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Recent rankings reports from different organizations paint a similar picture: Minnesota’s health system tends to rank among the best in the nation, while also demonstrating some signs of worry.

First, a Press Ganey Pulse Report finds that Minnesota ranks 5^th among the 50 states in shortest visits to the Emergency Room in 2009, averaging 3 hours, 11 minutes per visit, a mere 16 minutes behind the leader (Iowa). Only Iowa, the Dakotas, and Nebraska ranked better. The national average is 4 hours, 7 minutes, with Utah bringing up the rear, with an average ER visit lasting 8 hours, 17 minutes in 2009. Shorter visits are correlated with high patient satisfaction; as it currently stands, shorter times are indicators of efficiency, not rushing. Both the length of Minnesota’s average ER visit and the national average have not changed much since 2008, though other individual states have seen significant improvements or declines.

Next up is a newly-released ranking from the Census Bureau on percent of those without health insurance under age 65 per state in 2007. Minnesota comes in 3^rd at 9.6%, one of only four states under 10% (the others are Massachusetts, Hawaii, and Wisconsin). This compares to a U.S. average of 17.1%. The report is also useful in that it includes breakdowns by county (see map). For instance, Minnesota’s lowest uninsured population is in Anoka County, at 7.3%, while Cook County struggles the most, with 18% uninsured.

Now for the bad news: when these numbers are examined over time, our trend is worse than the nation’s. Based on numbers from America’s Health Rankings, Minnesota has seen a 21.1% increase in the size of its uninsured population since 2001, compared to a U.S. increase of 11.5%.  It’s also important to note that because Census data is only available up to 2007, before the Great Recession, the total uninsured percent of the U.S. population has likely increased in the last three years.

Finally, the Annie E. Casey Foundation’s annual Kids Count report ranks Minnesota 2^nd in children’s well-being for the third year in a row, behind only New Hampshire. The ranking is based on statistics such as youth mortality rates, teen births, school attendance, and children in poverty. However, the Star Tribune reports that many Minnesota child advocates “fear Minnesota’s poverty rate – higher than a decade ago – could undermine its success.” These advocates worry that while our numbers remain strong in many categories, our increasing poverty is a leading indicator that these numbers could soon be declining.

The Tribune quotes research director for the Children’s Defense Fund-Minnesota Kara Arzamendia, who was speaking of the Kids Count results but whose comment is true of Minnesota’s health system as a whole: “Minnesota isn’t doing very well compared to itself.”

It’s become a common theme: In snapshot comparisons to the rest of the country, Minnesota’s health continues to hold up well. But compared with our proud past, in category after category, Minnesota has begun to slip. We’ll need to reverse that trend if we want to maintain our high quality of health and remain the national leader we are today.

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Macalester College students started the Experimental College of the Twin Cities (EXCO) in 2006, responding to what they saw as an unfair admissions policy change at their own school.   Co-founder and volunteer organizer David Boehnke says at the time, he saw EXCO as a “vision of free, diverse, and participatory education intimately tied to the process of people coming together to meet each other, strengthen networks, build movements, and create the world they would like to see in the present,” according to a Minnesota Daily article.

Heading into its fifth year this September, EXCO continues to take on that vision, by committing itself to transforming education on the principle that everyone can teach or take classes and that all classes are free. Fortunately, the program gets $15,000 in annual funding through its student chapters at area schools. However, that is only enough to cover class supplies and $300 stipends for instructors, who might otherwise not be able to teach these classes.  This funding does not supply the program with permanent classrooms. Instead, classes are located at the U of M, Macalester and throughout the community, such as libraries, churches, community centers, parks, etc.

After starting with only six classes, EXCO has expanded to more than 40 classes per semester, ranging from the seemingly ordinary (Introduction to the New Testament: Historical Context of Early Christianity; Renewing Our Future: Energy, the Economy, and Climate; and Creative Writing for the Non-Creative) to the unusual (Anarchist Anthropology, Imprinted Sexual Fantasies: A New Key for Sexology, Basic Bike Maintenance).

Along with the growth of class selection, the program itself has also grown to include chapters at the University of Minnesota and the Academia Comunitaria for the Latino community.

