When an insurance company walks away from rural Minnesota

If the election 2016 was an opportunity for a comprehensive discussion of health care insurance, the nation failed badly. Instead, it was a debate over a word and a general concept — Obamacare. You’re either for it or you’re against it. What are its components? Mere details.

That’s too bad because there are people — Republicans and Democrats and everyone in between — who are suffering under the byzantine health insurance system, just as they suffered under it in the pre-Obamacare days.

Take the politics of it all away, and you’re left with people.

Away from the attention of the Cities, a health care crisis has exploded in northeast Minnesota this week, St. Cloud Times reports. Blue Cross Blue Shield has canceled its contract with the representative of independent clinics across northeast Minnesota as of February 1.

“Blue Cross believes that continuing to negotiate rates through a third party is not in the best interest of our members,” the company said. “Additionally, having separate agreements provides greater opportunity to address rising health care costs while ensuring that local health care options remain affordable.”

The clinics — pediatricians, for example — say they can’t afford individual contracts, the Times reports.

“Our ability to drive a fair market rate lies in that network,” said Jill Smith, Sartell Pediatrics administrator. “At the network level, we are better able to negotiate a contract.”

Sartell Pediatrics is a small practice, with one doctor, a physician’s assistant, a pediatric nurse practitioner and a licensed psychologist.

“When I think about the future (of our clinic), this will be impossible to maintain,” she said. “And right now, we are not in a position to take on a clinic level contract.”

Thirty percent of the clinic’s business is insured by Blue Cross Blue Shield. Few businesses can afford to lose 30 percent of its customers.

But 30 percent of its customers can’t really afford to lose access to doctors and care.

The story is the same at the Cromwell Medical Clinic where half the 2,000 patients have BC/BS coverage, the Duluth News Tribune says.

Anne Dugan has been Ripp’s patient for only two years, but said, “I’ve been incredibly impressed with the care I’ve received. It’s incredibly efficient. I call, I get responses and I just feel like I’m a person there.”

Dugan, who lives on a farm near Wrenshall with her husband and young child and is expecting a second child in February, said she couldn’t afford the cost of out-of-network coverage. Although she directs the Duluth Art Institute, making medical appointments in Duluth would be “really, really difficult,” Dugan said.

“I’m frankly sad and a little panicked that Blue Cross Blue Shield would ignore rural Minnesota,” she said.

The Times tells its story through Sarah Gill, a young teacher who was pregnant in 2013 when a defect was discovered in the baby she was carrying and she realized the importance of having a pediatrician nearby. In 2014, her husband died.

She has two kids now and says she’s at the pediatrician “all the time.”

Her employer — she’s a teacher — provides health insurance, but only through Blue Cross Blue Shield.

“It’s scary,” Gill said. “I don’t want to think that it’s a possibility, honestly.”

But it is a possibility and how can we discuss people being caught in a game of “health care chicken” without wallowing in the gridlock of politics that has prevented a solution?

Related: Health insurers post some grim numbers (MPR News)