Seeking a cure for health care policy with two doctor-lawmakers

With less than three weeks left in the Legislative session, Republican lawmakers still need to work out a deal with DFL Gov. Mark Dayton on big budget issues.

MPR News host Mike Mulcahy asked two first-term senators, Sens. Matt Klein, DFL-Mendota Heights, and Scott Jensen, R-Chaska, for their perspective. Both are medical doctors.

On life as a freshman lawmaker

It's like "drinking from a fire hose," the lawmakers agreed, especially in regards to the multiple budget bills.

"I probably have learned that I'm a little naive, and perhaps a little overly optimistic," said Jensen. "Voting the party line is a pretty powerful encouragement that you get as a freshman senator. I don't feel like I've ever been bullied, but I do feel like the message is there: If you're not going to vote with us, then the perception is that you'll be voting against us."

On the U.S. House passing the health care bill

Jensen said one of the most encouraging parts of the legislation gives states more authority to act on their own through waivers. However, he's concerned that people who have insurance now wouldn't if this bill became law.

"That scares me," he said. "Does a basic health care package come with being a citizen of the United States? I'm there. Did it take me a while to get there? Sure. If you would have asked me that in the 1970s, I would have said 'no.'"

Klein doesn't like the bill, particularly how it "weakens" the individual mandate to have insurance, the requirement to cover preexisting conditions, and the expansion of Medicaid.

"I'm not sure how the legislation that passed is helping us at all," said Klein.

On the accessibility of health insurance

Jensen bucked his party early in the session when he voted with Democrats on a plan that would let Minnesotans buy into the state-run health insurance program, MinnesotaCare.

"Part of our Hippocratic Oath is to have a heart for our patients," Jensen said, noting that he voted with Klein on the issue. "We both feel passionately that every Minnesotan deserves an option."

It wasn't his first choice, Jensen said, noting he would prefer a private market that is responsive to what consumers want to buy. But Jensen said he voted for the amendment because it would have provided a secure option for every Minnesotan.

Lawmakers are working to stabilize the individual insurance market, where premiums have risen dramatically in recent years. Klein pointed out that insurers come at the situation with their own goal.

"Their directive is to ensure a balanced bottom line," he said. "We need to recognize that [insurers] might not always be on board with ensuring that people in western Minnesota have affordable health care. If it means they have to pull out of a market, if it means that they need to double premiums at the end of the year, that is absolutely what they'll do."

To Klein, the public option was necessary. He was concerned that something like reinsurance is just an expensive way to stabilize the market again.

"At the end of the day Scott and I are going to make sure Minnesotans have health care through whatever means it needs to be," said Klein.

On "BMW plans"

Jensen noted that some of his patients have much more generous health insurance plans than others. He called them "BMW plans," and suggested it would be better if everyone had access to a basic plan.

"We need to create a level playing field," he said. "I want to see some basic level of plan for all citizens in this country."

The lawmakers agreed there's not enough discussion about what doctors can do to cut costs.

"We cannot afford, nor should we, give away free healthcare to all people," said Klein.

On working at the Legislature

It's inspiring and a privilege, the lawmakers agreed.

"It still makes my heart race," said Klein.