EXCO illustrates how education can thrive through a community-based approach, due in part to the assistance of the chapter groups from Macalester, the University of Minnesota, and Minneapolis Community and Technical College.  This backbone of support includes students and staff.

Though it does not fit the definition of a typical college, nor do the credits atomically count toward a degree, EXCO does demonstrate the belief that education is for everyone regardless of financial circumstances. This is something we should all remain committed to.

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Townships have not been immune to state aid cuts over this period either.  In 2010, the township share of the “market value homestead credit” was cut by approximately $5 million statewide.  The cut was imposed by reducing the township’s credit by 3.66% of their certified levy, subject to various caps.  These cuts were initially imposed by the Governor in his July 2009 unallotment and subsequently incorporated into House File 1671 (chapter 215), which became law in April.

The one-year cut in township budgets was bad enough.  To make matters worse, the same amount that was cut in 2010 will continue to be cut in future years.  For example, the 2010 market value homestead credit cut for White Bear Township—the largest township in the state—was $97,000.  Each year in perpetuity (until the law is changed), White Bear Township will have its market value credit reduced $97,000.

The market value homestead credit cuts undermine accountability in two ways.  First, it will allow the state to claim credit for property tax relief to homeowners that it is not actually giving.  For example, the property tax statements of homeowners in White Bear Township for 2010 reflect aggregate state paid property tax relief of $105,000.  In fact, the total amount of state paid relief actually received by the Township will be only $8,000. The property tax of White Bear Township homeowners will not increase as a result of the credit cut, but White Bear Township will be left with a $97,000 hole in its budget.

Second, the cut will compel townships to levy more than they actually need in anticipation of the credit reduction.  As with all credits, the amount of the market value homestead credit is actually built into a jurisdiction’s property tax levy. The problem for the foreseeable future is that townships will not receive the full amount of the credit.  For taxes payable in 2011 and thereafter, townships will have to increase their levies by the amount of the market value homestead credit cut in order to obtain the full amount they actually need.

For example, assume that the amount of revenue needed by White Bear Township for 2011 is $2,565,000 (the amount of the Township’s certified levy in 2010).  In order to get $2,565,000, the Township will have to levy $2,662,000—$97,000 more than the Township actually needs—because the township will not actually receive $2,662,000 because of its $97,000 credit reduction.

Oh, what a tangled web we weave.  Townships will have to certify a levy that is greater than they actually need in order to generate what they do need.  Residents will see their property taxes go up—not knowing that all or some of that increase is not going to pay for increased spending, but to make up for a cut in state paid property tax relief.  Fiscal transparency and accountability is thus undermined.

Cuts in aids and credits to local governments are the state’s way to avoid the need for a state tax increase by shifting its budget problems on to Minnesota local governments and property taxpayers.  Expect more of this type of policy shenanigans until the state puts its fiscal house in order.

Anderson is accused of arranging a state Department of Education contract with the Texas-based National Math and Science Initiative organization prior to leaving MDE and joining the group. Ms. Anderson is alleged to have negotiated a services contract between NMSI and MDE, knowing that, after resigning from MDE, she would be the contract’s service provider. If so, Anderson violated her fiduciary responsibility to Minnesota in return for personal financial gain.

Ms. Anderson is a conservative educational policy advocate and experienced governmental administrator. She was the vigorous day-to-day operational leader of Governor Pawlenty’s conservative educational initiatives. In this capacity, little escaped her attention. The National Math and Science Initiative group has deep conservative ties. It is led by former Bush Administration education officials.

Conservative public policy’s chief goal is minimizing wealthy Minnesotan’s tax burden. With public education occupying a substantial chunk of Minnesota’s state budget, undermining public confidence in public schools mitigates public outrage over state funding cuts. National conservative educational policy, expressed in the federal No Child Left Behind Act, facilitates the anti-public agenda by creating a impossible performance standard. By 2014, every Minnesota school will, under NCLB standards, “fail.” As Deputy Commissioner, Ms Anderson had been an enthusiastic supporter of NCLB and other conservative educational policy initiatives.

It’s bad enough that conservative policy advocates work to unravel Minnesota’s prosperity, anchored in our strong public education institutions. Cashing in at Minnesota school children’s expense is uniquely distasteful. These allegations merit prompt attention from the Minnesota Management and Budget Office and the Office of the Legislative Auditor.

