Sen. Amy Klobuchar brought together a panel of experts on health care for seniors at a press conference. At the news conference she described a new approach to restoring fairness and access to care for Minnesota's elderly.

The press conference was held Monday at Methodist Hospital in St. Louis Park. Joining Klobuchar on the panel were MMA Legislative Committee member Benjamin H. Whitten, M.D., F.A.C.P; Sam Carlson, M.D., chief medical officer at Park Nicollet Health Center; Michele Kimball, AARP state director, Jennifer Lundblad, M.D., CEO of Stratis Health, and Lee Gracyk, issues director for the Minnesota Senior Federation.

Whitten summed up in his remarks the frustrations every Minnesota physician feels. "We know full well that doctors in Florida and California are paid significantly more than doctors Minnesota. But it's no longer just a question of fairness, it's now become a matter of access and a question of enabling physicians to provide the highest quality care they can."

Whitten is an internist who has practiced in the Twin Cities since 1985. He serves on the MMA delegation to the AMA and as the chair of the Legislative Committee.

"It's as if a transfusion tube were sucking all the money from Minnesota and moving it to Florida," Klobuchar said.

The worst part is, she said, that the patient in Minnesota is receiving care that is higher quality by any measure. "Better care is being punished by lower payments," she observed.

The result of this inequity is that low-payment states like Minnesota are losing money. Park Nicollet's Sam Carlson, M.D., said this shortfall totaled $85 million this past year, and that losses would grow to $147 million by 2010.

Klobuchar said three things need to happen to right the funding disparity:

• Medicare incentives that reward for quality care need to be enhanced. "For many illnesses and condition the medical profession has widely accepted guidelines that are proven to result in better outcomes. Yet some some doctors follow them -- specially in our state -- and some doctors don't. Medicare needs to set physician payment so that they follow quality guidelines."
• Medical services need to be grouped together, and paid as a bundle. "Right now Medicare  pays for tests and procedures one by one. Doctors and hospitals sometimes duplicate care. If doctors and hospitals are paid for the appropriate bundle of services, the right set of procedures for diabetes for example, we would have better coordination of care and less incentive to build Medicare purely on volume.'
• Hospitals that do a good job of educating patients about appropriate health care choices need to be certified for the quality they are providing. "Numerous studies show that building a patient's care plan around educating patients improves health care outcomes and patient satisfaction." 

Klobuchar conceded that changing the way physicians are funded is not easy because it pits less populous areas of the country against more populous ones. What gives her hope is that the issue of quality of care will give the issue leverage. "It's no good to get more funding if you are not getting decent health care outcomes," she said.