MinnesotaCare: a Model for Obamacare?

As an advocate of single-payer health coverage, I like MinnesotaCare. It has a few glitches, but once they’re identified and fixed the program could be the model for the Patient Protection and Affordable Care Act, otherwise known as Obamacare. (“Obamacare” is a term I’ve come to embrace. A one-of-a-kind program shouldn’t be known by an acronym, ACA, that is shared by millions of other organizations.)

After being on MinnesotaCare for several months, these are the benefits and challenges I’ve identified:

The benefits

• MinnesotaCare is single payer. One insurance provider covers medical, vision, and dental claims. I’m not crazy about the idea of a health insurance exchange, a central concept of Obamacare. Buying health insurance isn’t the same as window-shopping at the Mall of America for a flirty party dress and pair of peep-toe pumps. Shopping for health insurance isn’t fun – it’s tedious and frustrating.

• Premium payments are based on a sliding scale. No matter how much money you make, you feel you pay too much for health insurance. In the long journey to create Obamacare, details came into focus as policymakers drilled down. Through focus groups and listening sessions, they discovered that $400 a month for health insurance was beyond the reach of many American families. There is no short-form answer for determining MinnesotaCare premiums, as you can see from this schedule. But you can still qualify with an annual income as high as $52,512 – which isn’t that much when you think about it.

The opportunities

• Sweeten the reimbursement rates. Health insurance is useless if medical providers won’t accept it. The MinnesotaCare provider I chose is South Country Health Alliance. While I’ve had no problem using South Country for medical, prescription and vision claims, I have yet to find a dentist in southeast Minnesota who accepts it. (I’m on a couple of waiting lists that stretch several weeks out.) I don’t know if nonparticipation is because of South Country in specific or MinnesotaCare in general. If providers don’t accept Obamacare because of what it is (or who created it), opponents will say, “See, it doesn’t work.” We need to find a way to make sure it does work.

• Make it easier for customers (and providers) to ask questions. When you call the MinnesotaCare information line, you get a recording suggesting that you call on Thursday or Friday because of the high volume of calls. If you have a question on Monday, and need to schedule an appointment now to avoid a long waiting list, you don’t want to wait until Thursday or Friday. And the backlog I’m talking about is just for MinnesotaCare. Can you imagine the questions people will have about Obamacare coverage? Even if there’s an email address where you can leave your question and a representative will get back to you, you feel that you’ve done something.

• Remove income as an eligibility requirement. Awhile back I wrote about how I was too affluent as a Pine County resident to qualify for MinnesotaCare, but became eligible when I moved to Dodge County. Can you imagine if a similar yardstick were used for public school eligibility? “I’m sorry, but you’re too smart to qualify”? Public school is there for all who wish to use it, regardless of means level. You’re not forced to use public schools. You’re mandated to use a school, but it doesn’t have to be a public one. If you’d rather have your kids attend a private school, go forth and God love you.

MinnesotaCare isn’t Cadillac coverage care, as I discovered when I bought my latest pair of glasses. Still, less-than-Cadillac coverage is fine if you didn’t have a car in the first place. As President Obama has frequently said, if you’re happy with your private insurance coverage, you can keep it. But if you need insurance and can’t get it, you have an outlet. And Minnesota’s very own MinnesotaCare could be the model for it.

Related Posts

Hot Damn. I Have Health Insurance

You’re an Old Lady Now: or, Drawing the Line on Bifocals
Give Up My Pharmacist? Never!
When Health Insurance Is No Health Insurance

You're an Old Lady Now: Or, Drawing the Line on Bifocals

I found this image on Doris the Great's
delightful blog Aging Disgracefully.

I recently found out that my state-provided health insurance program, MinnesotaCare, doesn’t cover progressive-lens eyeglasses, otherwise known as lineless bifocals. If you’re over 50 you probably wear bifocals, or in my case trifocals, to combine near vision and distance vision in one pair of glasses.

It's not because of vanity that I refuse to wear lined bifocals. I refuse to wear them for reasons of effectiveness and safety.