Summer of Solutions (SoS)  is a program aiming “to build the green economy and youth leadership,” says program participant Martha Pskowski. This summer marked the third year for SoS, which is run through the non-profit Grand Aspirations.  Macalester students founded both in 2008. Now, nine SoS programs have spread nationwide.

The Twin Cities program includes roughly thirty individuals participating either full- or part-time, and seeks to partner with existing community organizations to broaden its reach and increase its impact in four focus areas: energy efficiency, bicycle transport, urban agriculture, and green manufacturing.

For energy policy, the group partnered with Cooperative Energy Futures to recruit and train a sales team to sell energy efficiency kits to low income families. SoS’s Willy Raedy says that the kits are designed to pay for themselves within a year’s time, as the group knows many low income families are renters who move around a lot and need the savings to manifest quickly.

Both Pskowski and Raedy helped with SoS’s bicycle transport focus, which was conducted through a partnership with not-for-profit Sibley Bike Depot. Sibley offers free bike repair help from mechanics and teaches repair skills, while also doing bicycle loans and even allowing individuals to earn bikes through volunteering. SoS conducted a listening project to see what other services community residents would want from Sibley, and as a result, designed a women-specific bike repair class.

With urban agriculture, SoS partnered primarily with the Harrison Neighborhood Association and worked to build up and network preexisting urban gardens while helping implement a market at which to sell produce from the gardens.

Finally, for their green manufacturing focus, SoS partnered with the Alliance to Re-Industrialize for a Sustainable Economy (ARISE) and designed a plan for transitioning a St. Paul Ford manufacturing plant slated to close in 2011 into a green technology plant. SoS also built a universalized template from the plan that can be utilized elsewhere.

Though the SoS program itself will come to a close with the end of July, its projects are designed to sustain throughout the year until SoS launches again next year. Pskowski and Raedy are proud of their service within local communities in the Twin Cities over the summer and of the groundwork they have laid for the future. Looking ahead, Raedy hopes SoS participants will start down the entrepreneurial path and create future green jobs. He says interested individuals should look to apply for Summer of Solutions 2011 next spring, and hopes the program can fundraise enough to offer participants some financial support.

Pskowski hopes that their work will prove “being socially and environmentally responsible can work for businesses and communities as a whole… It’s about creating a system that can make money, but has greater benefits as well.”

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I chose a recent Thursday to rent a bicycle and ride around. I parked my car on the south end of Uptown and walked the few blocks to a rental station. As it happens, I probably chose to park as far as I possibly could from any Nice Ride station. I only had to walk two or three blocks to get a bike, but as I found on my ride, a lazier person can find a station every couple of blocks along a busy street, especially in Up Town and downtown Minneapolis.  The process of renting the bike is straightforward. You insert your credit card into the machine, you get the unlock code, and you take a bike out of the dock. Adjust the seat, and you’re good to go.

I spent time roving around backstreets, jaunted around Lake Calhoun, and made my way down the Green Way over to the Midtown Market for a snack. The pea-green bikes attract a lot of attention. It prompted discussion among passers-by about the program. I had several, “Hey, nice ride!” comments as I passed nylon-clad commuters. Fellow bicyclists seemed genuinely pleased to see the program up and running.

I kept my bike longer than most would, and the charges reflected it. For an afternoon of bicycling, I paid $12, including the mandatory $5 24-hour subscription fee. A fee of $7 is probably too costly for every day use (though a rental under thirty minutes is free). I forgot my credit card at home, and so I was forced to use my check card. Nice Ride places a hold of $250 on your account to make sure it gets the bike back, though the hold disappears after several days. This is the one downside of the program; I couldn’t access that cash for about a week after the ride. That I chose the wrong card is my own fault, but it is an issue for other riders to be aware of.

The success of the program will be getting more people on bikes who would otherwise not be so inclined to go out and give cycling a spin. Nice Ride bikes are available twenty-four hours a day, and they’re geared toward short, quick trips. For that convenience, the customer pays a premium. It is well worth it if you use the a Nice Ride bike infrequently, but in the long run it is more economical to purchase one’s own bicycle. And that’s sort of the point. Nice Ride will succeed because it is a Fischer-Price program: it is not an end unto itself; it’s is a great first step toward changing urban travel for the better.

