Health care law, Vikings, stabbings

 

Catching up on impact of new health care law

 This report in the Washington Post last week may be a little eye opening for those who follow news on the federal health care reform legislation.

In my mind, the media covers far more of the controversy over this law than some of the substance.

Here's an example of substance. In effect, the law requires insurance companies to provide rebates. Almost unbelievable when you think about it. That provision was actually provided by Minnesota Sen. Al Franken, because it is more or less modeled after Minnesota Law.

Not all is rosy with this provision, however.

Here's the salient points of the Post story:

" Insurance companies will have to return more than $1 billion this year to consumers and businesses, thanks to a new requirement in President Barack Obama's health care overhaul, a report released Thursday concludes."

"That's real money, says Larry Levitt of the Kaiser Family Foundation, which analyzed industry filings with state insurance commissioners. The law requires insurers to spend at least 80 percent of the premiums they collect on medical care and quality improvements — or issue rebates to policyholders."

"This is one of the most tangible benefits of the health reform law that consumers will have seen to date," said
"
Levitt, an expert on private health insurance. The nonpartisan foundation is an information clearinghouse on the nation's health care system, and its research is widely cited."

The report comes with a caveat. It lacks data on the nation's most populous state, California, because complete filings there were not available. Nonetheless, the analysis estimates that consumers and businesses in other states will receive rebates of $1.3 billion, in some cases in the form of a discount on next year's premiums.

The insurance industry says consumers should take little comfort from the rebates, because the companies expect premiums to go up overall as a result of new benefits and other requirements of the new law.

"The net of all the requirements will be an increase in costs for consumers," said Robert Zirkelbach, spokesman for America's Health Insurance Plans, the main industry trade group.

"The report says the rebates are only one of the ways in which consumers may benefit from tighter scrutiny of the health insurance industry under the federal law, which provides funding for state regulators to monitor the companies more closely. Self-conscious insurers may be hesitating to push state regulators for premium increases as large as they were able to win in the past."

"This `sentinel' effect on premiums has likely produced more savings for consumers and employers than the rebates themselves," the report said.

Fly-speck scrutiny of the insurance industry won't solve the problem of rising health care costs, the report acknowledged, but it "can help to ensure that consumers and businesses get greater value for their premium dollar."

Legislative showdown arrives again.

The scene at the Legislature with a last minute showdown between Gov. Mark Dayton and Republicans in the Legislature seems reminiscent of last year. That seems to be what a lot of the political reporters are saying on Twitter the last few days.

I wouldn't be surprised to see the whole thing breakdown into a "do nothing" year, but I'll be pleasantly surprised if they come to agreement on even one major issue.

I was surprised at Dayton's veto of bipartisan fireworks bill. Not sure what he gained on that one.

Also surprised Republicans did not pass Vikings bill. They apparently had many DFL votes in House and Senate and would have forced Dayton to veto it, which wouldn't have been likely to do.

But waiting, makes it part of Global deal and that may play into Dayton's hand. He gets leverage from something he was already in favor of.

Stabbings in Mankato

Social media on The Free Press website and on our Facebook page has more than the usual number of regular citizens wondering what's going on with these "stabbings."

The stabbing Sunday morning seemed very random, unless something else was operating there. We know the stabbing last week was a domestic dispute related stabbing, apparently.

Interesting that the day we hear about stabbings, the "serial stabber" of Michigan goes to trial. 

From the AP: "Nearly two years later, an Israeli-born drifter goes to trial Tuesday for the first time since Flint's shocking summer of 2010, when as many as 14 people were stabbed in the area, five fatally."

Weird, just weird.

Highway 14 safety gets attention

The saga of Highway 14 took a new turn this week as a safety audit by independent consultants determined the road from North Mankato to New Ulm was even more dangerous and deadly than previously thought.

