Think outside the pump

I'm interested in reaction to the talked about VMT system and the proposals in this PiPress editorial. Thanks.

Think outside the pump

In his budget proposal, Gov. Tim Pawlenty set aside $5 million to study technologies that could move Minnesota off a per-gallon gas tax and onto a "vehicle-miles-traveled" (VMT) tax — for good reason.

As in many states, gas tax revenue in Minnesota is flattening out — even though more people are driving more miles. That's because we're driving cars that are more fuel-efficient. So, from a tax standpoint, a gallon of gasoline purchased — and the tax it produces — doesn't relate to wear and tear on our roads in the way it used to.

Under a vehicle-miles-traveled system, instead of a tax-per-gallon system, drivers would pay a set amount for each mile driven on state roads. With GPS and wireless technology, a special odometer would measure in-state miles driven and the total would be transmitted to a reader on a gas pump when the driver refueled. The reader would calculate the amount owed the state, which would be included in the total purchase. Drivers would, as they do today, "pay at the pump."

The miles-traveled system removes gas-mileage variability from the revenue equation. The state would collect the same revenue from you whether you drove 1,000 miles and burned 50 gallons of gas in a midsize vehicle or you burned 20 gallons of gas in a 50-miles-per-gallon gas-electric hy-brid.

The current system, the tax-per-gallon one, does have a limited life span. We need to figure out a new, effective way to raise enough money to pay for roads. But the vehicle-miles-traveled system could well be a bureaucrat's dream and a consumer's nightmare. It will be expensive. It raises serious privacy issues. And it invites well-intentioned fine-tuning that ultimately confuses and frustrates consumers.

• Equipping new cars with necessary GPS and mileage reading devices will not be cheap. One suggested method is requiring the equipment to be pre-installed on all new cars shipped for sale in Minnesota. Ultimately, consumers would pick up the cost.

• Unless there's mandatory retrofitting, Minnesotans with older cars would pay the per-gallon tax while those driving new vehicles equipped with GPS and special odometers would pay the VMT tax. The per-gallon tax would need to be maintained indefinitely to collect revenue from out-of-state drivers and interstate truckers.

• In initial implementation, the VMT system would track only in-state miles traveled. It wouldn't stick its electronic nose into such personal details as exactly where or when the driver drove. However, once such technology is in place, the temptation is there to use it "for good" — in case of an Amber Alert, for example.

And when the door between your privacy and government's nose is opened, it's hard to close. Think wiretaps.

• The VMT system is prone to "project creep." The first obvious "improvement" in the system would be to charge a higher per-mile rate for larger, less fuel-efficient vehicles that emit more greenhouse gases and inflict more wear and tear on the roads.

From there it is a short leap to numerous "congestion-rate" schemes; charge a higher per-mile rate on westbound I-394 and eastbound I-94 during the 7 to 9 a.m. rush hour, for example. The more the system is tweaked for a false sense of precision and fairness, the more confusing it becomes for consumers, the more expensive and difficult to manage, and the more it will be perceived as unfair.

Given roads as a public good, our ideal road revenue system would distribute the public costs of driving and commercial use of roads across all who benefit, tie the cost of harmful effects of driving (pollution, for example) to those responsible, and create a transparent link between the amount we pay in taxes and actual road construction and maintenance.

With a little creative thinking and a lot less cost, it may be possible to eliminate the state gas tax for Minnesota residents and create a road revenue system that achieves those objectives. Our suggestion consists of four elements:

• Eliminate the pay-at-the-pump gas tax for all Minnesota residents.

• Reinstate variable vehicle license fees — with higher fees for larger vehicles (justification: more wear and tear on roads) and higher fuel consumption (justification: more pollution).

• Establish a uniform road revenue tax that reflects the universal value of roads to every Minnesotan.

• Require that the sum of vehicle licensing revenue and the road revenue tax cannot exceed the budget for state road construction and maintenance. That's the key to providing transparency. And it ties the dollars taxpayers pay for road construction and maintenance to the concrete and asphalt they get in return.

Indeed, the devil is in the details — as well as in the concept. We recognize a compelling state interest to move away from a per-gallon gas tax, but we don't see the VMT approach as a desirable alternative. We urge the governor and legislators to think outside the pump.

