Caledonia Argus

Dayton, Gutknecht reps discuss health care reform at township meeting

Posted: 7/22/03

by Andrew Miller
Argus News Reporter

Health care reform should work in favor of consumers, rather than big business or government, said spokesmen for Gil Gutknecht, First District Congressman for Minnesota, and Mark Dayton, U.S. Senator for Minnesota, who attended the July 16 Houston County Township Officers meeting.

Richard Larson, speaking on behalf of Gil Gutknecht, said that a bill to allow the free importation of prescription drugs into the U.S. is consuming much of Gutknechtís efforts. American drug companies are strongly opposed to the billñ Minnesota legislator Greg Davids pointed out that over 500 lobbyists have been hired to sway federal legislators in favor of the drug companiesí interests. Despite the pressure from drug companies, Larson said, Gutknecht feels American citizens should be able to take advantage of the low prescription drug prices in other countries.

Jim Gelbmann, state director for Mark Dayton, discussed Daytonís efforts in the Medicare reform debates. He noted that Medicare funding for ambulance services has hurt ambulance providers in rural areas, since 1/2 to 2/3 of people receiving ambulance service in rural areas are Medicare recipients, and the Medicare rates the federal government pays out are ìabysmalî and below the actual cost of the ambulance service. In Caledonia, for instance, the ambulance service lost $26,000 in 2002 due to low Medicare reimbursements. And in many cases, Medicare reimbursements to ambulance services are withheld if a patientís final diagnosis isnít severe.

For example, Gelbmann said, if someone feels like heís having a heart attack and is transported a hospital via ambulance, but the diagnosis is simply heartburn or indigestion, Medicare will deny the ambulance serviceís claim. An appeal can be made, Gelbmann added, and on the second or third appeal, Medicare will oftentimes end up paying the bill. Other times, Medicare will deny an appeal, and the ambulance service will end up eating the cost.

In Minnesota, Gelbmann said, there is the Prudent Person Rule, which states that if a prudent person determines that an ambulance is necessary, any private insurance company or HMO the patient is covered by must pay for the cost of the ambulance. However, the Prudent Person Rule is not applicable to Medicare. Dayton has introduced the Prudent Person Rule in Congress so that, if a prudent person determines an ambulance is necessary, Medicare cannot deny the ambulance service its reimbursement.

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