T-Paw Human Events Interview

T-Paw gave a nice interview to Human Events.  Here’s a sample response:

Minnesota has the highest percentage of Health Savings Accounts in the country: 9.5% of our population. The studies around that show there are significant cost-saving benefits to having people in HSAs. That’s No.1. No.2 is we urgently need medical malpractice reform. Harvard recently came out with a study showing 30% of the medical care in the country is medically unnecessary. This is for two primary reasons: First, doctors are afraid they are going to be sued so they run the checklist regardless of whether it’s needed or not, and second, misplaced capacity of the provider driving the decision as opposed to the medical needs of the patient.

A third thing we should do is, in an economy where people will be changing jobs a lot more than in previous generations, some portability of benefits would be helpful. In a dynamic economy, we should pay for better health and better outcomes — in other words, performance pay. We’re paying for the wrong thing right now. We should allow people to purchase health insurance across state lines. We should allow risk-pooling across state lines. We should incentivize electronic medical records and electronic prescriptions to make the system more efficient. 85% of the healthcare dollars are spent on five chronic conditions: cancer, diabetes, obesity, heart disease and end-of life-stage treatments. Where you go to get your care for those things matters a lot. It matters a great deal as to your healthcare outcomes and the cost. In other words, some places are dramatically more efficient and have higher quality than other places. If you let consumers know that, and you incentivize them to make wise decisions, they do. We have done that in Minnesota with dramatic results.  

I will give you one example. The Minnesota Advantage plan is our health insurance plan for state employees. In a very primitive way, many years ago, we tiered the providers in conjunction with the unions, and their back was being broken by healthcare costs, too. We negotiated this resolution: We’d tell the employees, “You can go anywhere you want, but if you choose to go to a place where there’s low quality, bad results, and that’s expensive, you’ll pay more. If you choose to go to a place that’s high quality, has good results, and that’s efficient, you’ll pay less.” And guess what happens? 90% of the entire state employee population migrated to more efficient providers. The good news in all this correlation between efficiency and quality is positive. In other words, the better providers tend to be more efficient.  

Be still my wonky heart.  Read the whole thing.