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Commission Reports and Documents

Minnesota
Department of Health

News and Announcements

 

April 24, 1997:
Commission Reports on Managed Care's Impact on Individuals with Disabilities, or Chronic or Terminal Illness

March 26, 1997:
Citing Successes and Lack of Consensus on Health Care, Commission Recommends its Own Repeal

March 10, 1997:
More Minnesota Children Have Health Insurance, Overall Uninsured Rate Holds Steady, Commission Reports


Commission Reports on Managed Care's Impact on Individuals with Disabilities or Chronic or Terminal Illnesses

April 24, 1997

In a report requested by the Legislature in response to public concerns about the impact of managed care on individuals with disabilities, chronic conditions or terminal illnesses, the Minnesota Health Care Commission found that managed care generally performs as well as more traditional fee-for-service medicine. The report was based upon analysis of national and state-based research.

The report also noted, however, that both managed care and fee-for-service arrangements emphasize medical treatment and insurance coverage primarily for acute, episodic conditions; this type of treatment and coverage is often inadequate to meet the needs of persons with chronic or long-term conditions. Consequently, both arrangements can and should be improved to better meet the needs of persons with disabilities, chronic conditions or terminal illnesses.

Further, the Commission found no evidence that managed care has led, as some groups alleged, to the rationing of needed care for or euthanasia of patients who have the greatest medical needs or are most vulnerable.

The report also found:

  • Given the extent to which individuals with disabilities or chronic or terminal illnesses generally rely upon the health care system, their concerns and apprehensions about the system must be better understood and addressed.

     

  • There is often a lack of knowledge of consumer protections, services, or help available to aid consumers in navigating the health care system.

     

  • The types of consumer protections that apply to an individual with a disability or chronic or terminal illness vary depending on the kind of health plan in which he or she is enrolled. State consumer protection laws generally do not apply to individuals enrolled in self-funded employer health plans.

     

  • There is considerable disagreement over what constitutes quality end-of-life care. Desires about the use of or limits to life-sustaining treatment are often not well communicated, acknowledged, or followed, regardless of the type of health care delivery system used.


Citing Successes and Lack of Consensus on Health Care, Commission Recommends its Own Repeal

March 26, 1997

St. Paul, Minn. -- Declaring that many of its goals "have been accomplished" and citing a lack of consensus on health care in general and its own role in particular, the Minnesota Health Care Commission wrote Carlson Administration officials and several Minnesota legislators recommending repeal of the Commission, effective July 1, 1997.

The letter reflects discussions at the March 19th meeting of the Commission and is partly in response to a bill repealing the Commission introduced by many of the members of the Legislative Commission on Health Care Access (L.O.C.).

Commenting on the letter, Chairman John Gunyou stated:

"The Commission was created during a time of bipartisan concerns over escalating health care costs and rising levels of uninsurance. Since then, we have largely accomplished much of what we set out to accomplish - health care costs have moderated, the rate of uninsurance has stabilized, and the number of uninsured children has declined.

As the health care crisis subsided, the consensus among Commission members and among legislators on cost containment and universal coverage gradually broke down. Without this consensus, the Commission found it difficult to do its work and make a contribution."

We are the victims of our own success. That's not a bad legacy to leave the state.

This is not to say that the work on health care is finished. Rather, Commission members believe that the important work that remains to be done on long-term care, uninsurance and health technology should be done in different venues.

The Commission includes representatives of consumers, employers, providers, health plans, unions and state agencies.

A copy of the Commission letter can be obtained by contacting us.


More Minnesota Children Have Health Insurance, Overall Uninsured Rate Holds Steady, Commission Reports

March 10, 1997

St. Paul, MN - In an annual report to the Legislature, the Minnesota Health Care Commission found that the state has made significant progress in reducing the number of children without health insurance. At the same time, Minnesota has bucked national trends of increasing uninsurance rates by holding steady on the general rate of uninsurance.

"This report shows that Minnesota is making progress in its efforts to achieve universal coverage, but that more work must be done," Commission Chairman John Gunyou said.

Between 1990 and 1995, the number of continuously uninsured children in the state dropped from approximately 51,000 to 31,000, a 39 percent decrease. During the same period, the national rate of uninsurance among children rose.

From 1991 to 1995, when the national rate of uninsurance for the general population climbed from 13.9 to 15.3 percent, the state's rate of uninsurance remained stable at between 6 and 9 percent. Two organizations - the University of Minnesota's Institute for Health Services Research and the U.S. Census Bureau - conducted studies that confirmed that the state's uninsured rate held steady.

Both surveys generally agreed that the uninsured are more likely to be male, single, younger, less educated, and have lower incomes.

According to the University's survey, over the same time period the percent of the uninsured who are minorities more than doubled, from 5.6 percent of the continuously uninsured in 1990, to 12.5 percent in 1995. Also, most uninsured adults were employed. At least 25 percent of the continuously uninsured were self-employed, and less than 16 percent of the intermittently uninsured were self-employed.

The Commission recommends that the state expand its efforts to reach an estimated 86,000 uninsured Minnesotans who are currently eligible for the MinnesotaCare subsidized health insurance program but have not yet enrolled. The Commission also recommends that the state expand eligibility for the program to single adults and families without children with incomes up to 175 percent of federal poverty level, effective July 1, 1997. Based on 1996 federal poverty guidelines, 175 percent of the federal poverty level is an annual income of $13,545 for an individual, or an hourly wage of $6.51 for someone working full time.

A copy of the Commission report, Progress Toward Universal Coverage: Annual Report 1997, may be obtained by calling or writing the Commission.

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Updated Tuesday, 12-Sep-2006 10:32:15 CDT