David West decided to fight back in song. An English and theater teacher in the Minneapolis Public Schools since 1996, he composed and recorded a funny send-up of educator-bashing with his eclectic acoustic band, the Fireroast Mountain Boys. “Blame It on the Teachers” points the finger at school faculty for everything from stammering students to rising taxes.

West, also a busy actor, stage director and storyteller, still finds time to serve on the Southwest High School Leadership Council and as an Education Minnesota union steward. He lives in Minneapolis with his wife, Miriam, and son, Skyler.

Click here to listen to “Blame It On the Teachers” by David West.

Under advice from the Lino Lakes’ contracted city attorney, the city council allowed non-English language publications relating to public safety, public health and education. But, in forbidding all other non-English publications, Lino Lakes raises its risk of unnecessary legal costs defending a conservative public policy distraction.

It’s no exaggeration to observe that Lino Lakes could face a $100,000 litigation bill defending its English-only publications policy. Going to court is never cheap. Comparatively, one hundred grand is roughly the cost of a single police officer, factoring in salary, benefits, uniforms and a financial slice of the department’s infrastructure supporting that officer. It’s a fair question for the get tough/taxes are bad/save money conservative crowd, asking how the possibility of cutting a police officer just to fund an unconstitutional act’s legal defense makes any kind of sense.

That $100,000, by the way, doesn’t include the cost of fines and financial penalties if the city loses. Of course, even if Lino Lakes were to win, it would still pay litigation expenses, taking money away from essential city services.

Lino Lakes is also paying a public perception price for embracing this conservative policy distraction. Lots of folks suddenly have an uneasy feeling about Lino Lakes. It will likely impact home value and retard business growth. That’s a cost that will haunt the city for years to come.

This begs the question: Why can’t states make use of simple borrowing mechanisms that the federal  government uses every day, especially in tight economic times like a recession?

Let’s think about this in the same terms that an 18-year-old and her family would use to pay for college.

As a high schooler, our 18-year-old took a series of part time jobs earning about $3,000 each year for four years.  Going into Freshmen year, she’d have about $12,000 in savings, assuming she didn’t tapped into that cash for a prom dress or any other expenses.

Being from out-state Minnesota, she’s going to need about $25,000 in yearly expenses, including room, board and tuition at the U of M. Even if she’s able to earn up to $7,000 working a part-time job, she’ll still need some loans to get her through.  And why not let her borrow against her future earnings?

But when it comes to states, we have institutions that either have very little ability to borrow or aren’t allowed to borrow at all. In the last couple of years, most state and local governments have been getting that extra boost to weather the economic storm via federal stimulus funds. But that line of cash has run out  and Congress is refusing to extend the life preserver.

Why can’t we handle this problem on our own? Because Minnesota has a law mandating a balanced budget every biennium, which means it can’t run deficits.  In theory, that’s a good thing, especially during a normal economic cycle.  But in bad economic times, we need the flexibility to make other fiscal choices.  We wouldn’t tell a student to go to college on minimum wage and pay as she goes without taking on any loans; not only would it take far longer but it would mean years of lost productivity.

Completely different, right? Not really.

Simple economics tells us that when times are bad, people have less income, which, all else being equal, means less tax revenue. At the same time, that smaller pot of money is expected to fund programs that expand as more recession-struck citizens need unemployment benefits, health care assistance, and other forms of government aid. On the national level, we can sell our debt in the form of government bonds and we can continue spending while the downturn persists. This stimulates the economy and helps minimize the pain. This part of the story is pretty familiar.

But there is a very important secondary piece of the puzzle many ignore. When times are good, the economy is booming, and we have extra cash, we must pay down that debt.  We shouldn’t have huge tax giveaways, as we saw earlier in this decade.  We also need to invest in schools and infrastructure when money is thick.  Irrationally demanding that states balance their budgets during recessions along with long-term tax and spending cuts is costing us economic efficiency and making the recession last longer.

How do you see the way forward? What will it take for Minnesota to recover from Pawlenty’s disinvestment in education?

City Councils do Minnesota’s heavy governmental lifting. They lack the state legislature’s grander Kabuki theater drama. City council scale is generally modest. Little physically separates city council members from their public. In small towns, everyone -council members and attendees- might actually sit at the same table.

