Candidate Q&A: House District 27A

Aug. 22--Author's note: This is a continuation of the Herald's candidate Q&A features and the second such feature with State Rep. Peggy Bennett (R-27A) and challenger Thomas Martinez (DFL). In this feature, the candidates were asked questions regarding health care in their district.

Here are their responses.

Q: How would you rate the overall state of health care in District 27A?

Thomas Martinez

Martinez: Our health care is high in quality and cost, but low in access. Last year, despite the efforts of Save Our Healthcare, Albert Lea lost general inpatient services and the Baby Place. This year, my wife and I had to drive to Austin in the midst of a pandemic so she could give birth to our fourth child, Mabel.

Under Mayo Clinic's shadow, Southeast Minnesota has accrued the highest healthcare premiums in the state. Albert Lea specifically is the third highest, according to Minnesota Community Measurement. Loss of services and higher costs is a common theme in rural healthcare all across America, but we are fighting to regain local control here.

Early next year, MercyOne hopes to open a new clinic in the old Herberger's site in Northbridge Mall in partnership with the Albert Lea Healthcare Coalition (ALHC). This week I asked Brad Arends, president of ALHC and owner of Intellicents, if the presence of another provider in our area will affect premium costs. He replied, "It already has. A number of employers in Albert Lea have switched to MercyOne and seen their premiums drop by 20-30 percent."

Bennett: What does a thriving health care system look like? It is one that promotes lots of providers and competition, which brings increased access and lower costs. It is a compassionate system where patients know and have a relationship with their doctors. It looks very similar to what Minnesota had prior to 2010, when our state had what was considered one of the best health care systems in the nation, including a then state-of-the-art program to provide health care to people with preexisting conditions.

Sadly, the 2010 Affordable Care Act (ACA) was a big game changer in the health insurance world by virtually usurping all Minnesota insurance laws and dismantling our state's progress toward excellent health care. Our local area was hard hit by the ACA and we've seen our health care struggle ever since. We have watched health insurance costs skyrocket and important health care services exit our community.

Our state could have worked on improving that top-in-the-nation Minnesota health care system we had. However, instead of allowing us to build and improve upon that system, the ACA dismantled it. It has been a struggle for our area and our state ever since.

Q: What concerns have you heard from voters when it comes to health care in District 27A?

Martinez: I hear a lot of great things about our doctors and nurses bedside manner and the quality of care that people receive, but the common concern I hear is that we pay top dollar for procedures that we now have to travel further for.

I work at St. John's Retirement Home and a common refrain I hear from residents is that we have such a nice hospital facility, which our community has invested heavily in; it's a shame not to use it. They say, "Look how busy it is, what sense is there in closing down whole departments that we depend on?"

I have talked with other parents my age that complain about a lack of pediatricians in our area for their children. Both my three-year-old boys used a nurse practitioner as their primary care physician for a full year before a licensed pediatrician became available. I am grateful to hear that family medicine physician Dr. (David) Heine has joined the Albert Lea MercyOne team.

Rep. Peggy Bennett (R-27A)

Bennett: Many individuals have expressed concern with the high cost of health insurance. Not only are premiums high, but deductibles are extremely high for many as well. Families and individuals pay thousands of dollars out of pocket before health insurance kicks in. It's almost like not having insurance at all.

In addition, many people have expressed frustration at losing our hospital services in Albert Lea. Mayo and its employees offer many quality medical services to our area, but the loss of hospital services was a real blow to our community.

I have spoken with many area small business owners and they have shared with me the struggle they encounter to be able to offer health insurance for their employees. Though they want to offer health insurance, the cost is simply too high and some are feeling forced to drop that coverage, sending their employees to the individual market. It really puts businesses and individuals alike "between a rock and a hard place."

Q: Do you think Gov. Tim Walz took proper steps in responding to the coronavirus pandemic in Minnesota? Why or why not?

Martinez: Tim Walz has been an effective leader. While our president downplayed the significance of the virus and scapegoated China, our governor immediately mobilized his team to protect Minnesotan lives. Declaring and extending emergency powers was necessary to have the flexibility to take decisive actions while responding to data being reported in real time.

Right now we have a divided legislature with Republicans leading the Senate and Democrats leading the House. Waiting for them to agree on a plan for Walz to sign isn't an option when our schools, health care facilities, nursing homes, meat processing plants and small businesses need immediate direction and assistance.