This story is of great interest to the communities along the road and us here at The Free Press. In 2010, reporter Mark Fischenich spent months researching the crash rates on the highway and interviewing numerous sources for what became a three part-series on the highway.

Pouring over pages and pages of statistics, our report determined Highway 14 from North Mankato to New Ulm had a fatal crash rate nearly twice the state average. In my mind it is one of the most significant reports on public policy this newspaper has ever done.

The series has been recognized with awards from various organizations.

But the recent safety audit only confirms what we determined, but even more so.

The recent safety audit determined it is now three times the state average.

In a positive sign, it appears MnDOT officials are going to do something about the safety. There are several shorter-term solutions to improve safety quickly, including a center cable fence, rumble strips in the median and widening the road in places.

But the complete four lane expansion from North Mankato to New Ulm did not appear to be a solution MnDOT favored, mostly because officials say the state does not have $300 million to spend on it. Although it's important to note Sen. Kathy Sheran got MnDOT officials to say at a recent hearing that the four lane was not out of the question.

We argued in an editorial Thursday, that the money doesn't have to be the hold up. The "convenience project" of upgrading the Highway 169, 494 interchange cost $125 million alone.

I've been communicating with legislators and the governor's office, arguing again and again how important it is to make this road safe and how long we've been fighting for it. Local legislators of both parties are supportive. We're seeing the governor's office give this more personal attention than ever before.

The next step may be gathering public support to at the very least get approval of some of the more significant temporary measures and get the four-lane project on MnDOT's 20 year list for completion.

Stay tuned for how you can help.

Civic center and economic development

People have come up to me, even legislators, and asked if Mankato's bonding request to expand the Verizon Wireless Center is anything that will really generate economic activity or benefit anyone other than those who do business near the civic center.

Well, my short answer is yes. And we can look to history as our evidence.

I covered business in Mankato from 1990 until 1996, and even some after that, but that was the period when the civic center was developed. The 1990 downtown Mankato was a very different place than it is today.

Extremely different.

The River Hills Mall opened in 1991 and much of the downtown "Mankato Mall's" retail left downtown for the mall on the hill. There was nothing that was going to stop this. The business trends were simply dictating it.

Retail tends to be a business that grows best and fastest when it is together in one location. That's not really rocket science.

So, we had all this infrastructure in the mall and the old Brett's building that was not going to be used for retail shopping anymore, or anytime in even the distant future.

The next idea was to create an entertainment district drawing people downtown for eating and drinking places. But you still need traffic to operate those businesses on any kind of scale.

As retail left, so too did the foot traffic. One could not operate a small sandwich shop successfully. Remember Ruth's deli? In the mall's heyday, she did just fine. When retail left, so too did Ruth.

So business and city leaders had to come up with a way to generate traffic downtown. You needed not only regular traffic but also event traffic.

City leaders moved on transforming the mall infrastructure into a government/office use with some success. But they needed to get things going by locating Mankato City Hall and the District 77 offices in what was the old JC Penney building. They also added on a facade and extra space.

But the city and school district offices were one of the first tenants in the new revitalized downtown space. That started the ball rolling. Later, developer Gordon Awsumb came into buy the balance of the mall and the Brett's building.

He was able to get other tenants like the Minnesota Workforce Center, Social Security and Public Defender offices.

It was important Awsumb not just get other business tenants. Businesses come and go. He landed the government office tenants that would bring some stability to the property. The property was sold as a "government services center."

That made a lot of sense.

The Civic Center came next. There was a referendum on imposing a local sales tax to pay for the bonds. It passed. The center was built and opened around 1995.

Since that time, the civic center has had up and down years for concerts, tradeshows and the like. That's not really surprising. Civic center business flows with the economy.

As a business reporter and observer and someone who has some training in economics (a master's degree), I would say that the downtown of 1990 Mankato was going nowhere without some help. It turned out to be government help, and the help of a developer who was able to purchase property at a price that posed little risk if things went south.

