Tuesday, August 10, 2004
Minnesota may have its hands full with new "best practices" legislation
[Conrad F. Meier, "Minnesota 'Best Practices' Law Riles Opposition," Health Care News, The Heartland Institute, 1 August 2004.]
"Best Practices" is one of those catch phrases that sounds like a good idea but really just means more government control. Think of single-payer health care - wouldn't it be more efficient if we got all of those competing insurance companies out of the way and just had one agency in charge of it all? The last thing the health care system needs is further government intervention. Yet, as this article shows, some policymakers will go to some great lengths to have a say in what your doctor should or should not be allowed to do for you:
Minnesota has recently become a national hotspot in the battle over health care reform. Pushed by employer groups, state agencies, and health plan providers, Minnesota House Republicans proposed legislation mandating the adoption of "best practices" as a cost-containment strategy in January. Senate Democrats offered their own version of the measure, and Republican Governor Tim Pawlenty blessed the notion early on.
Minnesota citizens responded to the best practices proposal with a large stack of petitions opposing it. The governor refused to budge, and in late June he signed HF 2277, a Department of Human Services (DHS) licensing bill into which the "best practices" mandate was placed. But it's clear the battle is not over.
Mandating "best practices" is not a new idea for Democrats. President Clinton included it in his failed health care plan 10 years ago, and state and federal proposals for government-defined "best practices" in medicine are popping up around the country.
Under an early version of the Minnesota plan, physicians who followed government-issued best practices would be protected from certain medical malpractice allegations. This didn't sit well with attorneys in the Republican caucus, however, and the proposal was dropped.
Nonetheless, the governor made it clear early in the 2004 session that best practices would be his key health care strategy. In his State of the State address, Pawlenty said he would "force health care providers to use best practices." A week later, Rep. Fran Bradley (R-Rochester), chair of the Health and Human Services Finance Committee and author of the cost containment bill, amended his bill to include a new best practices provision. No public testimony was allowed during consideration of the amendment.
The new provision authorizes state health officials to work with an HMO-funded group to create and distribute statewide a list of "best" medical practices. Physician adherence to the list is to be tracked, monitored, and publicly reported. To bring physician behavior in line with government treatment protocols, state agencies responsible for state employee health insurance and Medicaid would be permitted to withhold partial payment from providers who do not comply.
What started out as a simple little bill eventually had 60 amendments attached to it. The House and Senate Health and Human Services omnibus bills never made it to a conference committee because the two bodies could never agree to an overall state budget. As a result, at the 11th hour and without any public notification, the legislative leadership decided to use HF 2277 as the vehicle to get a package of health care bills into law.
Parts of bills or entire bills were added to it over a period of about eight hours. At the beginning of the meeting, the chair of the conference committee for HF 2277 announced, "amendments you have seen and amendments you haven't seen are going to be added to this bill."
Despite...opposition, Pawlenty signed the bill into law soon thereafter. Within three weeks, the Minnesota Department of Health announced plans for a state Web site to report physician adherence, and Pawlenty announced the formation of a Governor's Health Cabinet focused on implementing best practices.
Meanwhile, physicians who are becoming aware of the law have threatened to drop out of the MMA, and delegates at the State Republican Convention added their opposition to best practices to the state party's platform.
Although the Minnesota best practices law is in force at least temporarily, much opposition has been aroused, and it appears the notion stands on increasingly shaky political ground in the state. As similar battles pop up in other states, both supporters and opponents of "best practices" will find an interesting arsenal of battle strategies in the struggle in Minnesota.
[Conrad F. Meier, "Minnesota 'Best Practices' Law Riles Opposition," Health Care News, The Heartland Institute, 1 August 2004.]
"Best Practices" is one of those catch phrases that sounds like a good idea but really just means more government control. Think of single-payer health care - wouldn't it be more efficient if we got all of those competing insurance companies out of the way and just had one agency in charge of it all? The last thing the health care system needs is further government intervention. Yet, as this article shows, some policymakers will go to some great lengths to have a say in what your doctor should or should not be allowed to do for you:
Minnesota has recently become a national hotspot in the battle over health care reform. Pushed by employer groups, state agencies, and health plan providers, Minnesota House Republicans proposed legislation mandating the adoption of "best practices" as a cost-containment strategy in January. Senate Democrats offered their own version of the measure, and Republican Governor Tim Pawlenty blessed the notion early on.
Minnesota citizens responded to the best practices proposal with a large stack of petitions opposing it. The governor refused to budge, and in late June he signed HF 2277, a Department of Human Services (DHS) licensing bill into which the "best practices" mandate was placed. But it's clear the battle is not over.
Mandating "best practices" is not a new idea for Democrats. President Clinton included it in his failed health care plan 10 years ago, and state and federal proposals for government-defined "best practices" in medicine are popping up around the country.
Under an early version of the Minnesota plan, physicians who followed government-issued best practices would be protected from certain medical malpractice allegations. This didn't sit well with attorneys in the Republican caucus, however, and the proposal was dropped.
Nonetheless, the governor made it clear early in the 2004 session that best practices would be his key health care strategy. In his State of the State address, Pawlenty said he would "force health care providers to use best practices." A week later, Rep. Fran Bradley (R-Rochester), chair of the Health and Human Services Finance Committee and author of the cost containment bill, amended his bill to include a new best practices provision. No public testimony was allowed during consideration of the amendment.
The new provision authorizes state health officials to work with an HMO-funded group to create and distribute statewide a list of "best" medical practices. Physician adherence to the list is to be tracked, monitored, and publicly reported. To bring physician behavior in line with government treatment protocols, state agencies responsible for state employee health insurance and Medicaid would be permitted to withhold partial payment from providers who do not comply.
What started out as a simple little bill eventually had 60 amendments attached to it. The House and Senate Health and Human Services omnibus bills never made it to a conference committee because the two bodies could never agree to an overall state budget. As a result, at the 11th hour and without any public notification, the legislative leadership decided to use HF 2277 as the vehicle to get a package of health care bills into law.
Parts of bills or entire bills were added to it over a period of about eight hours. At the beginning of the meeting, the chair of the conference committee for HF 2277 announced, "amendments you have seen and amendments you haven't seen are going to be added to this bill."
Despite...opposition, Pawlenty signed the bill into law soon thereafter. Within three weeks, the Minnesota Department of Health announced plans for a state Web site to report physician adherence, and Pawlenty announced the formation of a Governor's Health Cabinet focused on implementing best practices.
Meanwhile, physicians who are becoming aware of the law have threatened to drop out of the MMA, and delegates at the State Republican Convention added their opposition to best practices to the state party's platform.
Although the Minnesota best practices law is in force at least temporarily, much opposition has been aroused, and it appears the notion stands on increasingly shaky political ground in the state. As similar battles pop up in other states, both supporters and opponents of "best practices" will find an interesting arsenal of battle strategies in the struggle in Minnesota.
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