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Lawmakers consider health guarantee

ST. PAUL - It's not that Minnesota legislators don't support the concept of ensuring all Minnesotans receive health care coverage - most do.

But like so many issues debated at the Capitol, the biggest chasms between lawmakers emerge when it comes to dollars and cents.

Wednesday proved that health care is no different.

At a Senate health committee meeting, lawmakers considered a bill that would lay the groundwork for universal health care in Minnesota and another that aims to make comprehensive and affordable coverage a basic right under the state Constitution.

The issue of universal health care is an ongoing political struggle between Democrats - who control both chambers in the Legislature - and Republican Gov. Tim Pawlenty, who opposes a government-run system.

The legislation doesn't necessarily call for a government-funded system, the bill's author, Sen. John Marty, DFL-Roseville, noted, although he supports one.

"I actually think that could be the best way to go," said Marty, who chairs the committee.

But since that approach is a shoo-in for a Pawlenty veto stamp, Marty is pushing the universal coverage bill, which doesn't assign direct authority to the state or otherwise.

Instead, the bill calls for the health commissioner to lead a group to design a universal health care system and propose it to the Legislature in a year.

A complementary bill creates a mechanism to put that commitment into effect - an idea Sen. Tony Lourey, DFL-Kerrick, backs.

"It will hold our feet to the fire," he said of the constitutional amendment.

Legislation calls for the universal system to go into effect by the end of the decade.

The bill's most vocal opponent on the committee, Sen. David Hann, R-Eden Prairie, pressed Democratic colleagues and witnesses on why anything other than a market-based system should be considered.

The answer? For Hann, it's simple: "Make sure we have a robust market."

A constitutional right, he said, "doesn't do anything to change the dynamics" of a system that doesn't send a message opposing a right to health care. Hann said that if it is laid out in the constitution, costs are inevitable.

And until financial repercussions are properly addressed, forging the political will to pass the legislation will be a challenge, said Sen. Yvonne Prettner Solon, DFL-Duluth.

Still, Prettner Solon said she'll support the legislation.

"(The U.S. is) the only industrialized nation without universal health care," she said. "We're doing something wrong and we need to learn something."

Lourey said he supports the ideals behind the push for a constitutional amendment.

"Constitutions are meant to delineate basic human rights," Lourey said, "one of which I believe is health care."

Republicans on the committee urged funding language to be built into the constitutional amendment.

"We can't separate the amendment from what and how we fund," said Sen. Betsy Wergin, R-Princeton.

Sen. Paul Koering, R-Fort Ripley, attempted to crystallize Wergin's point.

"You don't go buy a new Cadillac and not know how you're going to make the payments," he said.

If voters were to approve an amendment mandating affordable and comprehensive coverage for Minnesotans, legislators would determine ways to enforce it, said Sen. Linda Berglin, DFL-Minneapolis.

But can that political will find traction this legislative session? Marti said it can.

"It does have a very good chance," he said, but added, "It's not a done deal."