See You In Court

Five years ago Mike Hatch was just another failed politician. Then a dying woman walked into his office, and a crusade was born.

Critics of the measure, including Minnesota Business Partnership executive director Duane Benson, claim it will add more than 20 percent to the medical costs of people covered by managed-care plans--as much as $600 million in all--and compel smaller companies either to self-insure or to drop medical coverage for their employees. Hatch counters that a similar bill passed two years ago in Texas resulted in just a one percent increase in health-care costs, according to a Congressional Budget Office study.

"Duane Benson knows as much about health insurance as I know about nuclear science," Hatch scoffs. "Six hundred million is la-la land. If the HMOs are saying this will result in that much more coverage, that means they are denying a significant percentage of what doctors want."

Michael Scandrett, executive director of the Minnesota Council on Health Plans and the man to whom managed-care organizations referred all questions for this story, says insurers are not opposed to trying new treatment methods--in fact, he says, they constantly collect data and compare results. Coverage for "experimental" treatments is denied, he says, when a drug or procedure has not been adequately tested and might be harmful to the patient. "Minnesota enjoys higher quality and better outcomes in medical treatment than any other state, and one reason for that is that we rely on research," Scandrett says. "I am really concerned that there are some things in this bill that may take us away from that."

Advocates on both sides of the issue say the Fairness in Health Care Act--sponsored by Minnetonka Republican state representative Jim Abrams and Brainerd DFL senator Don Samuelson--will be one of the most hotly contested bills in the Legislature this year, and that its fate probably won't be determined until the final days of the session. To lobby for the measure, Hatch says he will stage a rally at the Capitol and bring forward an "HMO patient of the day"--culled from the more than 200 calls he has received on his newly instituted consumer hotline--through late March and April.

If passed, the bill is sure to have far-reaching implications. It would directly impact health coverage for one million Minnesotans and change the way medicine is practiced throughout the state. Observers say it could also help galvanize the burgeoning backlash against managed care and add impetus to calls for a federal Patient Bill of Rights. "It would be big," says Kip Sullivan, research director at COACT and the author of several studies on managed care. "Texas is the only other state that has done this. And of course, to do this in Minnesota--the cradle of managed competition--is quite significant. This is the state that, until recently, everyone was looking to to determine the future of health care."

Hatch, meanwhile, claims that the measure represents merely a first step. "Our health-care system is changing, but it isn't one big change," he says. "It is lots and lots of baby-step changes that make up a big change. I think 20 years from now we are going to have a substantially different system, and there are huge ethical and moral issues afoot along the way. If people think the abortion issue is difficult, cube it and you get some idea of the complexity of issues we'll be facing in health care over the next 20 years. I believe the function of the attorney general is to protect people as much as possible from abuse as we go through those changes."

There is one person who, more than any other, may have been responsible for Hatch becoming Minnesota's attorney general. Hatch will refer to her only as Rita--"I don't want to tell you her last name, because I haven't ever been back in contact with the family," he says. She is the only patient who died while Hatch represented her.

"The doctor thought she should have a certain treatment, and the insurance company sent her in for an independent examination and then said, 'We don't think she qualifies.' 'Fine,' I said. 'Let's go to court.' And they called back and said, 'Well, let's get her a second exam.' And they kept calling her back, holding out hope. She went through four exams. And I told her, 'You know they are going to do this until it is too late.' She said, 'Can you guarantee me we'll win?' And I had to tell her there are never any guarantees. She kept going back until it was too late."

After a long ten seconds of silence, he adds, "I kind of wonder if maybe I screwed up there. I should have just told her we were marching into court. She had kids.

"You want to know why I'm here? That's why I'm here."

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