Several years ago I wore my one and only pair of lined bifocals. I was amazed at the number of activities that involve near and far vision. Scanning an entire grocery aisle while locating a specific product. Wending your way through a berry patch while trying to find the ripest fruit. Even walking downstairs becomes hazardous. I’m surprised that lined bifocals are even made anymore. Lined bifocals, in my mind, are comparable to an old infant car seat that was taken off the market for safety reasons. I also compare lined bifocals to another item that women over 50 will remember.

You're a Young Lady Now

Back in the 1960s, each of the girls in my sixth-grade class received a plain white envelope from the school nurse. Inside was a mimeographed notice inviting us to view a very special filmstrip. Tommy Brooks asked me what was inside the envelope; I showed him. He never showed me his when the boys received their notice to view their own very special filmstrip. But I never thought to ask.

The cover from the 1960s-era booklet,
located at the "odd, funny and
well-researched Web site," www.mum.org.

Anyway, the filmstrip was about menstruation, the life-changing event that each of us pubescent girls would experience. When the film ended, each girl received a booklet called “You’re a Young Lady Now”  and a pink plastic pouch dotted with rosebuds. Inside the pouch, a sanitary belt and pad. That, I didn't show to Tommy Brooks.

According to the Museum of Menstruation and Women's Health (now, there's a name), the sanitary belt was first created in about 1945. From the museum's Web site:

Tabs from a disposable menstrual pad snaked through the buckles of this American menstrual napkin belt, worn around the waist; it's probably from the 1940s. Disposable pads gradually replaced washable pads in America in the 1920s and 1930s. Catalogs and stores of the time, and until the early 1970s, sold dozens of models. Adhesive pads appeared in the 1970s, almost killing the belt-and-tabbed-pad industry.

Like the archaic sanitary belt, lined bifocals are more primitive, more clunky, less effective, and less safe. (We're talking metal buckles.) I'm surprised the belt-and-tabbed-pad industry, as MUM puts it, exists at all.

People will say I shouldn’t complain about MinnesotaCare coverage. Their tax dollars pay for my healthcare, they’ll say. But nowhere in the Constitution are we guaranteed the freedom to pay only for things we agree with. Otherwise, there’d be 282 Republicans in the U.S. Congress whose healthcare payments I’d cut off. Their Gubernatorial counterpart, Jan Brewer of Arizona, recently signed the mother of all anti-abortion bills: Life Begins at Menstruation.

I'm an Old Lady Now

Who knows, perhaps lined bifocals will be the next "geek chic" fashion trend. But until then, I'm drawing the line. What has been your experience with lined bifocals? Old ladies and young, please share!

Give Up My Pharmacist? Never!

Tom Sengupta, owner of Schneider Drug in Minneapolis.

When deciding on a health plan, most people choose the plan that lets them keep their doctor or dentist. My choice was determined by whether I could keep my pharmacist: Tom Sengupta, owner of Schneider Drug in Minneapolis.

In the past 15 years I've lived in Minneapolis, in east central Minnesota, and in southeast Minnesota. I've been a customer of Schneider Drug for the entire time, the last 11 years by mail. Comparatively, I'm a newbie; some of Tom's customers have been coming to his store for over 40 years.

It's been difficult for medical and insurance professionals to understand why I visit a pharmacist who is 70 miles away. A specialist at Olmsted Clinic in Rochester asked if I wanted to switch pharmacists, and was probably surprised at my defiant "No!"

I checked with an insurance specialist about whether Schneider Drug was a participating pharmacy. "You live in Dodge Center?," the person asked.

A cornerstone of Minneapolis's
Prospect Park neighborhood. 

"Yes."

"And Schneider Drug is in Minneapolis?"

"Yes."

"Is it a compound pharmacy?"

"I don't know what that is," I admitted.

"A pharmacy where they make the medications," the insurance specialist explained.

"No. It's just a store where they give excellent customer service."

"Oh."

An Ask-Your-Pharmacist Type of Pharmacist

You won't find toys like these
in a big-box drug store.

