What comes after fixing insurance costs?

Shockingly, health-insurance premium increases will exceed 50 percent for individual purchasers for 2017. As the Star Tribune's editorial "A state fix is needed on health rate hikes" (Oct. 20) rightly said, the state must act promptly even if only a small portion of Minnesotans are affected.

In this campaign season, Republicans blame DFLers by attributing these increases to the Affordable Care Act. DFLers respond by pointing out previous attempts, without help from Republicans, to repair glitches in the system.

However, the ACA did not cause the problem; nor is it the solution. Those huge increases are not the fault of MNsure, our state's implementation of the ACA. They are a result of the volatility of the individual insurance market when most people have group coverage. Subsidies provided by the Affordable Care Act will mitigate the problem, but they do not resolve it.

Addressing the unacceptable premium increases is urgent, but it is a temporary fix. Think of this as a way of stabilizing the patient in preparation for a cure we can provide.

High health costs led to numerous reforms during the decades aimed at saving money by creating obstacles for people seeking care so they use less of it. Limiting provider networks, requiring referrals and prior authorizations, and using ever larger co-pays and deductibles discourage patients from getting treatment. As a result, Americans do visit the doctor less often than people in other countries. Even so, health spending continues to outpace inflation, as those premium increases show. That approach has failed.

The United States squanders outstanding health care resources — excellent providers, clinics and hospitals, medical research and technology — on a broken system that makes it difficult for many people to get medical care. Why would any society want to make it difficult for its people to access health care?

When other advanced nations provide comprehensive care to all of their people — with better outcomes — and they do so for roughly half the amount we spend, we should learn that trying to save money by making care more difficult to get is counter-productive.

After years of frustration and a feeling that our political system is merely tinkering with this dysfunctional system, I developed a blueprint for a health system that works.

Rather than start with a focus on saving money, focus on designing a health system that keeps people healthy and enables them to get the care they need, when they need it. Ironically, by designing a logical system focused on health, we actually get a system that costs less.

Start by taking a few steps back, identify the problems, then develop principles for a good health system; principles that benefit all people. Our health system should: cover all people, for all of their medical care, including dental, vision and hearing, mental health, chemical dependency treatment, prescription drugs, and long-term care. It should allow patients to choose their providers, and leave medical decisions to doctors and their patients, not insurance companies or government. It must be affordable to all with premiums based on ability to pay.

Then, map out a plan based on those principles. The proposed Minnesota Health Plan legislation was designed around such principles and would be bound to them. It would end the convoluted, intensely bureaucratic billing and insurance paperwork system, and replace it with a commonsense plan that enables people to get medical care.

Beginning in 2017, states can get an "innovation waiver" from the ACA to try new approaches. The proposed Minnesota Health Plan would deliver an affordable health system that would qualify for the innovation waiver.

Last session, Gov. Dayton and the Minnesota Senate took an important step forward, proposing a thorough economic analysis to compare the total costs and benefits of a universal system like the Minnesota Health Plan to our current insurance-driven system.

It seems counterintuitive that covering everyone, with comprehensive benefits, would cost less. However, there is strong evidence that a system like the Minnesota Health Plan is less expensive due to administrative savings, more efficient delivery of care, and better price negotiations. Conducting that proposed economic analysis would be a responsible step forward.

Yes, we must immediately address the premium spikes. But it is time for a new model. Nobody goes without police and fire protection. Nobody has to worry about a $3,000 deductible before the fire department will come. Nobody lets their employer dictate what police coverage they get. And nobody faces reductions year after year in their "police and fire coverage."

A civilized, humane society that takes care of its people with universal police and fire coverage needs to do the same with health and dental care. It's time for the Minnesota Health Plan.

John Marty, DFL-Roseville, is a member of the Minnesota Senate and author of "Healing Health Care — The Case for a Commonsense Universal Health System." For a free eBook edition: mnhealthplan.org.