By Mark Fischenich
The Free Press
June 12, 2007
MANKATO– Uninsured people are often the focus of debates about America’s troubled health care system, but even those with insurance are struggling with issues of cost and access.
That was a consistent theme as Mankato-area residents told their stories to the Minnesota Senate Health, Housing and Family Security Committee Tuesday. Committee Chairman John Marty and other committee members are taking public testimony at a handful of hearings around the state leading up to the 2008 legislative session, when health care is expected to be a major focus.
Marty said a couple of pieces of testimony would stick with him.
There was the North Mankato resident with cerebral palsy who couldn’t find a local practitioner who would accept the minimal reimbursement offered by his Medical Assistance.
There was the Comfrey farmer undergoing chemotherapy who saw the charge for the exact same treatment rise from $1,200 to $9,500 from one treatment to the next.
There was also plenty of testimony that members of the committee have heard before about people agonizing over how to get the medical treatment they need.
“We all understand that access to affordable health care has reached a crisis point in Minnesota,” Marty said during the hearing at Minnesota State University.
Of the 10 people who testified, most work for agencies or organizations that help those who don’t have access to affordable medical care.
John Thormodson, a rural Madelia farmer, was one of the regular folks.
A farmer with a 10-year-old daughter and 7-year-old son, Thormodson described a typically idyllic farm life in his introductory remarks. Then he started talking about health care.
In Thormodson’s case, it isn’t about tragic bad luck or catastrophic illnesses. It’s about the standard eye infections and ear aches, and the need to balance health and finances.
Even paying $650 a month for insurance and prescription drugs, Thormodson and his wife faces deductibles that make a trip to the emergency room a hardship. With nearby clinics closed on weekends, it’s the ER or nothing on Saturday or Sunday.
“When you have kids, eye infections come up and ear infections come up, and it’s not always Monday through Friday when this happens,” he said.
They took their son to the emergency room with one bad ear infection that hit on a weekend. The bill was $500. Now, Thormodson said, he and his wife wonder if they should try to wait until Monday when a medical issue arises on the weekend.
“Why should parents have to debate whether or not to take their child for medical care — whether it’s Monday or Saturday,” he said. “It’s frustrating.”
Another farmer testified a bit later. Alfonse Mathiowetz lives near Comfrey, saw his farm mostly wrecked by a 1998 tornado, found out four years ago that his wife had cancer and recently began cancer treatments himself.
Matiowetz described driving to Mankato for his chemotherapy treatment, paying $1,200 a visit. The same provider also served a facility in New Ulm. So, looking to save time and some gas money, Mathiowetz asked if he could get the same treatment there.
He could. But when the bill came for the exact same treatment, it was $9,500.
“I think this is highway robbery in broad daylight,” Mathiowetz said, adding that he never got a good explanation for why two facilities could have such extreme variations in price for the same treatment.
He wrote a letter to the New Ulm facility: ” I said I may not die of cancer, but I could die of a heart attack getting bills like this.”
Others who testified included Ann Vogel, the physician at Mankato’s Open Door Health Care Center for the uninsured; Lynn VanDervort, the regional director of the Minnesota Senior Federation; and Lynn Solo of the Nicollet County Social Services Department.
Vogel said thousands of people use the free and reduced-price clinic each year.
“We’re the safety net for southern Minnesota,” she said.
But she warned that the facility can’t meet growing needs of the uninsured projected in the future.
VanDervort talked about how the aging of America’s population is presenting extraordinary challenges for the health care system. She said people as young as 5 years old have joined the Senior Federation to take advantage of its prescription drug benefit, which includes bus trips to Canada where more affordable drugs are available.
The government’s response has been short-term fixes, VanDervort said.
“But these stopgap measures will not hold back the tidal wave of spending ahead of us,” she said.
And Solo told of the 22-year-old North Mankato man with spastic quadriplegia who needed dental work. His parents asked Solo to help find a dentist who would take him and his government-provided insurance.
Hoping he could use his motorized wheelchair to get to the appointment, their preference was the clinic four blocks from their home. Their second choices was a facility a half-mile away.
Solo contacted both. Then she worked her way through the nine pages of dental clinics in the Mankato Yellow Pages. Then she expanded her search to find a dentist willing to take the man and Medical Assistance reimbursement rate.
Solo finally found one who would take him — in Savage, 63 miles away.