To judge from much of the popular debate, whether people should be required to have insurance seems to be the central question swirling around the nation’s health.
But ask 1,100 Minnesotans and it no longer seems that simplistic.
Over the past four months, the Citizens League and the Bush Foundation have held more than 40 community meetings around the state to get a better sense of what’s on people’s minds when they think about their health and the care they get. In structured small-group discussions, what emerged was a desire for treating health much more broadly than simply a question of insurance dollars.
The two organizations (disclosure: the Bush Foundation provides support for MPR News’ Ground Level project) delivered a report on the community discussions today to the state task force examining Minnesota’s approach to health care. That group is expected to make recommendations to Gov. Mark Dayton and the Legislature.
The report, called “Public Conversations and Public Solutions: Making Health and Health Care Better in Minnesota,” says:
Minnesotans want to assume a greater role in supporting health. They understand the health care system alone does not define good health.
To be sure, when organizers asked participants in these discussions what the main problem is with the health care system, more cited the lack of affordability than any other characteristic. And they expressed their analysis of where to save money: administration, support for preventive care and coordination among parts of the system.
But the groups found people eager to participate in decisions about their health and willing to recognize their own role in practicing healthy behaviors. Read the full report here.
What struck me was the larger finding of a sense that the health deck is stacked against people in the way society arranges its incentives.
Healthy salads often cost more than twice what fast-food hamburgers cost. Access to healthy foods and opportunities to stay physically active are often limited. And with jam-packed lives, long hours at work, parental responsibilities and more, families often feel too mentally and financially exhausted to make the healthy diet and exercise choices they know they should.
Employers, families, lawmakers and others all have a role in changing those incentives, participants said.
It’s tough to say exactly how this information should fit into the task force’s role of advising policy-makers. But seeing the problem as more than simply a set of numbers — dollars or a count of the uninsured — seems like a good start.
UPDATE late afternoon:
Sean Kershaw, executive director of the Citizens League said that while there weren’t specific recommendations to the state task force, his hope is that the principles laid out in the report encourage the task force to look at a bigger picture than just costs and health care reform.
“We tried to give them permission to look broadly at health,” Kershaw said.