by Diane J Peterson
Equality in access to health care should be a right. But access is wrongly affected by a person’s socio-economic status, plus conditions of their physical and mental health. Although wanting a fair health care system, I perceive our nation lacks a logical system of health care delivery. Actually, I never refer to an American health care system. Instead, I observe America has health care chaos. Since 2006, I’ve been active to reduce this corporation-friendly chaos and replace it with a humane, fair system.
In 2015, I discovered that Minnesota’s Medical Assistance program uses a discriminatory practice of sorting Medical Assistance patients into two categories: a small percentage permitted to choose the doctors and other health care providers to treat them, and the remaining majority are forced into a managed care organization which controls the network of doctors and other providers dispensing care. The state should not privilege the approximately 200,000 Medical Assistance patients with the right to choose while it discriminates against the remaining 1.3 million patients by denying them that right. Those 1.3 million do get to choose which managed care organization supervises them, but are denied equal freedom to refuse enrollment into those organizations. This discrimination should stop. For those who like the services provided through those organizations, they can certainly keep on with that. But for those who want the freedom to choose providers according to personal preferences, the state should guarantee that right to choose.
Last year, Rep. Tina Liebling (DFL-Rochester) and Sen. Jim Abeler (R-Anoka), agreed with my citizen activist group, Health Policy Advocates. We believe that Minnesota should pass a law guaranteeing the Freedom to Choose in Medical Assistance. They introduced a bill to accomplish that, but it didn’t pass. This year, it was reintroduced by Sen. Alice Mann (DFL-Edina) and Rep. Kim Hicks (DFL-Rochester). All of these supporters have extensive medical backgrounds. Abeler is a chripractor and Mann is a doctor. Hicks has years of work experience in the state agency handling Medical Assistance patients with disabilities. Thankfully, the bill continues to have Liebling and Abeler as co-authors, along with nine other legislators. Health Policy Advocates named the bill “Freedom to Choose;”legislators calls it “Opt Out of Managed Care.”
At a February 16 hearing, I testified that “Freedom to Choose” more accurately describes what the bill is about. It restores a right all Medical Assistance patients had decades ago before the state began experimenting on them by putting them into managed care organizations. Indeed, the state still uses language describing placement of Medical Assistance patients into managed care as the “demonstration project.”
This project amounts to an experiment which should have been evaluated years ago to determine whether it actually saves the government money, as claimed. A thorough evaluation of the experiment by an independent auditor has never been done. Yet the state keeps on experimenting: this project keeps 1.3 million Medical Assistance patients under managed care supervision. Informed consent from the human subjects put into this experiment hasn’t been ethically obtained. Let’s stop the uninformed consent, stop the coercion into managed care. It’s time to restore the human subjects’ right to stay out of the state’s experiment, thereby restoring their right to choose health care providers they decide are best for their needs.
Enacting HF816/SF404, the Freedom to Choose bill, could also reduce racial disparities in health care, since patients of color could exit managed care restrictions and select culturally sensitive providers they trust. A final consideration is found in a government cost projection, generated last year, explaining the state would have saved $10 million if the bill had passed. Let’s enact equal rights, for less cost, this year.
Editor’s note: Diane J. Peterson is co-founder of Health Policy Advocates.