I discovered Schneider Drug in 1996, when I worked in the Prospect Park neighborhood of Minneapolis. I was pregnant, needed to buy maternity vitamins, and wanted to find a store within walking distance. Schneider Drug fit the bill, with the added benefit of having a retro 1960s feel. Years later, when I'd come in with my son Wyatt, Tom would give him pennies for the gumball machine or a special price on a small toy. Whenever Mike and I were unsure of which cold medicine to purchase, we'd say, "Let's ask Tom." When the best purchase was no purchase, Tom would say so. He'd remind me of when blood tests were due, or explain when formulary (brand name) drugs could be safely replaced by generic drugs.

The Politics of Healthcare

A young Hubert H. Humphrey helped
out at Schneider Drug before Tom owned it.

If you’re a person whose shopping decisions are guided by progressive values, you probably already know about Schneider Drug -- a store where a young Hubert H. Humphrey sometimes helped out at, according to Liz Riggs in this fascinating article. Tom Sengupta is an advocate for universal health care and regularly holds town hall meetings. Back in the 1990s, visiting politicians would ask U.S. Senator Paul Wellstone about health care in Minnesota. Wellstone would tell them, “Ya gotta talk to Tom.” A Wellstone! sign is still prominent in Tom's store.

In 2004, Democratic Presidential candidate Bill Bradley phoned Sengupta while Tom was waiting on a customer. Sengupta apologized and said he had to put Bradley on hold; the candidate understood. The idea of the less-than-dynamic Bradley on hold makes me chuckle. But it's absolutely indicative of Tom's customer-first work ethic. 

One time back in the 1990s I had forgotten to call in my refill,  and Schneider Drug was closed. So I stopped at the Target pharmacy on Broadway in north Minneapolis, where I lived. I showed the pharmacist the empty bottle so he knew where the prescription had been previously filled.

"Schneider Drug. Are they still open?," the Target pharmacist asked.

Paul Wellstone's politics are alive at Schneider Drug.

The next time I was in Tom's store, I mentioned the exchange at Target. As I left the store with my purchase, Tom called after me, "You tell Target we're still here. And we're going to be here for a long time." It was the only time I saw that gentle man's ire up.

The Broadway Target closed in 2003. Schneider Drug is still going strong.

My Pharmacist? You Bet!
I try to avoid referring to service professionals as "my mechanic" or my this or that because they're not possessions. But with Tom Sengupta, I make an exception. Someday Tom will retire. Someday I will have an emergency and will need a same-day prescription. When that day comes, I'll find a local pharmacy. Until then, Tom Sengupta of Schneider Drug is my pharmacist.

Read Liz Riggs' Bridgeland News article about Schneider Drug here. And listen to an NPR story by Michael May below:



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Hot Damn. I Have Health Insurance.

A round of binge surgeries for the house, barkeep.

Of course I jest. But former Republican Presidential candidate (and Minnesota Governor) Tim Pawlenty wasn't kidding when he compared healthcare to an open bar. When healthcare, like booze, is free, you imbibe more, Pawlenty says.

My health insurance, which will be provided through MinnesotaCare, isn't free. It costs $59 a month. Currently I am uninsured and pay $50 a month for a maintenance prescription. So to pay nine bucks more a month and have health coverage, has me positively giddy. No binge surgeries are planned, but I'm meeting the dentist and optometrist for Happy Hour.

Children under 18 are covered under MA, but their parents aren't. When health coverage is provided to parents, they are able to better care for their children, but that's just my opinion.

The $10,000 Doughnut Hole
Qualifying for MinnesotaCare came as a total surprise because Mike and I had applied twice when we lived in Pine County. The median income for a family in Pine County is $44,058.  In Dodge County, it's $54,261. Our family was in the $10,000 doughnut hole.

Though health insurance wasn't the reason for our move from Pine County to Dodge County, it's an unintended benefit: our entire family is now covered. A popular meme that's being disputed is people move to Minnesota for the benefits. I guess having health insurance puts our family in that category. We moved from Point A to Point B, and now have a benefit that we didn't have in Point A.

In a me-first society, I move to better myself and my family. Everyone else moves to sponge off others. In a me-first society, I get benefits. Everyone else gets entitlements. Benefits for me, entitlements for thee.

