The newly released Senate health care bill does nothing to address the concerns the mental health community had with the first version. Allowing health plans to not cover treatment that affects 1 in 5 Americans (mental illnesses), or to not cover treatment with substance-use disorders during an opioid crisis, simply doesn't make sense. We remember when plans weren't required to cover such treatment, leaving families devastated or leading to poor outcomes such as unemployment, homelessness, criminal-justice involvement or suicide. "Austere plans" really mean plans that won't cover the illness you might develop. Unfortunately, we don't get to choose which illnesses we develop.
The Senate bill would continue to cap Medicaid funding to states, which is particularly concerning, since we are in the midst of building our mental health system. The costs of increasing access won't be included in those caps. Medicaid is the largest funder of mental health services, and more Minnesotans were able to have insurance cover their treatment than ever before. Limiting funding is arbitrary and has no connection with innovation, quality or cost-effective measures.
These changes will reverse the progress we have made. The bill obstructs our vision for the future. Once again mental health treatment is not viewed as necessary.
Sue Abderholden, St. Paul
The writer is executive director of NAMI (the National Alliance on Mental Illness) Minnesota.
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Blanket programs of health care insurance coverage do not lend themselves well to the precepts of the insurance mechanism. I agree with U.S. Sen. Ted Cruz that those experiencing known severe health problems should (and generally do) pay far more for their health care ("Senate consumer choice idea may raise premiums for sick," July 13). One prime example is Medicaid, where we require spending down assets and income to qualify for this government program of last resort. We all must work hard for our best health outcomes and realize every incentive to do so.
Should young healthy families, struggling financially to make ends meet, really be expected to pay higher insurance rates to subsidize those requiring extreme health care? Common-sense underwriting for every other type of insurance mandates screening out obvious high-risk individuals and businesses that don't meet underwriting standards.
We do need that high-risk, government-subsidized pool for those not qualifying for standard health care policies, similar to Medicaid. Individuals might be expected to contribute a certain percentage of income and assets to their health care needs to qualify for that pool. The irony of all this is that we the taxpayers will only pay for their care through taxes rather than higher insurance premiums. Thankfully, the wealthy, able to afford those higher tax subsidies, will pay those taxes and never miss the money. We should also tax the excessive profits of the entire medical industry to pay for that pool. Finally, we need to reduce all the fraud and inefficiencies that drive up costs.
Michael Tillemans, Minneapolis
The writer is a retired insurance underwriter.
ELECTRIC CAR CHARGING STATIONS
A 'plot' to develop a network? Or just good state planning?
A July 12 letter writer wrote about state agencies "plotting" to support a niche market by exploring an electric car charging network in prominent Minnesota travel corridors. He called electric cars a "novelty." He quoted numbers that might support that claim. Right next to his letter in the print edition was a Chicago Tribune editorial that noted that Volvo would be installing electric motors in all of its vehicles in two years, eventually ditching gasoline engines altogether. All of the major automakers, both here and abroad, have announced similar plans, albeit on different timetables.
Some of the hybrids that are on the road today also have plug-in capability that will use the same charging stations as the electric cars. The writer mentioned his assumption that the electricity would be "free." It wouldn't take much to incorporate a feature in which you key your license plate number into the charging station's controls or swipe your credit card. The fee for the juice could either be charged directly to your card or added to your electrical bill. I think most would feel right at home with a system like that.
If you review automotive history, you'll note that one of the earliest problems with gas-powered autos was a lack of fueling stations making long-distance trips inconvenient, or impossible. That makes me ask: Are state agencies "plotting"? Or, are they, as I would hope, wisely planning ahead so we don't get caught with our recharging pants down when electric cars really take off, as I suspect they eventually will?
David N. Gawboy, Rosemount
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EVs (electric vehicles) will become the predominant new cars purchased within seven to 10 years, and will nearly completely replace all new ICE (internal combustion engine) vehicle purchases within 13-15 years. This is being driven by pure economics. The price of lithium-ion batteries is dropping dramatically (similar to the cost of computers, smartphones, etc.), and the battery is the main cost of an EV. EVs have fewer than 20 moving parts, compared with more than 200 in an ICE engine alone. EVs will soon be cheaper than ICE cars to both produce and maintain. At that tipping point, EVs will supplant ICE cars like automobiles replaced horses.
Charging stations would not be on the "taxpayers' dime," because the EV owner pays for the energy consumed, and a surcharge would recover the infrastructure investment.
It's time to stop "assuming" that EVs are a niche and that EV owners are not willing to pay for the energy they consume. ICE cars will be the niche by 2030.
Steve Addington, Woodbury
MINING
Why is Nolan trying to rush a land exchange through Congress?
I'll be blunt. I don't know exactly how copper-nickel mining will harm the marine life of the Boundary Waters Canoe Area Wilderness and Lake Superior. I just know it will. I don't know how it'll impact the health of the people in the community. I just know it will. And I don't know which part of the tourism and recreation industry will be affected first in the pristine waters of the BWCA. I just know it will.
How do I know? Because I spent two years teaching on the Navajo Nation, where I saw damages firsthand. While the government leased land to uranium mining companies from 1944 to 1986, uranium was leached into their water. Although the last mine was shut down in 1986, the Navajo are still forced to haul drinkable water to their homes. As a nonnative, I was inconvenienced during my time there, having to refill gallon jugs every week at the grocery store. The Navajo people weren't as lucky; cancer and kidney disease-related deaths continue to this day.
If you think this won't happen in Minnesota, think again. It has taken 32 years for the U.S. government to start enforcing the cleanup for the people of Arizona and New Mexico. How would the leaching of sulfuric acid into the water in northern Minnesota compare to what happened to the Navajo Nation? What does U.S. Rep. Rick Nolan of Minnesota's Eighth District get for rushing a bill through Congress (HR 3115) that would approve an exchange of National Forest System land? (A hearing before the House Subcommittee on Federal Lands is scheduled for Friday.)
Call to ask Rep. Nolan these questions (https://nolan.house.gov/CONTACT/OFFICES). We must protect the people and resources of our great state today.
