One way to achieve publicly-administered, efficient health care delivery is from the bottom up — starting with local government, especially counties. This also has the advantage of local control, and more responsiveness to local circumstances. It is already being done, in part, by 28 of Minnesota’s 87 counties. They are operating what is called County-Based Purchasing (CBP) programs, in which they directly run the state’s low income health care programs, instead of private HMO middlemen.
What are the advantages of CBP? Several:
- There is much less administrative overhead — about half of that of the private HMOs.
- No million dollar-plus CEO salaries or fancy, expensive office buildings.
- Cooperative partnerships with local health care providers, not antagonistic relations.
- No army of bureaucrats busy delaying or denying services and payments.
- Better payment of dentists, so enough participate to provide access.
- A true public-purpose, public health motive, not a corporate bottom line.
A better way for all:
Once a county-based system is well in place for the public programs, it could decide to expand to offer coverage to the general local population. This would not be government-subsidized coverage, but it would be lower cost and better value than what the insurance companies sell, because of the lower overhead and efficient, public-purpose attitude of the county systems.
To view in more detail the basics of County Based Purchasing, read our fuller description by clicking here: GMHCC Basics of County Based Purchasing
Our role to help county systems:
The Citizens Federation and Greater Minnesota Health Care Coalition have, for five years, told the public and state lawmakers about the advantages of County-Based Purchasing. We have countered the negative propaganda against CBP generated by the private HMOs and their allies in the state regulatory agencies.
County systems have been falsely accused of having higher administrative expense than the HMOs, and inferior quality of care, when in fact the opposite is true on both counts. One of the systems was also falsely accused of financial mismanagement, when the problem was created by the state government itself. Now, with major foundation backing, the Citizens Federation is helping to promote the spread of CBP into more parts of Minnesota, and combat the misinformation.