UHS advocates a “united health system.” A united health system is any system that embodies the following characteristics. Any system that is structured by these principles we consider desirable system and we support it. What follows are the basic foundational principles of a united health system followed by some organizational proposals and additional comments regarding other parts of the Minnesota proposal evinced in the single-payer bills currently under consideration by the Minnesota legislature: Senate File 414 and the companion House File 481

Provides Life “Give me medical care, or Give me death” is an unnecessary reality in America. How many Minnesotans would be alive if none ever received any medical care? American’s value Life as an unalienable right. Life cannot be guaranteed, but medical care can be guaranteed for all, and it is essential to ensuring Life, considered a basic, inalienable right of Americans since the adoption of the Declaration of Independence in 1776. According to the Institute of Medicine, 2003, 18,000 Americans die each year due to lack of ability pay for necessary medical services.

The main reason a people form a government is to ensure their personal safety and well-being, and that government's main duty is to ensure its citizens' well-being and safety. This main duty has been understood in America to mean protecting Americans from physical harm and ensuring their well-being. Our governments do not fulfill their responsibility to that duty. When that attacker is an army or a terrorist with guns, the government does a good job in protecting the well-being of we citizens. But when the attacker is cancer or diabetes, our government is AWOL from fulfilling its fundamental duty. The federal and state governments do not protect the well-being of citizens when the harm is coming from a clogged artery, or cancerous cell. The responsibility is the same: look after the well-being of citizens, yet by failing to provides guaranteed access to medical regardless of financial situation is dereliction of duty.

Provides Pursuit of Happiness. Another inalienable right, pursuit of happiness is defined in health and medical terms. The lower the degree of health status, the lesser one is able to experience and pursue happiness. The sick, infirm, and disabled can not pursue the life activities they once could, or would want to now, due to their ill-health status. And that idea of “limited” ability extends across a whole spectrum of levels of health. Without having guaranteed access to medical care at any point in the development of a malady, a person can end up a lesser health status than necessary. This lesser health status can separate or prevent that person from pursuing hobbies, work, relationships, education—all sorts of human endeavors—than would be the case had they been able to receive medical care earlier than they did—if ever. Government cannot fulfill it’s responsibility to protect citizens from being denied their pursuit of happiness without guaranteeing access to necessary medical care regardless of financial situation.

Provides Universal Coverage. Providing universal, guaranteed health care access is consistent with the principle of equality. With an equality of status in the health system, society is then stratified into classes based on health access, but also creating classes based on health status and financial burden of health costs. Those classes produced include the class of the Dead and the Bankrupt. Universal access allows anyone to receive medically necessary treatment at the appropriate, optimal time in medical terms, without their care compromised by financial concerns.

Provides equal coverage. Everyone is covered, and all have coverage equal to that of everyone else. Equal health outcomes cannot be guaranteed, but equality of opportunity to medical care access is an essential American principle.

Provides as much liberty as possible. The health system we support respects individual liberty: It allows free choice of doctors, clinics, and hospitals for everyone. No managed care organization or bureaucrat will interfere with personal choice; personal liberty. Freedom is revered in America like no other value.

Restores the sanctity of the Dr.-patient bond. This ensures quality care, advice, and patient consent to all treatments without interference from outsiders, like HMOs. The state reforms the financing function, but does not involve itself in medical-decision-making: any medically necessary medical services will be paid for by the state.

Uses the insurance-financing mechanism known as “single-payer” or “Medicare for all.” Based on the Medicare model, the financing of medical costs comes from public funding. This “single-payer” mechanism replaces the millions of payers in the current system: HMOs, insurance companies, employers, and individuals with one statewide payer. This uses the basic economic principle of “economies of scale,” reduces unnecessary duplication and multiplication of efforts, and establishes one big “insurer.” Providers deal with one payer, compared to hundreds of insurance companies today.

Provides comprehensive care. This includes vision, dental, prescriptions, TLC, preventive medicine, ongoing care, emergency care, and major medical coverage.

Is funded by a progressive tax. Nearly all Minnesotans will pay less for this tax than what they pay in health costs now by eliminating all health care premiums, deductibles, co-pays, car liability medical coverage, and worker’s compensation taxes.

