In this wide-ranging conversation, Mike Opat, chairman of the
Hennepin County Board of Commissioners discusses changes to the
state’s General Assistance Medical Care (GAMC) law and how it affects
the Hennepin County Medical Center’s response to a new funding
mechanism for low-income, childless adults.
He addresses the relationship of
Hennepin County to out-state counties with significantly different
priorities; the choice to elect or appoint county sheriffs; and
actions Hennepin County is taking in response to looming budget cuts.
For the complete
interview summary see:
Readers have been asked to rate, on a scale of (0) most disagreement,
to (5) neutral, to (10) most agreement, the following points discussed
Average response ratings are shown below. Note: these average
ratings are simply the mean of all readers’ zero-to-ten responses to
the ideas proposed and should not be considered an accurate reflection
of a scientifically structured poll.
such as Hennepin County Medical Center should provide preventive care
for poor, single adults, not just be reimbursed for expensive
emergency room care. (6.3 average
sheriffs should be appointed, not elected.
(6.0 average response)
governments as well as city governments and state government should
become involved in economic development.
(6.7 average response)
Richard Angevine (2.5) (7.5) (7.5)
Robert Freeman (10) (2.5) (10)
Trauma hospitals. Better still the hospital should have gotten these
people into participating partner clinics to receive that care - this
may be a moot point now as Dayton expands Medicaid eligibility.
Sheriffs. Appointed by whom - the governor? The county
Economic development. Everyone should be rowing in the same
Dave Broden (10) (5) (10)
Trauma hospitals. Why did the question say poor, single adults only?
Why not all citizens who are of an appropriate need category, poor, or
other special condition. Preventive care must be part of the core
solution and HCMC is the best delivery approach for many of this
Sheriffs. This has always been a political animal for discussion.
Merits certainly both ways. I lean toward an appointed approach but
only if the appointment process can be made politically neutral by the
term of the appointment or by who does the appointing etc. The Sheriff
should not be driven by the periodic potential shift in who controls
the county board etc. 3. Economic development. Short answer is
‘yes’, but only as a coordinate role--certainly not as a separate
economic development team and group. There should perhaps be friendly
competition between counties as well as cities but not at the risk of
not getting the economic development that Minnesota needs. A well
thought out state approach with focus on various areas, (with) the
governmental units well-linked (and with) some local goal, objectives,
and development approaches, thrusts, is recommended. Duplicating staff
is not consistent with the needs for fiscal control-but we clearly do
need a strong and aggressive economic development thrust and action.
Anonymous (5) (2.5) (7.5)
Don Anderson (7.5) (7.5) (10)
Trauma hospitals. All hospitals should provide preventive care (to)
all who need it including poor families as well as single adults.
Sheriffs. County Boards are more qualified to know the qualifications
of candidates for Sheriff (other than persons who commit crimes).
Economic development. Since all of government is accused of not
knowing the problems of the private sector maybe becoming involved in
economic development would be a good idea in bringing the private
sector together with the government sector.
W.D.(Bill) Hamm (5) (0) (7.5)
Trauma hospitals. This is great wishful thinking but very unlikely to
happen without a funding scheme. The for-profit system has gotten
worse at preventive medicine not better. On the other side of the coin
we can't afford the cost or trust of a top-down Socialist structure to
ever meet the preventive needs of the poor, especially dental. The
only structure that can accomplish this is a locally controlled hybrid
Coop structure such as that used by the Industrial Coops in the
Mondrago region of Spain.
Sheriffs. We need a Sheriff who is independent of the county board
and accountable to the people he or she serves, not under the thumbs
of or beholden to any County Board members. 3. Economic development.
While I believe these organizations need to be supportive of economic
development, being too involved only distracts from other things and
tends to lead to unproductive favoritism that far too often ends in
failure. I point to the IRRB as a perfect example of an economic
development fund that has turned into a political giveaway every year
before election. We have lost more money to that kind of stupidity
than most people can imagine. Politicians and public servants
rarely-to-never create private sector jobs.
Joe Mansky (10) (5) (5)
Virginia Rutter (2.5) (10) (7.5)
Trauma hospitals. The summary didn't address as much as I would have
liked (maybe the original conversation did?) whether there are better
places for preventive care to be provided to these individuals --
clinics, etc -- to which the funding would need to go. I think that
the trauma hospital should be reserved for emergencies and other
serious situations/conditions, and preventive care should be provided
Peter Hennessey (2.5) (0) (0)
Trauma hospitals. Single adults have no excuse to be "poor," unless
of course they are old or disabled. Then it is the job first and
foremost of private charities to provide assistance. Primary care is
the natural job function of individual doctors, not hospitals.
Emergency rooms have no business delivering "primary care"; it is a
gross misuse of their function. Private doctors can always form a
walk-in clinic, with or without being directly affiliated with a
particular hospital. As to the comment in the Summary, "Society's
appetite for services grows with time," the only possible reply to
that is a quote from Frederic Bastiat: "When plunder becomes a way of
life for a group of men living together in society, they create for
themselves in the course of time a legal system that authorizes it and
a moral code that justifies it." Or a quote attributed to Jefferson,
Madison or Franklin, which says that “the end of democracy comes when
people realize that they can vote themselves benefits that others have
to pay for”, or something like that. Of course demand for free
services increases with time... The only way to stop that is not to
have them paid for by the government in the first place. If the
service is valuable, someone will go into business to provide it and
figure out how to make it both profitable for himself and affordable
for his clients. But as long as some fool in government is throwing
money around like it was free, people will be all too happy to grab it
Sheriffs. Absolutely not. The people have a right to determine who
will enforce our laws and by what standard we decide to judge those
who apply for the job.
Economic development. Absolutely not. It is the function of the
Chamber of Commerce to advertise the economic benefits of locating in
their geographic area, to entice businesses from other regions to
relocate, to promote local growth. It is the job of the government at
any level to make sure the economic climate is favorable: low and
predictable taxes, minimum and equitable regulation, safe streets,
good schools (if we must have government schools...) and fair and
impartial enforcement of the laws.
Arvonne Fraser (5) (10) (7.5)
Trauma hospitals. Preventive care is important. HCMC might be
involved but this should be thought through carefully and not rushed.
Sheriffs. As a voter I know little about sheriffs. Hiring one should
be up to the board that can vet the candidates. And they shouldn't
have to be so transparent as say, the U presidency was! Hiring and
firing employees should be left to elected and appointed boards.
Economic development. Depends on what is meant by economic
development. If it just means helping businesses, I don't agree. If
it means serious thinking of what economic development encompasses,
Will Shapira (10) (na) (na)
When are you going
to tackle the billion-dollar Vikings stadium issue?
Robert J. Brown (10) (10) (8)
Jerry Fruin (4) (4) (2)
Bert Press (10) (10) (10)
Bev Bales (10) (10) (10)
We are involved in
No. 3, Economic Development
Chuck Lutz (10) (10) (9)
William Kuisle (5) (0) (0)
David Detert (2) (9) (10)
Quie (0) (10) (5)
should be provided in community settings.
Marianne Curry (8) (10) (3)
The best preventive care for the homeless is secure housing, which
goes a long way toward preventing health care problems. First things
Law enforcement is a professional job, which requires proper
credentialing best evaluated by county board evaluation and selection
notoriously poor at deciding who the winners and losers are in terms
of economic development. I believe this is a private sector
responsibility and governments should get out of the way by easing the
regulatory process and streamlining permit applications. Time is
Tom Swain (7) (5) (2)
RogerA Wacek (0) (0) (10)
Tom Spitznagle (8) (5) (5)