Our governor has taken bold steps at great political risk to himself to ensure the best possible outcome for Minnesota. I feel proud and fortunate to have Tim Walz as our governor.

Bennett: I applaud the governor for the strategies he implemented in the first 30 days of the coronavirus. At that time, we didn't have enough information about this virus. The governor acted quickly and did what needed to be done.

However, I disagree with the governor's handling of the virus after Easter. By Easter, we had much more data available to us. We could see that various areas of our state were being affected differently by the virus. It was evident then that rural Minnesota should have been treated differently than the more heavily populated metro areas, providing for a more targeted approach. This has proven to be a correct evaluation after examining the results that Wisconsin, Iowa, and the Dakotas have. Each of those states has fared much better (all have significantly lower death rates than Minnesota) without universal one-size-fits-all mandates.

I feel bad for the people who were hard hit in nursing homes (our state should never have released COVID-19 positive patients into nursing homes) and for the many people who had serious non-COVID-19 health conditions who could not get treatment because of the hospital closure mandates.

I believe we would have had better results for our state had the voices of all three branches of government been involved in the decision making instead of the governor making the sole decisions.

Q: Do you support a single-payer health care system? Why or why not?

Martinez: All that single-payer health care means is that instead of having insurance companies making millions from selling healthcare plans, a single entity is charged and costs are distributed evenly.

This system is used by many other advanced democracies in the world for its cost effectiveness and better health outcomes. There is no reason it wouldn't work here, except for the political weight of private market interests.

A single-payer system would save everyday Americans thousands of dollars annually in out-of-pocket expenses, protect people with pre-existing conditions, and lower prescription drug prices. Unfortunately, neither presidential candidate supports this, so there is little chance of it becoming reality anytime soon. There isn't sufficient support in the Minnesota Legislature yet to make this a priority on a state level, so what I really want to do is offer the best and most affordable care to as many Minnesotans as possible by expanding the MNSure buy-in option.

Bennett: A single-payer is a system for the rich. It might sound good on paper, but when one digs down and examines it, you will find that it results in a two-tier health care system where the wealthy are able to purchase better health care and the average citizen would have to make do with what the government deems appropriate. People who have money will be able to see their own private doctors; not so the rest of us. This is the system many other countries have. Our current system obviously needs improvement; however, dismantling it is likely to bring more imbalance between the rich and the poor.

Single-payer would require massive new taxes to pay for the costs of the program and would hamper innovation of new treatments since there would be no guarantee of the government covering that under the single-payer plan.

A single-payer system pays a significantly lower reimbursement rate than private insurance. This would devastate our rural hospitals and clinics that are already struggling with stretched budgets. We will have nothing left here and will have to travel to the larger metro areas for all our health care.

I cannot support a system like this that I know would greatly hurt people and hurt our area.

Q. Anything else you want to add?

Martinez: From what I have learned, dying from COVID-19 is terrifying, painful and lonely. I know we are all sick of wearing face masks and we are all aching for things to get back to normal, but we can't let this divide us. We need to trust in science and listen to our experts as they make their recommendations. That is how we get through this.

I was dismayed to see Rep. Bennett undermine health experts with a misleading post about face masks on her Facebook page. I believe it is beneath the office to give fear and angst the upper hand by spreading confusion. I expect better from a public official, and I look forward to providing this district with leadership that brings us together. I urge everyone to wash their hands regularly, practice social distancing and wear a mask when out in public.

Bennett: I believe affordable and accessible health care is a critical issue for our area and for our state. That is why I have chief authored, co-authored, and voted for legislation to increase providers (hospital, doctors, nurses, dentists, etc.) in rural areas and to lower health insurance and pharmaceutical costs.

Two related bills I have chief authored would encourage provider growth in rural areas by providing tax incentives and would eliminate red tape that can hinder hospital growth caused by the state's hospital bed moratorium.

I voted for bipartisan reforms that successfully passed aimed at reducing the cost and bringing more transparency for prescription drugs in our state. I also helped block a harmful funding cut to our nursing homes.

Lastly, I have fought for and supported a Republican initiated reinsurance program for our state that allows Minnesota to receive federal dollars, which we then use to reduce premiums and create market stability. Before reinsurance, premiums were going up at a rate that was totally unsustainable. Now we have at least stopped the bleeding, allowing us to examine how we can continue to stabilize the market and eventually lower the costs of health care.

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