General Assistance Medical Care – Minnesota

For poor, health care at extremes, By Warren Wolfe, September 19, 2010, Minneapolis-St. Paul Star Tribune: “Perched on an exam table at Hennepin County Medical Center in Minneapolis, Ron Beasley, 46, sits at one end of the spectrum under Minnesota’s revamped health care program for the poorest adults, General Assistance Medical Care (GAMC). Hospitalized four times this year, he now gets intensely coordinated care from a medical team in a new clinic that seeks out and treats some of the state’s most difficult patients. The goal: Improve his health, avoid a medical crisis and save the health care system a bundle. At the other end of the spectrum is Joe ‘Smokey Joe’ Johnson, 53, a grizzled veteran of the Twin Cities streets who is pretty sure he’s got diabetes, ‘some kind of breathing problem and a bum leg.’ He hasn’t had a regular doctor or clinic for years and doesn’t want one now. ‘When I get sick, I just go to whatever ER I’m closest to. I get to decide.’ The two Minneapolis men illustrate the extremes of care under the program, which was the subject of a fierce tug-of-war between legislators and Gov. Tim Pawlenty last spring and is just now taking full form in Minnesota hospitals. For thousands of the poorest and sickest Minnesotans in GAMC, the type of health care they get depends more on geography and choice than on how sick they are…”