But according to former Sen. David Durenberger, R-Minnesota, there are ways we can become smarter about health care.

"It's time we accept the challenge," Durenberger said. "Why do we focus on cost (of health care) rather than on quality?"

Durenberger recently spoke in Brainerd at a forum on the state and cost of health care in Minnesota. He chaired a health care study, "Listening to Minnesotans: Transforming Minnesota's Health Care System."

Durenberger, a Republican, was in the U. S. Senate from 1978-1995. He is now chairman of the National Institute of Health Policy and serves as a senior health policy fellow at the College of St. Thomas in St. Paul.

"I left the Senate and have never regretted it," he said. "Today there is no room for the middle ground."

The issue of health care was never debated by the presidential candidates, Durenberger said.

"In our five state area, health care costs rose 59 percent," Durenberger said. "Income in the same period rose 15.7 percent. Money is going into health care rather than salaries. Income is being diverted to protecting the family."

Durenberger said technology is very expensive, yet there are 21 CT-Scanners within two miles of Fairview Southdale Hospital in the Twin Cities, and two within one square block in St. Cloud.

Durenberger said he wonders if these technologies are primarily being used to make money, rather than enhancing patient care.

"We have to rely on doctors to make the right decision at the right time for the right reason," Durenberger said.

Every hospital doesn't need every new high-tech device, Durenberger said. Medical care costs could be reduced if the local hospital/doctor who refers a patient to the specialty clinic or hospital could somehow be reimbursed, the idea being that high-tech equipment is not used 24 hours a day, seven days a week. Therefore, it doesn't need to be available at every hospital/clinic.

Durenberger said we need to re-think who benefits financially from the latest technology. It might be more cost-effective if ownership was collective, with hospitals and clinics jointly owning the high-tech equipment located at one facility.

"The line between capitalism and greed is hard to draw," Durenberger said. "There is so much science, so much technology."

Medical mistakes

Durenberger said "the culture of medicine" is hard to understand. There is no way to rate hospitals in Minnesota.

"More people die each year from hospital (mistakes) than from breast cancer or auto accidents, according to the Institute of Medicine. We are not privy to this information. We need to ask the legislature to require hospitals to report mistakes," he said.

Durenberger said that the public can't expect perfection, but should be able to know that hospitals and doctors are reporting their mistakes and whether they are doing something to change.

"We need to make people (the medical profession) more responsible."

He said there should be in-state reporting of mistakes, and that patients should not pay for mistakes.

Older citizens

The last six months of life are the most expensive, Durenberger said. He suggested that the elderly should resign themselves to hospice care rather than hospital stays.

Another problem is chronic illnesses, he said. No insurance company will guarantee coverage of a chronic illness.

Prescription drugs

"No one knows the real cost of drugs," Durenberger said. "The federal drug program will be in crisis sooner than Social Security."

Some very hard decisions to be made, he said. The pharmaceutical industry sells the same products on the world market for less than the cost of those sold in the United States.

"The drug companies are afraid of what we might do," Durenberger said. "The day has come to push for a bill to allow Medicare to negotiate drug prices."

He urged 75-member audience to contact their legislators and demand the government start negotiating drug prices.

Solutions

There needs to be more information about costs, programs available, and quality of care, Durenberger said.

There should be incentives to encourage healthy behavior. And technology should be used only when necessary.

"Individuals need to get the information on what questions to ask, what's covered, what clinics can they go to," he said.

Sponsors of the forum were the League of Women Voters of the Brainerd Lakes Area, Brainerd Dispatch, The Rosenmeier Center for State and Local Government, Brainerd Lakes Area Chambers of Commerce, Mille Lacs Band of Ojibwe, Mille Lacs Health System, and St. Gabriel's Hospital in Little Falls.