One by one, the buildings and infrastructure of the downtown mall would have turned into East St. Louis fast. You might have had a marginal business here or there, but in my mind it would have gone absolutely nowhere. We might have been famous for the ugliest downtown in outstate Minnesota.

The mall owner was going to let it go back to the bank, as they did the Brett's building.

These properties would have cost the city of Mankato much, much more to demolish or deal with than providing a developer with a subsidy or relocating their own offices.

Downtowns at the time were deteriorating all over in cities the size of Mankato.

Today, we've got development, we've got property values that have soared from their 1990 lows. We've got people who have a reason to come downtown. The crowds that come in for civic center events and hockey games would be unimaginable in 1990.

In 1990, if you would've have told someone that in five or six years, you wouldn't be able to find a spot to sit at one of six of seven restaurants before an event, they would have laughed at you.

In economics, you measure business in two ways. You either increase your profits, or minimize your losses.

Mankato was facing some huge losses in 1990 if it did nothing. I would say we not only minimized losses, but we pretty much hit this one out of the park.

Franken meets Free Press editors, writers

Sen. Al Franken met with Free Press editors and writers for about an hour today in his first meeting with the staff since he took office in July 2009.

A few takeaways from the meeting:

Franken only won Nicollet County by about 150 votes and Blue Earth County by about 800. All seven surrounding counties voted for Norm Coleman in the 2008 election.

Franken was asked if he feels he had done anything to convince more of those who voted against him to maybe be with him come re-election time.

"As I go around, I feel people saying "You've exceeded my expectations." he said, then joked, as he thanks them for having low expectations.

Franken seems to really have sort of flown under the media radar for his first four years, which have gone by quickly. That seems like it's by design, as Franken says he wanted to be a "workhorse" not a "showhorse" when he arrived in the Senate, winning the election by only 312 votes and getting only 42 percent of the total.

A few things that he can claim credit for:

He did author a provision in the health care reform bill that requires 80 to 85 percent of  amount insurance companies charge in premiums be spent on actual health care, not on administration or pay bonuses.

It's something he took from what already happens in Minnesota law and it was adopted into the federal health care law. If the companies don't meet the standard, they have to give back part of the premiums to ratepayers.

The law was implemented in 2011, but one study showed it would have saved people $2 billion in general on their health care costs that year. Aetna in Connecticut apparently lowered its premium 10 percent this year because of the law, according to Franken.

Franken also takes credit for a part of the financial reform legislation that removed conflicts of interest rating agencies have with investment banks. The investment banks paid out fees to the rating agencies and rating agencies in turn had incentive to provide ratings that were better than they should have been.

Franken got the amendment on the bill with bipartisan support with 65 votes in the Senate.

It was later watered down in conference committee, because, according to Franken,  Sen. Chris Dodd, author of the bill, didn't like it. But he said the new provision did require a study of the conflict and if it is determined the conflict did not go away, it will be implemented.

Franken also said the federal help for funding Highway 14 may be difficult now that "earmarks" have gone away.

He said he disagreed that the health care mandate is unconstitutional and said a 5-4 Supreme Court decision on repeal would not be good for the court or its legacy.

Florida teen-shooting case provides context in "Castle doctrine" debate

Minnesota Republicans passed the Castle Doctrine law that would have made prosecution of self defense cases tougher, but Gov. Mark Dayton vetoed it.

Dayton argued the vast majority of law enforcement in state said it would make their job more dangerous.

Florida's "Stand your ground" law goes much further than the Castle Doctrine would have, it seems, from a general understanding.

The "neighborhood watch" citizen was apparently chasing Trayvon Martin in Sanford, Fla., thinking he was "up to no good" according to 911 call. Ultimately, they had a confrontation and the neighborhood watch guy shot Martin with a nine millimeter automatic.

Florida authorities didn't charge him because they determined he was in "defensive position" which is allowed under Stand your ground. You don't have to retreat.

