Minneapolis Star Tribune, Sept. 1
Albert Lea flap spotlights need to help small hospitals recruit, retain medical providers
The bitter battle over the future of a small southern Minnesota hospital has spotlighted a sensible step state lawmakers can take to fortify other outstate medical centers.
In 2018, the Legislature should move swiftly to boost funding once again for a student loan forgiveness program that helps entice medical providers to practice in rural and other underserved areas. While the 2015 Legislature approved a healthy increase to the program, “there are still more applicants than slots available in all of the eligible professions,” according to the Minnesota Department of Health (MDH).
The difficulty of recruiting and keeping medical providers in small communities is one of Mayo Clinic’s key justifications for the controversial changes it has proposed to the Albert Lea hospital. The Freeborn County city’s former Naeve Hospital has been part of Mayo’s outstate network since the 1990s.
In June, Mayo abruptly announced plans to consolidate services at its Albert Lea and Austin, Minnesota, campuses. Intensive care, labor and delivery, and most inpatient services will move to Austin. Behavioral health services and outpatient surgeries will remain in Albert Lea, along with emergency care. The move understandably set off alarms in Albert Lea because citizens will need to drive 22 miles east for important medical needs.
In an interview with an editorial writer, Mayo officials emphasized how challenging it is to attract physicians to work in small medical centers. New medical school graduates may have dozens of job offers, they said. Bigger facilities, with their larger patient volumes, are also thought to provide more opportunities to hone providers’ skills.
Recruiting medical providers to rural regions is not a new problem, of course. It will take innovation on the part of health care systems like Mayo to maintain a level of service a community expects. City leaders will also need to step up and find ways they can make their communities attractive to young professionals.
But state lawmakers also have a role in addressing this challenge. That’s especially true in Minnesota, where agriculture powers the economy and small towns perched on the prairie and at the edge of the North Woods are a vital part of the state’s culture. Boosting funding for the health professional student loan program is one solution.
The program, administered by MDH’s Office of Rural Health and Primary Care, currently has 300 enrollees. Data suggest that the state loan forgiveness program works. “About 80 percent of the participants remain for the long term in their original or a similar setting in Minnesota,” a program spokesman said. The professions the program is open to include doctors, mental health professionals, dentists and public health nurses. The annual “forgiveness awards” are based on 15 percent of the average educational debt of recent graduates in each profession.
The 2015 Legislature gave the program a welcome boost, increasing annual funding from $740,000 to $3.2 million. State Rep. Debra Kiel, R-Crookston, merits praise for her leadership on this.
Kiel has been watching the Albert Lea flap unfold and doesn’t mince words about the difficulty of recruiting doctors to rural areas. Minnesota, she said, has a “serious problem.” She agrees that more needs to be done and that strengthening the student loan forgiveness program again should be looked at.
Lawmakers, especially those who made campaign vows to prioritize the needs of greater Minnesota, ought to heed Kiel’s concerns. They also ought to work to prevent another serious threat to the loan program’s future. Dollars for the program come mainly from the state’s health care access fund. The medical provider tax generating revenue for this fund is slated to sunset in 2020.
The fate of the tax likely will spur robust debate in coming legislative sessions. That it helps fund a loan forgiveness program vital to small communities’ future well-being should be an important part of the discussion.
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Post Bulletin, Sept. 1
So long, summer, it’s been too real
So long, Summer 2017. You’ve been a doozy.
With constant protests, fresh battles over the Civil War, racial tensions and the threat of a looming nuclear war, we can be forgiven for feeling like this summer has left the nation more divided than before. But 50 years ago, Americans had similar butterflies in their stomachs. The “Summer of Love” featured widespread protests over the Vietnam war, race riots and a bunch of hippie youths exercising their most indulgent whims as a direct refutation of the previous generation’s social conservatism.
Questions over the direction of the country often were replaced with ruminations on its survival.
Similar to our predecessors in the ’60s, we’ll probably find a way to muddle through. We could wind up transcending the pitfalls that previous generations have succumbed to. We enter the fall of 2017 with a beautiful way forward, thanks to the example given to us by our southern brothers and sisters. What should have been the darkest news event of the summer, a tropical hurricane barreling down on the nation’s fourth largest city, mostly has revealed the golden spirit bubbling underneath the rough veneer of modern American society.
Sometimes we lose sight of the remarkable sameness we all exhibit. When nature sows disaster, that veil of anonymity shatters. It’s impossible not to see ourselves in the old woman stuck on top of her house, or hope we would be the man carrying her to safety. Either event could happen to anyone, which is why we fall back on one another.
Only a human being can understand the effects a disaster has on another human. Only we can appreciate the awesomeness of rescuing someone from their home on a Jet Ski.
These tendencies do not only express themselves in times of disaster, though. As citizens, it’s on us to practice minor acts of solidarity to keep these impulses alive and healthy. On our way into fall, we also say goodbye to the Minnesota State Fair. While some see the Great Minnesota Get-Together as an excuse to collect political bumper stickers and mow down Doritos-flavored corn on the cob, we see it as an opportunity to encounter fellow Minnesotans face to face, to save a stranger’s spot in line, to pick up their fallen funnel cake or to help a stroller up a curb.
Small favors are more than just a courtesy. They’re the glue binding society together. Make them a regular practice in your life, and you’ll have played a part in keeping America together.
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Mankato Free Press, Sept. 2
NAFTA talks loom large for Minnesota
Minnesota has much at stake as talk between the Trump administration and Canadian and Mexican officials begin renegotiating the North American Free Trade agreement, commonly known as NAFTA.
Minnesota’s rich agricultural base and its diverse manufacturing sector, creating everything from medical devices manufactured in the Twin Cities to farm and heavy equipment parts made at Dotson Foundry in Mankato, have always been of interest to foreign buyers. But prior to NAFTA’s implementation in 1994, many of those goods were difficult to export to our neighbors to the north and south due to high tariffs and other trade restrictions.
Minnesota long had a huge trade deficit with Canada, with many more imports than exports. Since NAFTA, that trade deficit has been cut nearly 60 percent. And Minnesota long had a trade deficit with Mexico, but now exports more products there than are imported here. Many of those exports have been corn and other farm products.
In fact, Canada and Mexico are now the top trading partners for Minnesota, according to state government figures.
That’s why a wide array of agricultural and manufacturing associations in Minnesota have been working to ensure that a renegotiated NAFTA does not trigger trade wars on certain products that would harm Minnesota producers and manufacturers.
As productive as Midwest farmers are, the United States produces just one-fifth of the global supply of corn. A rewritten NAFTA agreement that puts Minnesota crops at a disadvantage would be a blow to the state’s economy and to farmers, particularly with the recent years of low crop prices expected to persist into at least the near future.
If Midwest crop markets are too costly, Mexico can easily turn to South American countries to fill the void.
Renegotiating NAFTA is not in itself a bad idea. Any agreement made nearly 25 years ago undoubtedly requires some adjustments to address current global markets.
It now rests with the Trump administration to ensure those changes don’t trigger trade wars and that they create more benefits than pain for the country’s economy.
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