COLUMN -- Adopt a state senator

Thursday, February 22, 2007


Like most Minnesotans, I have lain awake nights tossing and turning over the plight of our state senators who suffer under the burden of an expense allowance of but $66 a day. How would you like to feed yourself on just $66 a day? And now, like Oliver Twist asking for a little more gruel, our senators humbly beg for a 45 percent increase to $96 a day, and some would deny it.

"What an ungrateful wretch I am," I think while staring at the ceiling. I shudder at the thought of what a mess I might make of my life were it not for those dedicated souls in the state Senate looking out for my welfare. And what, pray tell, have I done to thank them? Not a damn thing other than to have packed my lunch and provided my labor to help create the wealth necessary to support their good works. That is not enough.

Therefore, I am initiating an "Adopt a State Senator" campaign. What greater satisfaction could one have than sharing a little more of what you've earned with an overworked and underpaid public servant — someone like little Larry.

Little Larry lives in Minneapolis and drives all the way to the state Capitol in St. Paul every day the Legislature is in session. There is nothing worse for a legislator than to be sitting in his car on a congested freeway hungry and thirsty. Imagine pulling into a Starbucks and having to choose between a grande cafe mocha and a ham and Swiss bagel. On a meager $66 per diem there may not be enough money for both. Our state senators face tough choices like that every day.

But you can help our senators with your contribution of just $30 per day, or about $4,000 per legislative session. That's right! For just the cost of a 50-inch flat-panel plasma HDTV and premium HDTV service, you can ensure they never again have to choose between city tap water and Evian. You can ensure a senator never has to press his nose against the window of the pie display at Bakers Square or ponder the purchase of a chocolate chip cookie. No senator will ever again have to darken the door of a fast-food, trans-fat haven of health hazard temptations; senators can do lunch at the finest nonsmoking eating establishments in the cities.

And you'll sleep well at night, knowing that our senators are not only well fed, but fed well.

I know. You're thinking, "Craig, I have a family. Shouldn't I take care of them before I reach out to help needy senators?"

Of course you should, but just how much do you really need? Do you aspire to be one of those evil rich people who isn't paying his fair share in taxes? Do you want that indictment, the unbearable shame and guilt of accomplishment hanging over your head?

What would you do with an extra $4,000? Send your child to a school of your choice? Take a family vacation? Set up a bank account to cover the deductible on a

reasonably priced health insurance policy? Take care of an aging parent or send money to an adorable grandkid? Maybe even send $21 a month to Feed the Children so it can send 50 pounds of food to three cold and hungry American kids? Probably you'd just blow it on things you enjoy.

Do those individual pursuits of happiness justify denying our senators their cafe mochas AND their bagels? After all they've done to you?

Unlike state government, I can't coerce you with the threat of criminal penalties to send your hard-earned money to support our state senators. I can only ask you to consider what benefit these tireless souls bring to your life and then ask you to open your hearts and open your wallets that they might reap the rewards they justly deserve. Experience the joy that comes from adopting a state senator.

Thank you, and God bless.

COLUMN -- Embarrassed by Bachmann's votes for conservative values? Hardly

Friday, February 17, 2007


Choosing a topic for a weekly column is sometimes like picking a puppy in a pet store. Ideas are constantly barking for attention, but you've got to choose just one. Do you go with the playful idea and have fun with it? Or do you play to the loyal reader base? Or do you go the attack dog route? It can be a tough call.

Two ideas gnawed at me this week. Fortunately, Tuesday's Pioneer Press Viewpoints page provided the opportunity to pick a couple of puppies.

Side-by-side sat a biting column by 100.3 KTLK-FM talk show host Jason Lewis reminding the tax-and-spend apologists in the Legislature that "It's not your money" and a column by Stillwater resident Karl Bremer yapping about Rep. Michele Bachmann's "embarrassing" negative and losing-side votes on the Democrats' first-100-hours initiatives. The columns sprang from the same litter.

I had a late breakfast with Lewis last week. Although I kept my hands to myself, it was somewhat of a Bachmannesque thrill noshing with "Minnesota's Mr. Right." I am an unembarrassed big Jason Lewis fan. That's good news and bad. I used to be a huge Jason Lewis fan. Lately, his on-air persona frequently crosses the line between rant and rationality.

"I may rant a little more," Lewis admitted, "but it's out of frustration." And not just with liberal Democrats. Some of Lewis' most vitriolic rhetoric has targeted a Republican Party that he sees as unilaterally abandoning conservative principles. In a pre-election interview, Lewis flustered the usually unflappable Gov. Tim Pawlenty on issues from education funding to ethanol subsidies. It did not make Lewis popular with the GOP powers that be, nor did it silence him.