I'm thrilled that our family will have health insurance. But I won't be satisfied until healthcare is available to all -- without having to move from Point A to Point B.

A Liberal Tea Party: Just a Dream?

From a branding standpoint, the Tea Party is a work of genius.

• It has a robust identity that's a mash-up of past history and present culture: the Boston Tea Party of 1773 and the anti-tax sentiment of today, with the acronym Taxed Enough Already?
• It can be instantly identified with a simple and logo-ready symbol, the tea bag.
• It began as a viral communication and developed a life of its own.

I don’t agree with it ideologically. But I’m in awe of it in terms of marketing and branding.

Will Van Jones’s American Dream Movement be the Tea Party movement that liberals have been waiting for? Time will tell, says this Washington Post blog post by Rachel Weiner.

Coffee Party was Weak Kool-Aid

Weiner mentions previous attempts such as the Coffee Party. This iteration didn’t work, in my opinion, because it defined itself in terms of the Tea Party. What exactly is a Coffee Party, anyway? What did it stand for? And can such a movement work when it’s billed as nonpartisan?

The Tea Party embraces its partisanship. I’ve been toying with names for a liberal Tea Party that embrace the terms that are used to deride and silence liberals:

• The Class Warrior Party
• The HellYeah Party (HellYeah we’re liberal. HellYeah we want living-wage jobs. HellYeah we believe in the healthcare public option.)
• The Second Revolution (HellYeah, we’re embracing the French for rising up in revolution.)

But if Van Jones wants to try the American Dream Movement, I'm game.

What It Needs to Succeed

Jones, a former White House environmental official, announced the American Dream Movement at Netroots Nation, an annual conference of progressive political activists. For any type of liberal Tea Party to succeed, it needs to have a life beyond the Internet, beyond the digitally savvy and financially comfortable and politically plugged in.

• People who aren’t political junkies but are recreational users, if even that.
• People who don’t know chapter and verse of Robert’s Rules of Order, or the minutiae of legislative procedure. All they know is they’re frustrated because they’re not being represented by their party.

Going Viral Among the Unplugged

In 2003, Democratic Presidential  candidate Howard Dean was slapped down for saying he wanted to be the candidate for guys with Confederate flags in their pickup trucks. In a clumsy way, he was talking about people who are disinterested in or disengaged from politics. People who don’t have smart phones or RSS feeds or even Internet service. A liberal Tea Party needs to have the momentum to migrate off the grid and go viral among the unplugged masses. The question is, how. Thoughts?

The Economy's Sick. Up Its Meds.

I am a hobbyist homeopath. Based on the principle of "like cures like," homeopathy is the practice of treating illnesses by using trace amounts of the substance that caused the illness.

Say your allergies are acting up and your eyes are streaming as if you've been chopping onions. Tablets of allium cepa, or red onion, are recommended. If you can't sleep at night, reach for tablets of coffea.

There are hundreds of homeopathic treatments in all. They range in potency from a low of 6X  to a high of 200c, which are administered by skilled and licensed homeopaths.  I have a kit of 36 6X remedies at home. The kit cost $96 and has saved our family hundreds of dollars in urgent care visits, doctor's office visits, and even veterinary visits. When the nearest doctor is half an hour away and a greater share of healthcare expenses are paid out of pocket—assuming you have health insurance to begin with—homeopathy is worth considering.

Watch any TV commercial for a pharmaceutical and notice the long list of possible side effects. If you take the wrong homeopathic tablet for an ailment, the only side effect is nothing happens.

Homeopathy has its detractors, mainly people who practice traditional or allopathic medicine. A few years ago I was talking to a licensed homeopath about remedies I could recommend for a good friend's illness. The homeopath advised against the idea. She said if the remedy was incorrect or if the dosage was too low, people would say "See, homeopathy doesn't work."

A similar scenario is playing out with the U.S. economy. Some people say the stimulus didn't work because it was too small. Others say it didn't work because they don't like who's administering it. Count me in the first camp. The economy's sick. Up its meds. Stat!

Learn more about homeopathy from a homeopathic educator and published author.