Wednesday, November 15, 2006

COLUMN -- The candidate may have sunk, but his ideas are on the rise

Posted by Craig Westover | 7:33 AM |  

Wednesday, November 15, 2006

Well, after a hard-fought, photo-finish campaign between Republican Gov. Tim Pawlenty and Democrat Attorney General Mike Hatch, we find out who had the best ideas to move Minnesota forward — Independence Party candidate Peter Hutchinson.

Republican Pawlenty kicked off his campaign riffing that Minnesota's "worst nightmare" is "big spending, tax raising, abortion promoting, gay marriage embracing, more welfare without accountability loving, school reform resisting, illegal immigrant supporting Democrats." Since last week's sleepless election night, he's focused his rhetoric on the "meat and potatoes issues that most Minnesotans are concerned about" — Hutchinson's litany of education, transportation, health care and the environment.

The new speaker of the Minnesota House, Margaret Anderson Kelliher, a big-spending, tax-raising — you get the point — Democrat said on Public Television's "Almanac" that Hutchinson had some "good ideas" that provide common ground between the "nightmare" Legislature and the Republican governor — less than a week after Democrats were urging Minnesotans not to waste their votes on the Independence Party candidate.

"It turned out to be an election about ideas," Hutchinson told me amid the cacophony of closing down the Team Minnesota campaign office. "They co-opted our ideas. They're all about moving forward now, keeping the main things the main things. After you get over being (angered) about it, it is kind of flattering."

Flattering, yes, but compliments don't build parties. History teaches that third parties merge with one of the major parties — think Democrats and Farmer-Laborites in Minnesota — or they grasp an issue and replace a major party — think the Lincoln-led Republicans replacing the Whig Party on the strength of the abolition movement — or they simply fade away.

The Independence Party has no intention of being co-opted or fading away. Despite gubernatorial vote totals declining from Jesse Ventura's plurality win with 37 percent of the vote in 2002, Tim Penny's 16 percent in 2004 to Hutchinson's 6 percent statewide, the Independence Party is stronger than it's ever been.

"It's ironic," said Hutchinson. "We lost and Ventura won, but we sit here today with more party talent and a bigger, better-financed party than we were in 2002. We have a diverse collection of Republicans and Democrats — heavy hitters, influential people. One thing we did this election is branded the IP as not just the party of Jesse Ventura."

Maybe not the party of Jesse Ventura, but the party of what? Party chairman Jim Moore places the Independence Party's message of fiscal responsibility and social liberty at the center of the political spectrum. While the Independence Party clearly views government as a force for good, government, it understands, has its limits.

"What government should do, it should do well," said Moore. "But it can't fund everything."
And that reality-based distinction is what makes the Independence Party different and viable. Democrats and Republicans play expectation politics. They make promises they simply can't pay for.

"The elections are over," said Hutchinson. "But governing is never over."

The major parties' search for common ground is symptomatic of expectation politics. In the past week, Democrats and Republicans haven't abandoned power politics in a chorus of Kumbaya. Their mutual and first concern is not damaging their respective political positions. Their priority is finding common ground; neither has a comprehensive plan for addressing the main things.

"I'm an optimist" and hope the parties focus on the main things, said Hutchinson. "It should happen. We'll see if the major parties tackle the big stuff or just tinker around the edges of what's important."

Therein lies the role for an Independence Party anticipating 2008 and making a serious run at electing state legislators.

"The Independence Party needs to remind people about what we said during the election," said Hutchinson. "Not in an 'I told you so' way. We need to keep people aware that there are choices based on reality.

"The first reality is to operate from the state revenue forecast, agree there is no new revenue. The next question is, how do we spend what we have more efficiently? That's the method we suggested during the campaign. The major parties start with spending and promises and then try to find revenue. We have other choices."

Without the bully pulpit of a single statewide office or legislative seat, how much actual influence the Independence Party will have on the 2007 legislative session remains to be seen.
But for now, it's more than a little interesting that both Democrats (motto: We're not Republicans) and Republicans (motto: We're not Democrats) are looking to the Independence Party when they need ideas, when they need a plan.

