Tag Archives: Minnesota

Minn. reporter shares insights on covering the dental therapist debate

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Stephanie Dickrell

The debate over dental therapists continues to roil state houses across the country.

Many organized dental groups contend the technically trained providers lack the skills to perform irreversible procedures such as drilling teeth. Meanwhile, public health and grassroots supporters of a wider use of dental therapists contend that this is a good way to get cost-effective, badly needed care to poor, underserved and rural communities.

Dental therapists have been providing care in Alaskan tribal areas for more than a decade. In 2009, Minnesota became the first state to adopt the model for use statewide. Continue reading →

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Long-term care insurance premiums jump

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As the population ages and costs continue rising, paying for long-term care is a big issue for middle class families. Some say long-term care insurance can be a solution, but there are significant issues associated with these products.

In the Minneapolis Star Tribune, Jackie Crosby reports that, “Trapped between fast-rising costs for care and weak returns on their investments, insurers have been raising long-term care premiums by double-digit percentages in Minnesota and nationwide.”

Long-term care coverage has been around since the 1970s, and gained popularity in the ’90s, when the government started offering tax incentives. According to Crosby, it’s getting more expensive now because of what one expert called “the perfect storm.”

Insurers set their rates on assumptions that some people would let their policies lapse. But people held on to policies longer than expected. And their claims are bigger because they’re living longer.

Low interest rates have had perhaps the biggest impact, because insurers planned to cover claims based on reserves they invested. When those investments fell short of expectations, insurers turned to policyholders to make up the difference.

State and federal officials see long-term care insurance as key to limiting the strain placed upon government health programs by America’s aging popular, Crosby writes, and they have thus “spent considerable energy trying to encourage the middle class to plan ahead with long-term care insurance, without much luck.”

The Obama administration last month scrapped the CLASS Act, a long-term care insurance program and major piece of federal health care reform. Minnesota launched a program in 2008 that allows median-income households that buy long-term care policies to shelter some assets if they apply for Medicaid. Still, only about 11 percent of people in the state have the insurance.

Even though the Medicaid program was designed as a safety net for people in poverty, middle-class seniors routinely deplete their assets and turn to the state.

In Minnesota, Medicaid pays about 40 percent of elderly long-term care. Costs could rise fivefold by 2035 to an “unsustainable burden” of $5 billion, according to a report last year from the Citizens League.

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Reporter’s investigation exposes inefficient charity

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In the Minneapolis Star Tribune, Jane Friedmann used simple tax documents and a local woman’s complaint to show that most of the money raised by the Austim Spectrum Disorder Foundation goes toward sustaining the foundation’s fundraising, not toward families living with autism. It’s a brief, effective piece of reporting of the sort that can and should be localized more often. For the record, here are the numbers Friedmann got from the return.

The charitable group pulled in $1.2 million in 2009, according to its IRS filing, but the charity listed a negative balance of $29,679 at the end of the year. It listed three employees and 89,128 “volunteers” …

The group hired two companies to raise funds for ASDF in 2009, but neither did much to help the cause. Ohio-based Infocision kept all $876,832 it raised, while Missouri-based Precision Performance Marketing kept all but $37,842 of the $203,227 it raised.

The tax form reveals the group held no “structured, formal meetings” in 2009. It spent $313,751 on “materials and fulfillment” and $120,241 on postage.

She also called local and national autism charities for their perspective on the dubious foundation, then included a few paragraphs which helped readers make more informed choices when doling out charitable contributions.

To investigate charitable organizations in your area, find out how to to understand an IRS 990 form, the tax return that nonprofit organizations file. It tells you the organization’s revenues and expenses, and its assets and liabilities. You can see whether or not it is making a profit, and how its fund balance, or net assets, has changed over the past year.

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Duluth duo investigates disciplined doctor

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The latest crop of disciplined doctors stories, spearheaded by the work of ProPublica’s Charles Ornstein and Tracy Weber, has focused on problem caregivers in the aggregate, with liberal use of anecdotes. Now, Brandon Stahl and Mark Stodghill of the Duluth News Tribune have assembled an investigation that proves there’s still plenty of room for a disciplined docs piece with just one subject.

Working from court records and a state reprimand, the Minnesota duo found that Stefan Konasiewicz, a highly paid neurosurgeon who practiced in the city for much of the past decade, was the target of nigh on a dozen malpractice suits.

When he moved from Duluth about three years ago, Konasiewicz left behind two dead patients, one woman paralyzed from the neck down and six others who say his treatment caused them serious physical harm.

His former employer, St. Luke’s hospital, was aware of the harm Konasiewicz was alleged to have caused and yet continued to let him practice, according to records obtained and interviews conducted by the News Tribune.

The exhaustive report that follows is a tribute to their investigative tenacity, loaded with quotes from colleagues who long questioned Konasiewicz’ judgment and a careful, painstaking rundown of the malpractice cases filed against the embattled surgeon.

For more on how they searched court records to find malpractice cases, and on why malpractice suits in the state face such high hurdles, see Stahl’s sidebar.

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Fact-checking Pawlenty’s health reform claims

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In some parts of the country, health care-related posturing for the 2012 election is already in full swing. Over at CJR.org, AHCJ Immediate Past President Trudy Lieberman applauds a forceful bit of health care reform fact-checking by Minnesota Public Radio reporter Lorna Benson. In her piece, Benson carefully picks apart claims made by former Minnesota Governor Tim Pawlenty as he touts his health reform record as a key piece of his 2012 presidential campaign.

Pawlenty’s two big health talking points are his “baskets of care,” or bundled payments for certain procedures, and his pay-for-performance plan. While both sound promising on paper, Benson found that some gaping holes had opened up as soon as the rubber met the road. See Benson’s full piece for the details of how any real change has been difficult to track or, indeed, even to detect at all.

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.