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GAMC should also be part of health discussion

At a press conference held last week, the governor announced his proposal for several new health care reform initiatives. The announcement came at the same time the federal government moved forward on its own national health care reform. The governor's initiatives included allowing the sale of health insurance across state lines, ranking health care providers on cost and quality, and offering a high deductible plan and EBT card within the MinnesotaCare and Medical Assistance programs.

These ideas deserve discussion. What also deserves discussion is the effect of the governor's unallotment of funds that covered about 33,000 people from a health care plan for very poor people called General Assistance Medical Care (GAMC).

Who are they? Many of them are former patients of state hospitals and other institutions serving mentally ill and developmentally disabled persons. Many are veterans. What they have in common is that for one reason or another they do not qualify for federal government health care coverage because they fail to meet one or more criteria. By the federal government's standard, they are "cured." But to employers, they are often too difficult to maintain on the job, especially in a recession. What GAMC provides to them are the medicines and treatments that help attain a level that enables them to function on their own. Without them, some will slide back into dependence on far more expensive health care programs.

Some will debate about whether people in such a circumstance "deserve" help from the government. But there should be consensus on the fact that when these individuals need medical care, that local providers and hospitals -- and property tax payers and insurance policy holders -- shouldn't be stuck with the bills. There should also be consensus on the idea that an ounce of prevention is worth a pound of cure.

The result of the GAMC decision has already led to hospitals in every part of the state talking about cutbacks. Many hospitals have started the budgeting process for 2010 and are looking at extensive layoffs, reduction in services, and crowded emergency rooms. Some rural hospitals--already on the financial brink--may be forced to shut their doors.

There are five and a half million people living in Minnesota. A very small number, about one-half of one percent, are living in the shadows between ability and disability, between helplessness and self-sufficiency. Cutting off their access to the medications and treatment they need to function in society is false economy.

Any idea that helps keep people insured and our hospitals open is worth exploring. New initiatives ought to be discussed. At the same time, let's talk about how some existing strategies can be effective, too.