The guy, George Zimmerman, contended the 17 year old knocked him down and smashed his head against the ground several times. Police report says he "asked for help but no one would help him." That's apparently when he shot the Martin.

Police report is here.

It's tough to take a side in these cases when Trayvon won't be around to tell his side.

I'm just thinking I'm a older guy, possibly overweight. Do I chase down a 17 year old kid in Florida asking what he's up to, and do I carry a gun while doing it?

Do they need police protection that badly down there.?

Health care reform and the Surpremes (The government doesn't give us free broccoli)

Well the Supremes are going to be center stage this week as they consider cases on different sides of  the health care reform act Obama and Congress approved two years ago.

Key to the discussion: Can the government, under the Constitution's Commerce clause, force people to buy health insurance? It's often framed in that simplistic way, but it's much more complicated than that.

We can't compare it to anything else the government might make us buy because the circumstances are different.

 Those who try to simplify the argument (and there are many taking advantage of the average person's unwillingness to spend a lot of time understanding the issue), argue the government can't require you to buy broccoli or gasoline for that matter, so they should NOT be able to require you to buy health insurance or any other product.

Actually, they don't require you to buy it. If you don't buy it you pay a minimal surcharge of like $95 a year, which I understand escalates a bit after that but not more than say $2,200 a year for a single person making $100,000. (Which, actually would be a pretty good price for emergency health care whenever you needed it, no co-pays etc. I'll explain that next).

The argument is different because "Everyone consumes" health care or if they don't consume it they have the right -- given by Congress actually -- to consume it free of charge if you can't pay.

That law, codified under the Emergency Medical Treatment and Labor Act (EMTALA)42 USC Sec. 1395dd) was passed in 1986 by Congress and enacted "to ensure public access to emergency services regardless of ability to pay"

So, it's a law that anyone can get free health care. It reasonably follows that we all should have to pay for that, and it shouldn't be pushed on through the insurance system, but rather spread out through taxation or fines. The mandate is simply collecting a payment for what we gave away in 1986.

The Supremes could rule that since the Commerce clause allows for the providing of goods (health care)  by the government, the government should be able to require payment. Take away the guaranteed goods (health care for free) and you can take away the requirement.

The parallel argument that the government doesn't require us to buy broccoli would have to be set up to show that the government had at one time required broccoli producers to give you broccoli free if you met government's criteria.

We know that's not the case.

Good luck Supremes! Give me a call if you'd like to bounce some ideas off me.

Crime in Mankato region is worrisome

As someone who sees the serious, personal, violent crimes go from police reports to news reports, I am more than a little worried about what appear to trends in violent crime in our region.

I can cite six domestic homicides we have reported in about the last 18 months to two years. This is not something I could have done two years ago.

There was the double homicide in Lewisville, of a mom and her dad killed by the estranged husband. There was the shooting of Svetlana Mundt in front of her children by her estranged husband in Rasmussen Woods.

There was a young mother killed by her boyfriend in Kasota, a young college girl killed by a former boyfriend in broad daylight on Mankato's hilltop and there is a pending case in Blue Earth County Court that is turning in surprising ways in terms of who is guilty, but there was a domestic death.

Then a few weeks ago, we have an estranged husband killing his wife's male friend in Blue Earth, a town about 45 miles south of here.

Recently, another woman was abducted for short time by another former domestic partner. Luckily she escaped.

It's important to point out that these are "regional" crimes, not centered only in the city of Mankato or even North Mankato.

Mankato Director of Public Safety Todd Miller correctly asserts that violent crime in Mankato as well as other crime may be up in 2011 compared to 2010, but it is down from 2006.

He has the data to prove it.  There were 68 aggravated assault in 2006 and 45 in 2011.  There were 46 rapes in 2006 and 19 in  2011, through Nov. 30.

Still, the trend is more than a little unsettling, and we need to think about ways to reduce the risks of these kinds of things happening.