"There's no one up at the Capitol standing up for conservative principles," Lewis declares. "Republicans like Pawlenty have simply thrown in the towel. It's much easier to say, 'You can't say no to everything' than it is to push a conservative agenda — including tax cuts."

(More than 11,000 Minnesotans have gone to the KTLK Web site (www.ktlkfm.com) to sign the Minnesota Tax Cut Coalition petition, a number that surprised even Lewis. He was hoping for 10,000 signers by a scheduled April 14 tax rally at the Capitol. He reached that number in just two months — with no serious party or media call for tax reform.)

All it really takes for the left to win is for the GOP to place party over principle, Lewis says. Then conservative ideas aren't sold to the public. If you let the left educate the public, it should be no surprise the polls show the public leans left.

That brings us to Bremer.

Bremer has long since jumped the fence between supporting a cause and pursuing a vendetta. A frequent author of posts on anti-Bachmann Internet sites, Bremer is more obsessed with Michele Bachmann than Ken Starr ever was with Monica Lewinsky. His column betrays that irrationality.

Instead of objectively discussing the Democrats' first-100-hours initiatives, or even attempting to discredit conservative objections to the mostly symbolic gestures, Bremer simply charges that Bachmann "embarrassed" Minnesota by voting "nay" on all the Democrats' bills.

Why "embarrassed"? Because Bachmann's views differ from Bremer's?

There is nothing embarrassing about Bachmann's votes. She voted conservative values, nothing more, nothing less. That's what her supporters elected her to do. What would have been embarrassing, and disappointing, would have been Bachmann backing off of conservative values to accommodate popular opinion. Going along to get along is exactly what Lewis laments that most Republicans are doing.

I think Lewis is right. When Republicans can be intimidated off their core values by Bremer-like labels, "political debate" becomes oxymoronic. Republicans lose elections. Minnesotans simply lose.

That brings us full circle back to Lewis. He cites Ronald Reagan's conviction that if the polls are against you, you don't change your position; you stand strong and do a better job explaining why you believe what you believe.

"Frankly, it's my view that it's those in the political class, divorced from principle but not ambition, who are selling this notion that Reaganism is dead. Sorry, I don't buy it," Lewis said. Neither does Bachmann, and that's a source of pride.

As for Bremer's contention that Minnesota conservatives should be embarrassed by what they believe and embarrassed because their congresswoman stood up for her values? Well, that dog don't hunt.

Test results add up to a good case for vouchers

A good commentary from Mitch Pearlstein --

An urban, low-cost private school did a lot to reduce the achievement gap for blacks.

As Gov. Tim Pawlenty and legislators consider how to improve urban education, they may want to ponder research findings like these:Citing data from the National Assessment of Educational Progress (NAEP), political scientist Abigail Thernstrom and her historian husband, Stephan Thernstrom, have written about how African-Americans, by the 12th grade, "are typically four years behind white and Asian students," with Hispanics "doing only a tad better than black students." Translated, this means that black and Hispanic students are finishing high school, on average, "with a junior high education."

But how many local minority students might be "finishing high school" in the first place?
A 2002 report published jointly by Minneapolis Public Schools, the Minneapolis Chamber of Commerce and the Minneapolis Foundation showed four-year graduation rates for the Class of 2000 were 47 percent for "Asian Americans"; 31 percent for both "African Americans" and "Hispanic Americans"; and 15 percent for "American Indians." For "White Americans," it was a still-terrible 58 percent.

What about other achievement gaps locally?

In a 2003 study of 19 states with high school exit exams, as reported by the Minnesota Minority Education Partnership, Minnesota was found to have the "largest achievement gap in the country between African American and White non-Hispanic students in math," as measured on the state's Basic Skills Test.

Might dreadful results like these be caused by financially shortchanging inner-city schools?
A common myth is that schools across the country with lots of low-income students are less-well-funded than schools with fewer low-income students. The opposite, actually, is more routinely the case. Minnesota, in fact, recently ranked fifth best in the nation in terms of "extra poverty-based funding per student living below the poverty line." This (benevolent) gap was $3,075.

But given that African-Americans in Minneapolis are doing unusually poorly academically, how do these conflicting findings compute?