Update: Yesterday, Gov. Pawlenty outlined his health care priorities for the next four years. Key points the Governor made include --

• Universal coverage should be the state's goal.
• A health insurance mandate should be considered.
• The Legislature should cover uninsured kids.
• The state should implement a smoking ban.
• Prescription drug ads should be banned.
• Clinics should receive financial incentives to use electronic records.
• Doctors should be rewarded for low cost and high quality.

If one wants more details or a better understanding of “The Pawlenty Plan," he might check out the Team Minnesota web site and the Independence Party health care plan.

I expressed my praise and concerns for the Independence Party plan here. My main concern is that policy that works in aggregate to lower costs and improve quality through best practices does not always work to the benefit of individual patients. The first principle of medicine is “Do no harm,” not “Be cost efficient.” Policymakers need to look closely at the unintended consequences of motivating physicians through use of “best practices.”

Twila Brase of the Citizen’s Council on Health Care issued the following press release following the Governor’s speech:

For Immediate Release
Tuesday, November 14, 2006

CCHC Provides Response to Today's Speech by Governor Tim Pawlenty

St. Paul, Minnesota -- Twila Brase, president of Citizens' Council on Health Care, provides the following comments-pro and con-to points made by Governor Tim Pawlenty in his speech at the Midwest States Health Reform Summit in Minneapolis. The forum focused on bringing the 2006 Massachusetts universal coverage law and in particular, its controversial health insurance mandate, to Minnesota.

Governor: We must chart a path toward universal coverage.

CCHC: Universal coverage is a government-directed initiative, not a consumer-driven initiative. The discussion should not be about coverage. Coverage is not care. Many people with insurance coverage, including the privately and publicly insured in the U.S. and the entitled in other countries, fight to receive care every day. Health plans and governments use restrictions, bureaucracy, and control of dollars to ration patient access to care.

Governor: I think we should move to universal coverage. We need to move in steps. We've been studying diligently the Massachusetts model. We need to start with covering all kids. That's the logical next step to universal coverage in Minnesota.

CCHC: A health insurance mandate is a boon for insurers, a a bad idea for citizens, and a big step to government-run health care. A mandate is also unconstitutional. Government forces citizens to transfer their hard-earned incomes to the pockets of health plans. In addition, a mandate will not create universal coverage. As the Governor himself said, Minnesota requires car insurance, yet 17% of the public has not complied with the law.

Governor: Television advertising for pharmaceuticals creates consumer-driven appetites and should be limited if not temporarily suspended.

CCHC: Government should not limit citizen access to information on medical treatments. This is a patient protection issue. Health plans and government agencies are building data monitoring systems to direct and control the practice of medicine. If drug and medical device companies are not allowed to advertise, how will citizens and patients ever learn about treatments governments and health plans do not want doctors to tell them about?

Governor: We need to get to the point where we don't need to be a Ph.D to figure out your medical bills.

CCHC: Agreed!

Governor: We need to incentivize or require everybody to go to e-prescriptions.

CCHC: Computerization is not problem-free. Several studies report that electronic prescribing increases medical errors. A study in the Journal of the American Medical Association found Computerized Physician Order Entry (CPOE) added twenty-two new medical errors.

Governor: We need to pay doctors according to how well they meet recognized standards of care. We won't use a stick approach. We'll use a carrot approach. We'll reward doctors who meet the standards. This system is only going to get more robust.

CCHC: We disagree. This is a big government stick approach. Anyone who is not "rewarded" is penalized. They get a stick. There are no carrots, and increasing robust means increasingly punitive. This approach also permits government to intrude in private medical records and interfere with private medical decisions.

Governor: The role of the HMOs is called into question. Are they just banks? Are they just underwriters of risk? Or are they true partners. What is the health value of what they do? If they are just glorified aggregators of risk that don't meaningfully improve health, we need to chart a different future.

CCHC: We concur. We have long said that HMOs are banks that don't have to give the money back. In fact, they are allowed to write their own definitions of "medical necessity" and deny care based on those definitions. It's time for citizens to "bank" their own dollars, protect their assets, and keep the dollars they need to get the health care they want.

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Citizens' Council on Health Care is a non-profit, independent health care policy
organization that supports free-market ideas in health care.