Health care reform in Minnesota. Implications for the rural physician

Minnesota's health care reform plan (by any name) is a cost-containment bill with provisions to provide health insurance for some uninsured people, to examine quality of care, to increase support for rural provider education and migration to rural practice, and to develop state and regional health planning procedures. It is an ambitious bill with very tight time frames, vague language, and heavy reliance on regional commissions and volunteer groups that are just now being established. Will it have an impact on rural health care? Undoubtedly, it will. But somewhere between what the bill says and the desired outcome is a void that physicians can help fill with constructive work and criticism. If physicians do not take the lead, someone else will fill that void--nonphysician providers, legislators, bureaucrats, or consumers. Or the structure could implode, taking all of us with it.