Senate Republicans propose eliminating ‘middlemen’ in health care

Minnesota Senate Republicans unveiled a number of proposals on Wednesday that they say will eliminate some middlemen in the health care system and give Minnesotans cheaper options for care.

The bills include a tweak in state law that would allow patients to go directly to a primary care physician without an insurance company involved. Republicans also want to change law to allow patients the “right to shop” for a doctor, clinic — even individual procedures — whether or not they fall within their insurance network.

“We’re not going to nibble at the edges. We want to do something substantial on health care,” Sen. Scott Jensen, R-Chaska, said.

Jensen, a doctor who runs his own practice, said direct primary care would make it simpler for people to establish a relationship with their doctor and take care of small problems without involving an insurance company. Patients would pay a flat fee to their doctor instead.

“If Johnny’s got a wart: ‘Hey, can I get in, I just want you to freeze Johnny’s wart,’” Jensen said. “There’s a lot more simple stuff. The insurance company would be taken out of the equation. The middleman would be gone. It would just be the old fashioned way, patient, doctor.”

Another bill would regulate pharmacy benefit managers, a little known position paid by insurers and employers to help manage the costs of drugs. But Jensen said often those savings are not passed on to consumers.

Requiring pharmacy benefit managers to be licensed and disclose conflicts of interest could help lower the cost of drugs, he said.

“There’s no question we can help pharmacy benefit managers do their work in a more transparent environment that will be more beneficial to all of us,” he said.

The proposals come after an election where health care costs were a top concern for voters. Senators were not on the ballot, but they face the voters again in 2020.

Senate Republicans in the majority will have to find agreement with DFL Gov. Tim Walz and Democrats in control of the House. They want to create a public buy-in option on the individual insurance marketplace that they say could help lower costs.

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