To complicate matters even more, consider Ascension School, a K-8 Catholic school in north Minneapolis. Students are overwhelmingly minority; they're overwhelmingly non-Catholic; and in 2005, 90 percent of eighth-graders there passed Minnesota's Basic Skills test in math and 95 percent passed Minnesota's Basic Skills test in reading.

In contrast, eighth-graders in Minneapolis public schools, in 2003, passed at these rates in math: 82 percent for whites; 57 percent for Asian/ Pacific Islanders; 41 percent for Hispanics; 40 percent for American Indians; and 28 percent for blacks. Please note, though you probably already have, that the 82 percent passing rate for whites in Minneapolis public schools was substantially below Ascension's 90 percent for all its kids. MPS scores were significantly better in reading than they were in math; but again, they were significantly below Ascension's reading scores.

What are tuition rates (for non-parishioners) in inner-city Catholic schools in the state? According to the Minnesota Catholic Conference, they average under $3,200 for elementary schools and under $8,000 for high schools. By contrast, as long ago as 2003 -- in the wake of a recession -- federal, state, and local revenues in Minneapolis Public Schools totaled $13,658 per "pupil unit."

Now consider findings like these on voucher programs across the nation, as summarized by William G. Howell and Paul E. Peterson, both of Harvard:

"Voucher interventions that serve African American students seem particularly promising. ... [A]ttending a private school, compared with attending a public school, boosts African American students' test scores, educational attainment, likelihood of pursuing an advanced degree, and future earnings. Even studies that find little comparable benefits for whites typically find that private schools help African Americans."

This leads the two political scientists to conclude:

"The importance of such findings for the education of African American students has been underappreciated. ... With these new data from randomized field studies confirming prior observational studies, the positive impact of private schools on African American students' educational performance can no longer be dismissed as the product of some mysterious selection effect."

For the life of me, I can't understand how any educator, politician, editorial writer, or anyone else can read all of this and not believe vouchers are worth at least a try. Mitch Pearlstein is founder and president of Center of the American Experiment. The findings above are from his just-released study, "Achievement Gaps and Vouchers: How Achievement Gaps are Bigger in Minnesota than Virtually Anyplace Else, and Why Vouchers are Essential to Reducing Them." The report is also available at www.AmericanExperiment.org.

To read the Hon. Don Samuels's Foreword, click here.

Yes, separated at birth -- sort of

Perhaps you’ve noticed a slight resemblance between Survivor Fiji contestant Gary Stritesky, from Ramsey, Minnesota --


And Captain Fishsticks.

It is not mere coincidence. We share the same great-great grandfather.

Go Gary! (If he wins the million, I'll have to add him to the Christmas card list.)

Mercury-free flu shots are still available

MINNESOTA NATURAL HEALTH COALITION
For Immediate Release

People who choose to get a flu shot can still find some mercury-free doses throughout the Twin Cities area. Both Park Nicollet and Fairview Clinics reported this week that they still have a supply of the mercury-free version.

Clinic representatives advised calling before arriving, to verify that the mercury-free formula is still in supply.

Thimerosal is the name of the mercury compound used as a vaccine preservative. If the vaccine comes in a multi-dose vial, it likely has mercury in preservative levels -- of 25 microgramsfor 3-year-olds and up, or 12.5 micrograms for infants.

Parents can also ask to see the package insert and look for the presence of Thimerosal in the ingredients. However if the dose is already in a prefilled syringe, it is likely mercury-free.

Medical studies show that nutritional supplements boost immune function, such as Vitamins C, D and E. During the winter Minnesotans, especially shut-ins, are far less able to make vitamin D from skin exposure to sunlight.

For more information, contact Jerri Johnson of the Minnesota Natural Health Coalition at 651-688-6515 or jerrijohn@aol.com.

A Muslim Perspective

Some good background for discussion.

ISLAM-OPED: POLITICS, NOT FAITH, BEHIND SHIA-SUNNI DIVIDE IN IRAQ

By Parvez Ahmed

[Parvez Ahmed is board chairman of the Council on American-Islamic Relations, the nation's largest Muslim civil rights and advocacy group. He may be contacted at pahmed@cair.com.]

Almost daily, we hear distressing stories of sectarian violence in Iraq. This has caused many Americans to realize that Islam, like other religions, is not a monolithic faith.

With more than 1.2 billion followers worldwide, Islam naturally encompasses tremendous diversity in its followers. Islam guides its faithful to seek peace, justice and unity, yet Muslims have periodically failed to live up to these foundational teachings.