Leaves Dr.’s, clinics, and hospitals in the private sector. The government doesn’t own clinics and hospitals, and Dr.’s don’t work for the government. Provider networks can remain, or form, if they so wish and can be financially viable. This means that the network structure for delivering medical via HMOs, PPOs, etc can remain in place. What the “united health system” will do is to merely remove the insurance function from those entities, placing the payment of claims in the hands of providers and the State claims processing department, thus cutting out any middlemen.

Provides for democratic control of health-policy making and financing. As currently written in SF414/HD481, A Minnesota State Health Board is created, independent of legislative control, consisting of 6 Regional Board representatives’ statewide and 2 members each appointed by the Senate, House, and Governor. Regional Boards and the State Board share authority. Neither public officials nor health industry officials may serve on the Boards.

This process is flawed because the regions are not formed on the basis of proportional representation—based on population, which is inherently anti-democratic. For example, at the extreme, the 7-county metro area will consist of only 1 of the 6 regions, despite containing about half of the state’s population. The UHS proposal is to replace that regional design with one that is population-based, with putative organizing mechanisms of the 8 Congressional districts in Minnesota, or the 67 Senate districts in the state. Both of those two geographically-organized sectors are based on relative equality of residents.

What else the United Health System entails:

Under the plan we support, The Minnesota Commerce Department continues to regulate medical providers and companies as far as being business and financial entities.

The Minnesota Department of Health continues to regulate the “medical” or “medicine” aspect of our health care system re: regulation of providers as medical service deliverers, medical safety issues, compliance with medical regulations and interaction with various other medical ethics, oversight, and medical necessity assessment organizations. It also continues some of its research activities into general health and financing of health care issues, availability of providers, economic analysis of health care in Minnesota.

In the way described above, Commerce and MDH serve as checks and balances on The State Health Board created with UHS. A further, internal government check is provided by the State Legislative Auditor, which will perform the state government audit of the State Health Board. Additionally, each Regional Board will serve as a check on the State Board, and vice-versa.

The State Health Board controls costs better than currently as relation to the insurance or “pooling of risk” in one state-wide pool via the “single-payer” financing mechanism, as described above. The main elements of his cost saving results from: greatly reduced administrative costs, fee negotiation with providers, stronger oversight of capital expenses (construction of new medical facilities and capital expenditures by hospitals and clinics) and using the market force of Minnesota serving as one large consumer to negotiate prices with drug companies.

Reduced Administrative Expenses

Administrative expenses for Medicare are about 3%, while HMO administrative costs are from 15-35%. In addition to HMO administrative expenses, a united health system will eliminate administrative costs borne by employers in their provision of health benefits, help reduce overhead costs of providers, remove the re-insurance, eliminate, mostly, the need for Commerce Department regulation of private health insurance, since the role of commercial insurance will be reduced to an extremely small part of the health system. It can also eliminate or reduce the overhead costs of Third Party Administrators, Managed Care Administrators, Carve-outs, etc. No more: HMO advertising costs, high executive salaries, lobbying expenses.

Reduce legislative costs spent dealing with the whole of the health system by non-experts in health policy year after year and the partisan competition inherent in representative democracy. The development of rules and regulations with occur with in the State Health Board entity, with ultimate decision-making by Board members, full time health policy experts.

United Health System Funding

Our United Health System would establish the State Health Board as a semi-autonomous government entity, not directly subject to legislative or executive control. There are numerous ways to accomplish this, with the Federal Reserve and the Minnesota Comprehensive Health Association (MCHA) as potential models. The funding authority would place the authority to raise revenues—via taxes, fees, etc.—for the exclusive purpose of funding the Universal Health System. It is important that the same entity, the State Board, have the authority to both raise and spend the health system funds in order to prevent another body given the fundraising authority, legislative/executive, from de facto controlling the Universal Health System via using it’s levers of increasing or reducing funding based on its wishes for adoption or elimination of various policies, or elimination of the System and State Board themselves.

Summary

In Minnesota, we can do this with our proposal for a united health system. Lower costs; a better integrated, less complex and time-resource consuming bureaucratic structure, enhance our enjoyment of American’s unalienable rights and values.

It’s Just Health Care.

Various whole and partial examples of united health systems can be found in US Medicare, the Veterans Administration health system, Canada, and all other OECD nations.