Republican presidential candidate Tim Pawlenty said Sunday he would never support requiring everyone to buy health insurance, taking issue with the health care changes that 2012 rival Mitt Romney oversaw as Massachusetts governor. Instead Pawlenty has repeatedly said his national health-care reforms would differ from The PPACA and mimic Minnesota's. "Any federal reform should be based upon the principles of improving quality of care, providing consumer choice, lowering health care costs and promoting transparency in the healthcare industry."
Pawlenty disagrees strongly with the Massachusetts health care reform plan enacted under former Gov. Mit Romney. Romney asserts that while the federal government went too far in requiring individuals to buy insurance under President Barack Obama’s health care law, it was appropriate for states to decide if individual mandates were right for them.
Pawlenty asserts that, “I strongly oppose the individual mandate at any level,” Pawlenty said. “I think it’s a dramatic overreach.” He noted that he was party to a lawsuit in Florida trying to get the law declared unconstitutional. Pawlenty recently reminded an audience that Obama had stated that “he designed Obamacare after Romneycare and basically made it Obamneycare.”
As governor of Minnesota, Pawlenty backed a program that puts an emphasis on paying for efficient health care instead of rewarding health facilities that charge for what he calls "endless volumes of procedures."
Doesn't This Sound Familiar?
So far this may remind you of candidate Barack Obama in 2008 discussing how payment reform, or "bundling" is needed, as well as greater health care efficiency. I was intrigued. But then once elected, it seemed the effort to control costs was nearly completely forgotten, except for some incentive programs and the Accountable Care Organization pilot within Medicare.
So will President Pawlenty propose and actually present legislation along those principals, unlike President Obama? I guess time will tell, let's get back though to candidate Pawlenty's policy ideas.
The Pawlenty Plan
While Governor of Minnesota, Tim Pawlenty did enact several forward-thinking health care reforms. Here's the twenty second elevator speech of how the state employee plan was reformed: The plan works off the premise that health care providers should charge differently — that they should be paid one price for a basket of services. The message that such a plan sends to health care providers, Pawlenty says, is that they will profit from being efficient and successful, instead of larding patients' bills with small charges.
Some of the elements of the Minnesota plan are included in a pilot program put forth by the Obama administration but Pwawlenty sees a difference as he is critical of the PPACA. "I think what President Obama's proposal is ultimately going to do is, it's going to expand access, but it is going to do nothing to control costs," he says. "And for most Americans, their primary concern about their health care is that it's becoming unaffordable." Yes, he's right about that.
Health care costs for Minnesota's state employees had gotten too high, Pawlenty says. "We said, look, you can go anywhere you want. But if you choose to go somewhere that's really expensive, with poor results, you're paying more. And if you choose to go somewhere that has better results, and is more efficient, you will pay less."
Instead of the PPACA, Pawlenty said Congress should strive for, "Payment reform. Stop paying for volumes of procedures."
Pawlenty's Minnesota Reforms
Pawlenty began with modest reforms. Following his 2002 election, he spearheaded the Smart Buy Alliance, a public-private partnership which allows employers and groups to buy health insurance for their employees and members and sets uniform performance standards and reporting requirements. And the administration helped launch Minnesota Health Info, an online clearinghouse of health information where consumers can learn the cost of the 100 most common procedures. Pawlenty also signed into law the Flexible Benefit Plan which allows employers to eliminate mandates they deem unnecessary in the insurance plans they offer.
Later, Pawlenty implemented QCare, the first of a slew of changes that sought to make good on the administration's health-care mantra for his second term: to make Minnesota's health-care system even more market-driven, patient-centered and quality-focused.
The Quality Care and Rewarding Excellence program identifies quality measures, sets aggressive outcome targets for health-care providers and, most significantly, makes comparable measures transparent to the public while altering both private and public payment systems to reward outcomes rather than the number of patients seen.
Palwenty also implemented reforms to change how tax dollars providing incentives to employees who choose the more efficient health plan. Pawlenty says, "individuals who use more costly and less-efficient clinics are required to pay more out-of-pocket... Employees overwhelmingly selected providers who deliver higher quality and lower costs as a result of getting things right the first time."
The result: no or very low premium increases in the state employee insurance plan.
Then during Pawlenty's second term bigger changes were coming. In 2007, he signed legislation creating a new uniform billing and coding process across the entire state—a major change which has increased efficiency in the system and is expected to ultimately lower health-care costs. The following year, Pawlenty enacted what Cal Ludeman, the Commissioner of the Minnesota Department of Human Services, called the "most historic bipartisan health-care legislation yet."
The 2008 Health Reform Bill allowed for a number of unparalleled changes in Minnesota health care. Minnesota became the first state in the nation to create a provider peer-grouping system which publicly compares clinics and hospitals on cost and quality
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