Election 2006: Better to look good or feel good?

On the home page of Tim Pawlenty’s campaign Web site, his picture changes at random intervals to show him wearing a different outfit.

Whether dressed in a blue shirt with no tie or a white shirt with a blue tie, the Republican incumbent governor is all smiles.

Peter Hutchinson is on a trading card. Fans of the Independence Party can collect all six of the “Team Minnesota” members, including “Indy the Buffalo,” the party’s symbol. On the back of Hutchinson’s card, he challenges voters to show their “independence” by voting a straight ticket for his party.

While style may come before substance in Minnesota’s race for governor, the substance hasn’t been entirely obfuscated. One issue — healthcare — has been at the forefront, with no short shrift to education, transportation, energy and the overall economy.

Hutchinson warned early on the “5 Gs” — guns, gays, God, gambling and gynecology — could prove distracting, but that hasn’t been the case so far. Cutting costs in healthcare is just too important.

A ‘crummy system’

“Health care is now 15 percent of the gross domestic product,” Hatch said. “We’re looking at it going to 20 percent — that’s a projection. It’s a huge tax on business. It’s the biggest driver of bankruptcy for patients. It’s just a bad, crummy system.”

Hutchinson agrees. “If you don’t have savings from cutting costs, you can’t expand who’s covered,” he said, noting that far too many are not covered.

In the first gubernatorial debate on Sept. 27, Pawlenty said the current healthcare system is “obviously broken.” He did not grant an interview for this story.

“We have to control costs better,” he said during the debate. “The answer isn’t to have government take over healthcare. We don’t want government healthcare. We want patients and doctors in that relationship, deciding procedures with good information about quality and costs, and giving proper incentives for that to work. … we want patient- centered health care, not government-run healthcare.”

Neither Hatch nor Hutchinson suggest that government should “run” health care. But they believe it has a stronger role to play.

“It needs to set the rules,” Hutchinson said.

Hatch wants to use the Minnesota Comprehensive Health Association’s assigned risk plan to help businesses provide health coverage for high-risk individuals, including those with heart problems, cancer and mental illness. This would allow businesses to carve those individuals out of their regular plans, he said.

“If I’m a small employer — say I’ve got 25 employees — and I band together with (other businesses) and we have a bigger group that buys coverage. Well, if one of my employees gets sick, what can happen is the rate goes up for that group of companies and the companies with the healthier employees are going to leave because they don’t want to be paying a premium that’s not for their people. You end up with adverse selection and the rates go up higher and it becomes a major problem.”

Hatch said his plan would stabilize rates for small employers so they can continue to provide coverage for employees.

“If you want to stop the hemorrhage, you’ve got to help small companies be able to buy coverage,” he said. “There’s going to be an assumption of cost with that by the state, which is going to be passed back through an additional premium on everybody’s policy. But it spreads out the risk of pricey treatment.”

Hatch also believes the governor should appoint some members of the boards of directors to the states largest healthcare nonprofits to crack down on excess expenditures.

“Right now, 85 percent of our healthcare in the state is managed by three companies — Medica, HealthPartners and BlueCross BlueShield,” he said. “Right now, their boards of directors simply elect themselves … these companies handle billion of dollars. They handle more money on a discretionary basis than even the Legislature … every report we’ve issued has shown tremendous waste within the healthcare system. Up to 40 percent of the health dollar is going to administrative costs — to non-treatment costs. That percentage alone basically explains the gap between our country and others.”

Hatch also wants the state to negotiate prices for prescription drugs on behalf of consumers, establish more school clinics, establish a “false claims act” to prosecute false Medicare or Medicaid claims, and improve the public mental health system.

An ‘Independent’ view

Hutchinson’s top goal is to “cut the cost of administration and bureaucracy in half by 2010.” He estimates state and local governments in Minnesota could save as much as $800 million annually by simplifying administrative processes, requiring electronic medical records with capability for data interchange, and changing or eliminating state regulations that do not improve public health.

He said cities with unfunded public employee healthcare liability problems, like Duluth, would benefit from his administration.

“What Duluth is facing is not unusual,” he said. “If we succeed at what we propose, that obligation would be reduced. It has to be done. We’re not going to let cities go bankrupt.”

Hutchinson’s healthcare plan requires every resident to have basic coverage. “If you live in Minnesota and you have a body, you must have health insurance,” he said.

Basic coverage would include preventive, primary, mental health and catastrophic care, along with prescription drug benefits. Hutchinson’s plan would provide insurance within the existing marketplace. Low-income Minnesotans would receive financial assistance through sliding premium scales or refundable tax credits, while the “financially able” would pay their premiums without assistance.

Hutchinson estimates the net cost of the added coverage to be $550 million, after considering some savings in the area of uncompensated care.

His plan also includes incentives for consumers who take responsibility for their health, such as premium discounts for nonsmokers and incentives for getting immunized.

He also would push for public health measures like a statewide indoor workplace smoking ban, increased tobacco excise taxes, more anti-smoking, anti-drunk driving and anti-obesity initiatives, and making cellular phone use while driving a traffic offense.

Hutchinson also would improve healthcare quality and reduce its cost by reducing unnecessary and ineffective care.

About the candidates

Mike Hatch grew up in Duluth and graduated with honors from the University of Minnesota Duluth. He earned his law degree from the University of Minnesota and went on to practice business law during the 1970s. He launched his political career in 1980 when he was elected state chairman of the Democratic-Farmer-Labor party. From 1983-89 he served as Minnesota’s commissioner of commerce and has served as attorney general since 1998. He ran for governor in 1990 and 1994, failing to get the DFL nomination. His running mate is Judi Dutcher,

the former state auditor who was elected twice as a Republican, but switched to the DFL in 2000.

Peter Hutchinson was born in Faribault and graduated from Dartmouth College. He went on to earn a master of public affairs and urban planning degree from Princeton’s Woodrow Wilson School of Public and International Affairs, and completed the advanced management program at Harvard Business School. He served as deputy mayor of Minneapolis from 1977-79, and then was hired as an executive with Dayton Hudson Corp. In 1989, Gov. Rudy Perpich tapped him to serve as the state’s finance commissioner. He resigned at the end of Perpich’s term and founded the Public Strategies Group. The consulting firm took over Minneapolis

Public Schools in 1993, with Hutchinson serving as superintendent. He took a leave of absence four years into the job, eventually resigning.

His running mate is Maureen Reed, a physician who served as medical director for HealthPartners, and is a former University of Minnesota regent.

Tim Pawlenty was born and raised in South St. Paul. He earned undergraduate and law degrees from the University of Minnesota and went on to become a criminal prosecutor. He was elected to the House of Representatives in 1994 and became Republican Party Majority Leader in 1999. He planned to run for U.S. Senate in 2002, until Vice Pres. Dick Cheney asked him to step aside and allow Norm Coleman to run in the Republican primary without opposition. Pawlenty instead ran for governor, defeating Roger Moe and Tim Penny. His lieutenant governor,

Carol Molnau, is a former state representative. She also serves as Commissioner of the Department of Transportation.