half-billion dollars to keep our local clinics and hospitals strong.

It is time to ask: why are we wasting our tax dollars to support private insurance companies? Our private insurance companies are not providing people the choice to see the medical providers they want to see, the costs keep us from actually going to the doctor, and they are not making sure we have access to the care we need close to our homes. We are constantly being told that government is inefficient and takes away freedom of choice. Well, it is time to acknowledge that the private, profit-making “nonprofit” corporate model is failing nearly all of us.

I had the privilege of doing part of my medical training in Scotland, a poorer country than the U.S. and one with a government-run health system. I went out with the midwives to housing developments for the poor to bring young pregnant women addicted to heroin into the hospital to withdraw and keep them and their babies safe during the rest of their pregnancy.

In the long run, such a public health strategy saves money for everyone. Doctors spent time seeing patients, instead of conducting endless charting for billing purposes. When I joined my husband in Scotland, pregnant with my first child, I just went to the clinic, no questions asked about my “status.” I got excellent care, including home visits after birth, to make sure that my baby and I were doing well. And you should know that the Scots spend far less than we do for their healthcare, cover everyone and have better outcomes. The difference is that no one is profiting in the middle between patient and provider.

If this is the kind of system you believe we should have, then join us in demanding that we can no longer afford to have corporations profiting from healthcare, that everyone should have the dignity of care they need and that everyone should be in, no one left out, from access to care. Furthermore, healthcare should not be tied to employment. People should be free to start the business they dream their community needs and no one should leave the farm just for healthcare benefits. We can start by supporting the demand that everyone, regardless of income, should be able to be in a government run program like MinnesotaCare that works very well for those who have it. Tell your legislator this is what you want for Minnesota.

Dr. Aleta Borrud of Rochester, Minn., specializes in geriatric and hospital medicine and is a member of the Land Stewardship Project’s Healthcare Organizing Committee, as well as the organization’s board of directors. For more information on LSP’s healthcare work, contact Paul Sobocinski via e-mail or at or 507-342-2323. More information is also available here.