Minnesota's New Health Commissioner Effectiveness Questioned

Author: 
Twila Brase, RN
Article Type: 
Report from the States
Issue: 
May/June 1999
Volume Number: 
4
Issue Number: 
3

Jan Malcolm, Vice President of Public Affairs for the Allina Health System, Minnesota's largest HMO, was appointed on January 19 as Minnesota's new Commissioner of Health. We question whether Commissioner Malcolm, a top-ranking HMO executive, can effectively deal with the problem of managed care.

Following the 1973 federal HMO Act, Minnesota transferred regulation of HMOs out of the Department of Commerce, where all other insurers are tightly regulated, and into the Department of Health. Citing this relationship between the Department and HMOs, many organizations and legislators have been justly concerned the regulatory duties of the Department of Health may be hampered by the Department's dependence on HMOs for Medicaid enrollment, public health initiatives, and access to health data. One concerned legislator, Rep. Ron Abrams (R-Minnetonka), has introduced legislation since 1997 to transfer HMO regulation back to the Department of Commerce, but has thus far been defeated.

Commissioner Malcolm may carry a bias favoring the industry for which she has worked. Her allegiance to managed care can be seen in her press conference comments quoted in the St. Paul Pioneer Press, where she stated, "I really see my career as having been an attempt to do health care reform, to make health care more accessible and more of uniformly high quality. I've always seen managed care plans as a tool to do that."

The public outcry over managed care has increased as health care quality and access have decreased: Enrollees wait longer for appointment and tests, local clinics are not allowed in provider networks forcing patients to travel further distances, patient-doctor relationships have been broken, access to medications and treatment are arbitrarily denied as medically unnecessary, patients pay out-of-pocket for care denied, and patients are forced into litigation to access care.

While proponents of managed care cite such complaints as mere anecdotal evidence and advance managed care as the only solution to rising health care costs, we should point out the projected 5-13 percent increase in 1999 premiums and a 1997 quote by Senator Don Samuelson, chair of the Health and Human Services Finance Committee. After he was assured that placing people with disabilities into managed care would save the state money, he said, "My drawer is full of promises like that in my 26 years...So far all I've seen in managed care is more costs in more ways...It certainly hasn't saved any dollars I can see." (May 7, 1997 HHS Conferences Committee).

Ms. Brase is president of the Citizens' Council on Health Care. Web site: http://www.cchc-mn.org.

Originally published in the Medical Sentinel 1999;4(3);113. Copyright©1999 Association of American Physicians and Surgeons (AAPS)

No votes yet

It is now legend the AAPS legally lanced the secret task force and pulled its secrets...into the sunshine. It destoyed the Health Security Act.


The Oath of Hippocrates
and the Transformation of Medical Ethics Through Time


Patients within a managed care system have the illusion there exists a doctor-patient relationship...But in reality, it is the managers who decide how medical care will be given.


Judicial activism...the capricious rule of man rather than the just rule of law.


The largest single problem facing American medicine today is the actions of government...


The lessons of history sagaciously reveal wherever governments have sought to control medical care and medical practice...the results have been as perverse as they have been disastrous.


Children are the centerpiece of the family, the treasure (and renewal) of countless civilizations, but they should not be used flagrantly to advance political agendas...


Prejudice against gun ownership by ordinary citizens is pervasive in the public health community, even when they profess objectivity and integrity in their scientific research.


The infusion of tax free money into the MSA of the working poor give this population tax equity with wealthier persons...


It was when Congress started dabbling in constitutionally forbidden activities that deficit spending produced a national debt!


Does the AMA have a secret pact with HCFA?


The lure of socialism is that it tells the people there is nothing they cannot have and that all social evils will be redressed by the state.


Canada's fatal error — Health Care as a Right!


The Cancer Risk from Low Level Radiation: A Review of Recent Evidence...


...Moreover, the gun control researchers failed to consider and underestimated the protective benefits of firearms.


Vandals at the Gates of Medicine — Have They Been Repulsed or Are They Over the Top?