The current divisions in Iraq stem from an ancient feud, but are not caused by any profound theological differences. The historical context was always political and, despite severe disagreements in the past, the conflict never assumed the characteristics it displays today in Iraq: viciousness, indiscriminate killing, and complete disregard for human life.

Understanding what is happening in today’s Iraq requires a journey into the past.

On Prophet Muhammad's death in 632, his close companion Abu Bakr was elected as the next head of the Islamic state.

Abu Bakr assumed the title "khalifa" meaning the "successor to or representative of the messenger of God." The English word is “caliph,” and thus historically the Islamic state has also been described as a caliphate or "khilafa."

A minority felt that the caliphate should pass down only to Muhammad’s direct descendants via Fatima, his daughter, and her husband Ali ibn Abi Talib, who was also Muhammad’s cousin.

Ali did later become the fourth khalifa, but faced political opposition almost immediately, sometimes from other relatives of Prophet Muhammad, like the Prophet’s wife Aisha.

Tragically, Ali was assassinated by one of his own men who felt that he was too lenient in dealing with Muawiya, the governor of Syria who had refused Ali’s leadership. On Ali’s death, Muawiya assumed the title of caliph.

Ali's younger son Hussein agreed not to oppose Caliph Muawiya. However, when Muawiya died in 680, his son Yazid usurped the caliphate. Hussein led an army against Yazid but was outnumbered. Hussein and his men were slaughtered at the Battle of Karbala, in modern-day Iraq.

These events divided Islam politically between the party of Ali (Shia-tul-Ali or “Shia”) and the majority who came to be known as “Sunni” (from the Arabic sunnah, meaning the traditional way).

Despite this history of political differences, Sunni and Shia Muslims agree on the fundamentals of Islam. Islamic scholars on both sides have declared the legitimacy of each other’s traditions and systems of jurisprudence.

For example, Al Azhar University, considered the most august seat of learning in Islam and the oldest university in the world, issued a fatwa (legal opinion) in 1959 recognizing the legitimacy of Shia jurisprudence. Al Azhar University, though now Sunni, was founded by the Shia Fatimid dynasty in 969.

Given all that is happening in Iraq and the distressing possibility of this conflict widening to other regions, it is a duty of Muslim leaders and scholars worldwide to call upon all Muslims to focus on the shared values and beliefs of Shia and Sunni Muslims.

Muslims must unequivocally condemn this sectarian conflict and thwart efforts by extremists to sow sectarian discord. Demonizing people of other schools of thought, traditions, ethnicities, or faiths is strictly prohibited in Islamic jurisprudence.

American Muslims leaders are keenly aware of the volatility of the situation in Iraq and are resolved not to let the sectarian violence spill over into the U.S. They are also making efforts towards reconciling the warring factions in Iraq, which they hope will enable an expedited and orderly withdrawal of U.S. troops from the region.

Looking to an example in the past might also provide a solution to the current divisions in Iraq. The Prophet Muhammad, like some other prophets (David and Solomon), was not only a spiritual leader but also a head of state. When establishing the Islamic state in Medina, he drafted a constitution known as the Charter of Medina, whose many signatories included several Jewish tribes.

The Charter of Medina has been described by contemporary legal scholars as an early exercise in federalism: each tribe retained its own religious and ethnic identity while joining to defend the state against external aggression. The Charter also established protocols for peaceful resolution of conflicts without prescribing assimilation into one religion, language or culture.

Politics, not differences in faith, divide Iraq. Yet a political solution grounded in Islamic traditions can help bring peace.

It is our fervent hope that the Bush Administration and the U.S. Congress will reach out and enlist the help of American Muslims in developing a political reality that achieves lasting peace in the region.

Chldren's Health Security Act

This is one of those pieces that is so good, I wish I'd have written it.

February 8, 2007

Dear Mr. Chair and Members of the Health and Human Services Committee,

RE: HF 1 - Author Rep. Thissen (Children's Health Security Act)

Thank you for this opportunity to share our thoughts about HF 1. As you know, I had planned to testify in person, however, I have a previous commitment today that cannot be changed.

Citizens' Council on Health Care is a free-market health care policy organization supportive of patient and doctor freedom, medical innovation and entrepreneurship, and the confidential patient-doctor relationship.

