I found this in my email from the Minnesota Progressive Caucus regarding Franken & health care

[dflprincess]

Sen. Al Franken spoke in Duluth on Sunday evening (Aug. 2), at the
Progressive Roundtable conference. Here are some comments on what he said
regarding health care reform:

1) He referred to McAllen, Texas where doctors have integrated control of
health care services, and soak Medicare for many unnecessary procedures.
Franken pointed out that "Medicare is a single payer system," apparently to
make the point that single-payer is not the answer for this kind of wasted
expense, and emphasizing instead that "there are other things we have to
do" -- referring to cutting out unnecessary procedures by certain providers
who are greedy.

What Franken was really talking about is the concern of having a Fee For
Service system (separate payment for each procedure) without any controls
over unneeded, wasteful procedures. But by referring to single payer, he is
mixing apples and oranges. The idea of one payer, just alone by itself,
saves huge amounts of wasted money in administrative expenses. However,
when you create a single payer, you also have the opportunity to put into
place mechanisms to curb wasted expense in unneeded medical procedures as
well. It's too bad that Franken has gotten very mixed up on this, by
listening to those who deflect attention away from the insurance companies
(which are the single biggest cause of financial waste) by implying,
incorrectly, that the biggest source of financial waste in the health care
system is instead unneeded procedures.

2) He said that in Minnesota, we enjoy very efficient, cost-effective
health care. He said that Minnesota health care providers generally do not
do a lot of extra, unneeded procedures, and succeed in keeping their
patients relatively healthy. That is true. However, he also said that "90%
of what we pay the non-profit insurance companies in Minnesota goes to
health care costs," with only 10% going to overhead. This statement is
false. It is what the HMOs claim, and it is what the state regulatory
agencies say, and is also parroted by "experts" such as Rep. Tom Huntley.
However, the state agencies recently admitted that they do not audit or
verify the HMOs' administrative expenses, and do not know what they really
are. The one external, independent audit ever done on them (2000 AG audit
of Medica) showed that the true admin expense was 19%, not the 9% that
Medica claimed. The trick? Simply pretend that a lot of your administrative
costs are actual health care services - in other words, cook the books.

3) Franken correctly pointed out that a necessary element of reform is to
stop the insurance companies from "cherry picking" -- keeping healthy
enrollees, and avoiding sick, expensive ones. However, he seemed to be
unaware of all the tricks that insurance companies have up their sleeves,
including "shedding" customers -- deliberately making sick enrollees
disgusted with your insurance company so that they will leave voluntarily.
He is probably unaware that for over 10 years, it has been officially
illegal for Medicare HMOs to cherry pick their enrollees, yet they still
somehow manage to do so.

4) He toed the party line of top Congressional Democratic leaders, which is
that a public option might not be needed, as long as things are done to get
universal coverage, and to stop the worst abuses of the insurance
companies. This view underestimates the power of the insurance companies,
and the plain economic fact that "fixing" the affordability problem with
taxpayer subsidies is simply not sustainable and cannot work for very long.
Trying to rein in the insurance companies' behavior with regulation alone
(and without competition from a strong public plan) will be extremely
difficult if not impossible.

5) Franken's deep misunderstanding and misinformation is due to his
listening to the wrong people, and not listening to progressive Minnesotans
who have been deeply involved with health care reform for a long time.

6) In his election campaign, Franken said he strongly supports the right of
states to do their own experimentation, including single payer. Now we need
to know whether or not Franken will push for an amendment to allow states
to do this (and not be blocked by provisions of the new health care bill.)
This is especially important for Minnesota, which has a single-payer bill
with about half of the state senators and one-third of the reps as
co-sponsors. Endorsement of it is an official position of the state DFL party.

7) At the beginning of his talk, Franken said he is proud to be following
the tradition of progressive Minnesota senators McCarthy, Humphrey, Mondale
and Wellstone. Wellstone would be very displeased with Franken's and the
other Democrats' unwillingness to strongly confront the insurance companies
and directly address the question of how to diminish their power.

Two additional comments from Kip Sullivan, author, The Health Care Mess:
How We Got Into It and How We'll Get Out of It (which Franken and everyone
else should read).

Franken shouldn't make policy based on a single article in the New Yorker
about a single town (McAllen TX).

And it is not at all clear that MN providers are better at avoiding unnecessary
care than, say, Arizona or Florida providers. I'm trying to get to the root
of the mythology that MN providers do less and achieve higher quality. It
appears to me it is entirely based on the Medicare expenditure data
assembled in the Dartmouth Atlas at Dartmouth Medical School.

I get so tired of politicians who invoke Wellstone's name, but would never really support his positions.

[Eric J in MN]

1. When Franken campaigned, he said that he wanted to require...

...the states to cover all children with a Medicare-like single-payer system.

It's too bad that as soon as he got a seat in the Senate, his enthusiasm for single-payer dwindled.

[dflprincess]

2. He was never a fan of single payer for everyone

just for kids as you mentioned. Earlier in the week someone called into Stephanie Miller's show and said they heard Franken at the Duluth event and he sounded luke warm on the public "option" (how can it be an option when most of us won't be able to choose it for years?) and was willing to go along with that goofy coop idea.

I tried to speak to him about it once but it was quite clear he didn't want to hear from anyone who didn't agree with him (at least on this issue). He thinks each state has to find its own solution. That might have worked once upon a time and some states, like Minnesota (as it used to be) would have had great systems, others wouldn't have much of anything. But, with the budget problems states have now, I can't see how this would work. Though, John Marty has started pushing a single payer bill for Minnesota so maybe it could be pulled off. I just think a good federal system would be more equitable.

The Strib listed Franken as being #43 in money from health insurers - that's a long way from Baucus but I suppose if he lost it it would put a dent in his campaign treasury. The next time I get a call from his people wanting help covering the recount expenses I think I'll suggest they call Stephen Hemsley at United Health Group.