Expanding My Knowledge in Healthcare

Being a senior physician at Mayo Clinic in Rochester for several decades, I thought I knew quite a bit about healthcare and how it is paid for, but I’ve come to realize that my viewpoint was limited. There is always a lot new to learn.

My wife and I discovered the Land Stewardship Project many years ago through articles in the Rochester Post-Bulletin. Then we went on to make friends with some of our favorite vendors at the Rochester Farmers’ Market, and learned more about LSP through their experiences.

A couple weeks ago, I testified at the Rochester meeting of the Health Care Financing Task Force, created by the Governor and the Minnesota Legislature. The following story is a synopsis of what I told the task force:

A few years ago, I become a member of LSP’s Healthcare Organizing Committee. During a meeting at the Lewiston office, sometime before the Affordable Care Act was signed into law, nine of the members of the Organizing Committee were telling stories of their personal experiences with our healthcare system. It was an eye-opening experience for me. Every single other person on the Committee had really difficult, serious experiences, especially with outrageously high costs of health insurance premiums, deductibles, and co-pays. The only person who didn’t have any “horror” story to tell was me. I had a very good policy as an employee of the Mayo Clinic. The people who grow the food that we all eat were uniformly in terrible shape at this time because of the huge financial burden they carried in order to keep themselves and their families insured against medical catastrophes.

This experience really got me thinking that our system was truly out of kilter. I knew that the biggest cause of individual bankruptcy was medical disasters. At this Healthcare Organizing Committee meeting I was hearing stories that showed that people I knew and respected, and who I knew worked extremely hard, were at risk for falling into this group.

About this time I read a book that explained a lot about how healthcare is practiced and how it is paid for in other developed countries. The book is The Healing of America: A Global Quest for Better, Cheaper Health Care for All, by T.R. Reid. This book was published in 2010 just before the Affordable Care Act (ACA) became law. It explained that the problems that my LSP Organizing Committee colleagues were having would not be problems in virtually any other advanced country. Their healthcare systems vary in a lot of details, but in none of those countries do people lack health insurance, compared to well over 40 million uninsured individuals in the U.S. when this book was published. Now about half of that number remain uninsured.

Certainly there are problems with the ACA, brought on first by the enormous complexity of modern healthcare. Other major problems stem from the influence of for-profit health insurance and pharmaceutical costs. Two powerful groups, the health insurance industry and big pharma, actually were supporters of the ACA when it was making its way through Congress. They achieved major concessions for their support. I believe that any future changes to the ACA should severely limit the advantages that the health insurance industry and big pharma have now, recognizing just how much they distort our healthcare system and its costs.

In the past, Minnesota has demonstrated leadership in healthcare. Evidence of this is the existence of MinnesotaCare, a public option for folks making between 138 percent and 200 percent of the federal poverty level. With no deductibles, primary care, including preventative care, is accessible for all participants. It would be a step in the right direction if Minnesota would demonstrate leadership again by expanding the MinnesotaCare program.

Eventually, to cover everyone at a reasonable price, we will need to move to a single-payer system. This transition will likely occur in a few states initially and, hopefully, right here in Minnesota. If these experiments work, it will spread to other states and eventually a federal program could come into being. Certainly other developed countries have been able to accomplish this, albeit in their own unique ways.

Dr. Alan Hoffman is a member of LSP's Healthcare Organizing Committee, as well as the organization's board of directors. He served as a pediatric radiologist at Mayo Clinic in Rochester from 1977 to 2013. For more on LSP's Affordable Healthcare for All work, click here.