CCHC supports policies that advance individual freedom for citizens; policies that limit the size of government; and policies that limit government intrusion in the lives of individuals and the relationship individuals have with their doctors.

Entitlement Expansion
HF 1 would create a new entitlement. When government assumes a function of the private market, in this case medical insurance, government grows and private initiative, options, and innovation shrink. With every expansion of entitlement programs, the taxpayer is tapped to keep the program funded. He or she must work harder to meet his or her own needs while paying the growing tax bill. This means that the working taxpayer finds himself or herself with fewer and fewer dollars to make ends meet - or in this instance, to pay for private health insurance, and to cover medical bills through private means.

Eventually these taxpayers may find themselves forced to seek government health care because they've been taxed out of their ability to pay privately. Thus, entitlement programs can lead to ever increasing numbers of people entitled to the hard-earned dollars of an ever-shrinking base of working taxpayers.

Dignity
Entitlement programs diminish the dignity of every recipient. When is the last time you heard someone bragging that they were on Medicaid? As the Minnesota Department of Health's 2002 report on the uninsured notes, people are not comfortable with receiving welfare:

"Anything that can be considered county assistance or is registered by the county through the health and human services is associated with welfare. It is a pride issue. People just don't want to go on welfare."

Employer Effect
HF 1 offers a health care entitlement for every child who is a resident of the State of Minnesota. Although the program is voluntary, one of the likely effects is that the mere presence of the program will encourage employers to drop coverage for the children of employees, thereby shifting the burden to taxpayers.

Moral Hazard
HF 1 specifies that there will be no cost-sharing or premiums for recipients. This enables the moral hazard already well associated with entitlement programs, the lack of cost-consciousness. The taxpayer cost for this plan to cover children statewide will be extraordinarily high, yet the recipients will see it as free: Free care for all children. As in other programs, the entitled may find spending "somebody else's" money easy.

Intrusive Government
Section 12 enables government to intrude on the confidential patient-doctor relationship. The legislation requires doctors, hospitals and health plans to send private medical data to the commissioner "in the form and manner specified by the commissioner." No details. The commissioner will decide outside the purview of the legislature. This is private data on the recipients and on "private sector enrollees." (line 6.17)

We don't know, the legislation doesn't say, but most likely this reported data will be detailed information on physician treatment decisions and so-called "patient outcomes," as well as data on physician compliance with whatever treatment and initiatives the commissioner determines to be "quality of care." The bill will empower government in the practice of medicine, monitor patients, and police human behavior.

This is a serious infringement on the rights of patients and doctors to be free.

Report cards on patient outcomes not only require government intrusion in the lives of patients, but they have also led to less care for patients. There have been several studies, but I'll cite just one. According to a 2003 study, the New York state report cards on cardiac outcomes led not to decreased mortality and morbidity as initially reported, but rather to the sickest patients being denied care, and needing to seek care outside the state of New York. (When Doctor's Slam the Door, March 16, 2003, The New York Times)

Such attempts to monitor and control physician behavior can lead to implicit or explicit rationing of medical care for patients, putting their lives in danger.

Section 12 also appears to be an attempt to undo the will of the people of Minnesota:

o In March 2003, the Pawlenty administration was forced to withdraw the MN Department of Health (MDH) data collection rule. Our opposition to the government's plan to collect private patient data elicited over 1000 letters to the department, and front-page news articles in the StarTribune and the St. Paul Pioneer Press, as well as all the major television news stations.

o In 2004, at the last minute, a sunset date was added to the "best practices" section of the HHS omnibus bill. The section authorized MDH to begin directing the practice of medicine, and DOER and DHS to write contracts in accordance with physician adherence to those directives. We had opposed this section and our efforts brought nearly 2,000 petitions to the Governor's Office just days before the omnibus bill was finalized. As a result, that section of law expired June 2006.

Coverage is not Care - DHS Authorized to Deny
Finally, having "coverage" does not guarantee access to care. Ask anyone facing a government or managed care denial. DHS has statutory authority to ration care. The federal 1115 Medicaid/MNCare waiver allows placement of public recipients into HMOs, and the 2005 HHS omnibus bill gave DHS authority to define "evidence-based" treatment. The DHS medical director can deny a recipient's access to the HMO appeals process if the prescribed treatment does not meet the director's definition of an "evidence-based" treatment. Children "covered" by HF 1 could find their care limited.

