RDs on the Hill

Photo from Deb Greene

Late in February, I attended the Minnesota Dietetic Association’s Legislative Day on the Hill. Given that public policy affects the dietetics profession, this annual event was geared to show dietetic professionals and students how to affect public policy. This year’s attendance was triple that of last year's – we were packed into what I had thought was a spacious conference room.

We heard first from Carol Brunzell, MDA Public Policy Committee Member and ADA delegate. Brunzell presented Policy 101, an introduction to how a bill becomes a law (something we had covered recently in Community Nutrition) and when/how we can get involved. Maggie Powers, author of Eating Right When You Have Diabetes, followed with a description of her role in drafting health care reform legislation. She emphasized the importance of being at the table when legislation is being written and building relationships that provide support for the legislation.

Next, we broke into groups to role-play a visit to a legislator, a useful exercise. The RDs’ goal in the role-played visit was to introduce themselves to the legislator; outline the many roles that an RD can play; raise issues of concern, such as health care access and reform, access to safe and healthy food, and chronic disease prevention; and establish themselves as an expert on nutrition and as a ready resource.

Our sessions came to an end as Representative Kim Norton (DFL-Rochester) made her way to the front of the room. She painted a bleak picture of our economic situation and mentioned three current bills that require no funding, such as the current Farm to School Proclamation to raise awareness of Farm to School Programs in Minnesota. Rep. Norton urged us to spread the word about SHIP, the Statewide Health Improvement Program that promises to reduce health care costs in the future by working to lower obesity rates and tobacco usage.

At this point, we broke for lunch in the Great Hall, which was literally just a hall. I chatted with Louanne Kaupa from Owatonna, who had been in my break-out group, and Ramona Robinson, who had worked with Chery Smith on a couple of papers about sustainability. Then I joined a small group on the hunt for some action. We ended up in a committee meeting on Commerce and Consumer Protection. As we entered, Sen. Kelash was introducing a bill on lead acid battery purchase, return, and collection provisions modifications. What struck me was that the senator was not personally familiar with all the details of battery purchase, return, and collection – that’s why Brad Bergstreser, from Savage Auto Parts was there. He explained the reasoning behind the provisions modification and fielded most of the questions from the committee members. I could easily imagine a dietitian sitting in that seat next to a bill’s cosponsor, answering questions as a nutrition expert.

We left the hearing before the issue was resolved to visit Rep. Rick Hansen in the State Office Building. He had stepped out for lunch, but when he returned, we were welcomed into his airy office. After introductions, Sue Parks, RD, mentioned some of the talking points suggested by the MDA. Rep. Hansen described to us the difficulties facing Minnesota’s budget, which made our desires for SHIP funding to remain constant or for health care reform seem entirely out of reach.

In any case, the message of the Day on the Hill came through loud and clear: RDs must advocate for themselves if they wish to be reimbursed for their services. This event was a great stepping stone into getting more involved in public policy in the future.



Edited 2/28/11

One man's stiff shoulder

The Healing of America: A Global Quest for Better, Cheaper, and Fairer Healthcare, by T.J. Reid (Penguin Press, 2009).

I needed a break from reading about the food system. I got tired of reading about how badly school lunch fails, about the size of the average manure lagoon is, etc. I needed new topic.

Health care fit the bill. I guessed that a rundown of the U.S. health care system would be as disheartening as the rundowns of the U.S. food system, but at least it would be new material. I heard an interview with Reid on NPR this summer and the next time his book came onto my radar, I was primed to read it.

Here’s the premise. Journalist T. J Reid took his stiff shoulder to seven industrialized countries to assess their health care systems: Britain, Germany, France, Japan, Canada, and Switzerland and Taiwan (the last two recently to reform managed health care). For those new to health care discussions, he explains the four different models.

1. Beveridge model – the government provides health care and finances it with taxes. Familiar to U.S. veterans.
2. Bismarck model – the private sector provides health care and the government regulates nonprofit insurance companies that cover everyone and that are financed by employers and employees. Familiar to working Americans.
3. National Health Insurance – the private sector provides health care and a government-run insurance program financed by citizens pays the bills. Familiar to Americans over 65.
4. Out-of-Pocket Model – if you have money, then you can see a doctor. If you don’t, you can’t.

A major takeaway point for me was the folly of having for-profit insurance companies. They exist to make money, so sick, expensive patients are bad for business, while denying claims and not covering preexisting conditions is good for business. Meanwhile, healthy, cheap twentysomethings don’t buy much insurance. As I understand it, if we want insurance companies to cover everyone, then everyone needs to pay for insurance (the individual mandate).

One theme was the difficulty of pleasing everyone. When the government regulates health care closely or is the single player, it has the power to negotiate very low prices for procedures and drugs. These low prices are good for patients and the federal budget, but they can squeeze drug companies and physicians something awful. Luckily, doctors in other countries don’t have pay nearly as much for their medical education, if they pay for it at all.

There’s a lot of interesting stuff I could get into, like Reid’s Ayurvedic treatment in India or France’s carte vitale. The book is accessible and entertaining, though, so I’ll just recommend going straight to the source.

Urban Ag in Brooklyn Center

It's all very well and good to read about urban agriculture in Oakland or New York City, but a key to the good-food movement is locality. So that's why I was pleased to see this video from Fourth Sector Consulting, based in Minneapolis.

Urban Agriculture in Brooklyn Center from Fourth Sector on Vimeo.