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Lawmakers seek health-care reform

ST. PAUL - Some Minnesota lawmakers and health-care reform advocates say an ill state budget does not have to delay remedies to a troubled health-care system.

As the 2008 legislative session opens today, top Democratic-Farmer-Labor Party lawmakers and the Pawlenty administration say they believe some improvements to the health care system are possible this year.

Legislators and others who have been involved with dozens of health-care reform meetings in recent months are optimistic that by the time the Legislature's May 19 adjournment deadline arrives, Minnesotans will notice some changes to a costly and problematic health-care system.

In fact, health-care reform could be a rare major issue on which Republican Gov. Tim Pawlenty and DFL lawmakers reach agreement this year, and that may stem from an understanding that a compromise will focus on finding ways to cut costs and promote preventative health care.

Rep. Tom Huntley, the top House Democrat on health-care issues who recently served on two major reform panels, said the overarching goal is to go from "having a sick-care system to having a health-care system."

Lawmakers and Pawlenty face a state budget deficit estimated at $373 million and probably growing, making the case for significant new spending difficult.

"Obviously, the budget has an impact on us," said Huntley, a Duluth Democrat.

In advance of the session, Pawlenty has quietly met with lawmakers in recent weeks to discuss a variety of legislative issues, including health-care reform. Pawlenty spokesman Brian McClung said compromise is possible in that area.

"I think you're seeing the coalescing of ideas," he told reporters.

Minnesota House Speaker Margaret Anderson Kelliher, DFL-Minneapolis, also offered an optimistic assessment of health-care reform this legislative session.

"There will be a lot of work done on this and it does not necessarily cost money immediately to get this done," Kelliher said Monday.

Health-care reform is a contentious issue, however, and Huntley said both a legislative task force and a governor-appointed panel that developed reform recommendations will face opposition.

There are more drastic health-care reform proposals floating around the Capitol.

A veteran Democratic senator is teaming up with several freshmen House DFLers in promoting a so-called single-payer system in which a government-appointed board would oversee insurance coverage of all Minnesotans.

Supporters said moving to single-payer, universal coverage would allow patients to pick their doctors and focus on preventative care. But Pawlenty and Republican lawmakers oppose a government-run program.

The single-payer approach, which supporters unveiled Monday and said could take up to four years to implement, got the early support of the Greater Minnesota Health Care Coalition. Vicki Sanville of Duluth, the group's vice president, said patients would be more comfortable with that type of plan.

"People will be able to use the doctors they want to use," Sanville said.

The issue is on the minds of rural Minnesotans, advocates said. Health care ranks second only to the economy among some farmers, said Bruce Miller of the Minnesota Farmers Union.

Miller said health-care reform is critical for Minnesotans who must choose whether to pay for health insurance or other essentials, and must travel long distances to see doctors.

Some elements of the various reform proposals eventually would cost more money, Huntley said. Lawmakers may try to turn to a state health-care account that is running a surplus, but Huntley said that money only can be used once, and Pawlenty has made clear he wants to see cost savings before more dollars are spent.

Pawlenty and DFL lawmakers specializing in health care issues have not always had an amiable relationship.

The Republican governor long has criticized the rapid growth rate of state-subsidized health care for low-income Minnesotans and has proposed cutting spending in that area while some Democrats have tried to expand those programs to more citizens.

Senate Majority Leader Larry Pogemiller, DFL-Minneapolis, said leading Democrats on health care believe Pawlenty is "genuinely interested" in reaching agreement on health care reforms.

"We believe that this could be a pretty dramatic year in terms of moving toward universal health care," Pogemiller said.

Renewed discussion of health-care reform Monday came as an independent audit concluded Minnesota should do a better job containing costs in three state-paid health care programs for low-income Minnesotans.

Those programs are Medical Assistance, MinnesotaCare and General Assistance Medical Care, and together cost $6.5 billion in 2007.

A report by Legislative Auditor Jim Nobles' office found that state officials conducted limited reviews of the administration of those three programs.

Among other recommendations, the audit suggested more oversight of the administrative costs for those programs, which in 2006 totaled $200 million.