As Bernadine Healy MD, former director of the NIH and now columnist for U.S. World and News Report, warned last year in her column, "evidence-based medicine" can be used to deny access to care.

Better Idea
Truly competitive markets decrease the price and increase the quality of any product in which they operate. Governments expand bureaucracy and administrative costs leaving fewer dollars available for improving the private product's quality, price or accessibility. Legislation that supports real competition and expands private insurance options can better protect the dollars, dignity and rights of your constituents. Thank you.

Sincerely,

Twila Brase, RN, PHN
President

COLUMN -- Stubborn facts — and a stubborn defense of principle to go with them

Thursday, February 8, 2007


John Adams' defense of British soldiers accused in the 1770 Boston Massacre (and of the greater principle of due process) gave us his oft-quoted observation, "Facts are stubborn things, and whatever may be our inclinations, or the dictums of our passions, they cannot alter the state of facts and evidence."

Facts are still stubborn things.

Last week, the Health and Human Services Committee of the Minnesota House held a hearing on the Freedom to Breathe Act — otherwise known as the statewide smoking ban. In defense of a greater principle, Reps. Laura Brod, R-New Prague, and Tom Emmer, R-Delano, took on the cause of bar and restaurant owners who dare exercise their private property rights and permit smoking in their establishments. It was a good, old-fashioned political butt whipping. Brod and Emmer shredded the arguments of bill sponsors Thomas Huntley, DFL-Duluth, and Dan Severson, R-Sauk Rapids.

Unfortunately, the attitude that the end justifies the means is also still stubborn.

Ruled by its inclinations, the dictums of its passions and an altered state of facts and evidence, a 12-6 majority in that committee advanced the statewide smoking ban to the Commerce and Labor Committee.

Even if one favors a comprehensive statewide smoking ban, one ought be embarrassed by the bill passed out of the Health and Human Services Committee. Not only did ban supporters do a poor job of justifying the necessity of a statewide smoking ban, the Freedom to Breathe Act is a jumble of inconsistencies and potential unintended consequences.

And therein lies the problem: When legislation is predicated on inclinations and passions and justified by an altered state of facts and evidence, not only is the result unnecessary legislation, it's bad legislation.

The case can be made that all legislation is invariably subject to interpretation. If there aren't loopholes, some smart lawyer will create them and some "activist" judge will validate them. That may be true as far as it goes, but the assumption ought to be that legislators have done their best to create a tight piece of legislation. When legislation is fact-based and addresses compelling state issues, that's generally the case. When it follows the dictums of passion, it ain't necessarily so.

Brod, Emmer and others raised numerous implications and potential unintended consequences of the Freedom to Breathe legislation. Does the bill inadvertently affect private homes used for business? Does public law that provides Minnesota the authority to enforce "criminal and prohibitory law" on American Indian reservations affect the legislation's attempt to exempt tribal casinos from the ban? When does a patron violation become a violation for which the establishment owner is criminally liable?

Normally, such issues are resolved in the committee process. Last session, eminent domain reform that limited when government could take private property for a public use passed through eight committees before earning a floor vote. This year, when Brod raised the question of what committees would be hearing the Freedom to Breathe Act, Huntley said he had no idea what the path might be, but he "would just as soon send it to the floor as soon as we can."

If the objective were crafting a bill that best served Minnesotans, then, as Brod suggested, it would pass through committees on local government affairs and public safety as well as commerce. But if the purpose of the bill were simply to ban smoking, then, as is Huntley's inclination, the quicker it got to the floor, the better — especially after Brod and Emmer shredded every health and economic justification for a smoking ban, save two.

By the time the committee was ready to vote, Rep. Ken Tschumper, DFL-La Crescent, was justifying the trumping of private property rights with the only undisputed argument ban supporters could muster — secondhand smoke smells bad.

Rep. Tina Liebling, DFL-Rochester, finally clarified the real motivation behind the Freedom to Breathe Act — she declared a statewide smoking ban necessary to "set behavior norms" for all Minnesotans.

"I hear a train a' comin' — it's roaring round the bend," the American Lung Association's Pat McKone sorta sang, giddily concluding her pro-ban testimony with a fitting metaphor for a bill being railroaded through the committee process despite inconsistencies, unintended consequences and confused justifications.

Brod, Emmer and stubborn facts will get another shot when the legislation goes to the House floor for debate. The outcome may not be any better, but when gutsy legislators persevere against intrusive government, one can always hope.