City councils authorize every city expenditure, as they will tonight in Lino Lakes. They consider permit applications. Tonight, American Legion Post 566 has a temporary on-sale liquor license request for Blue Heron Days, Lino Lakes’ annual community celebration. In fact, the city council faces a fair number of Blue Heron Days-related agenda items. I expect all will pass because no city council member in their right mind, regardless of their determination to save the city money by not spending funds that they’re already not spending, wants to be the councilman who opposed Blue Heron Days.

Lino Lakes city council members will likely deny a variance request to a small auto repair shop that wants to add used car sales but doesn’t have enough space to conduct the business.  Permit and variance request hearings can be knock-down, drag-out, hot-tempered affairs. On the surface, the request for an exception to the city’s rules might seem simple enough, letting a mechanic sell used cars, especially with the recession. But, the business is already operating in a non-conforming use building and wants to expand its non-conformity. And, if the Lino Lakes City Council allows the requested variance, what about the next request or the one after that? It’s tricky, important and difficult work with little reward beyond contributing to the community’s stability and growth.

Even though Lino Lakes is a relatively wealthy northern Twin Cities suburb, it’s juggling declining revenues, expanding costs and community service expectations. City property owners are paying more and getting less, making, I imagine, more than a few Lino Lakes residents frustrated with their local elected officials. Under these circumstances, a handy conservative public policy distraction, like the one being considered tonight, could be a quietly welcome agenda item. I’m betting, though, that Lino Lakes residents are smarter than that.

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That’s because beyond the federal health reforms that will require more health information technology and therefore greater broadband use, Minnesota passed health reform measures in 2007 and 2008 that mandate all hospitals and health care providers have interoperable electronic health records by 2015, and that all prescriptions be filed electronically by 2011. “I don’t think a lot of other states were out in front with legal structures and incentives like Minnesota,” says Karen Welle with the Office of Rural Health and Primary Care.

Welle says the expanded subsidies—which will fund 85% of installation fees, 50% of recurring costs (up from 25%), and increase the types of facilities eligible—will allow rural health providers in Minnesota to increase broadband speed, enabling many augmented services. Central to these is telemedicine.

Minnesota 2020 has discussed telemedicine previously, but the central premise focuses on enabling videoconferencing between patients and specialists. “When you’re in the city, you just go to the doctor,” Welle says. But in rural areas, it can be very difficult to consult doctors and specialists, particularly on a regular basis. Welle suggests that with Minnesota’s aging workforce and aging citizenry, especially in the western part of the state, telemedicine and broadband access are things rural Minnesotans “have to have.”

Another clear positive of the expanded subsidies is that beyond direct health care providers, the subsidies are now also available to nursing homes, renal dialysis centers, administrative centers, and data centers. “Nursing homes have been a missing piece in the subsidy in the past,” reports Welle. She’s also enthusiastic about the expansion to data centers, which will allow smaller hospitals to pool their resources to meet their electronic needs.

As Minnesota transitions toward a more techno-savvy health care future, this subsidy will help make sure our rural communities aren’t left behind.

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A couple of weeks ago, in my Minnesota 2020 Journal column, I wrote about our fridge dying. We moved refrigerator contents into a plastic picnic cooler, a step requiring a five pound bag of ice daily to keep things cool. After the service technician informed us that repair would start at $600 but could likely spike to $1000, replacement rather than repair made more sense. That’s when I ran into the recession.

Appliance purchasing is not a discretionary spending activity like buying a book or going out to dinner. Appliance costs tend to prohibit impulse spending but purchasing decisions can roughly be categorized as “we have to replace a dead fridge,” “we’d like to replace our old fridge with a newer, better, more efficient model” and “OMG, I simply have to have that shiny, high-end Sub-Zero or I’ll die.” Business models largely dictate which retailers embrace which market segments.

My spouse identified several models at our price point. We were surprised to learn that no one had any in stock. Every option would take a week. Warner’s Stellian said that, as did Best Buy.

I know from previous experience that buying an appliance one day and getting it delivered the next just doesn’t happen. Still, a week? Seven more five-pound bags of ice? Geez. Then, I pulled up the national inventory reports.

According to the U.S. Census Bureau’s Manufacturing and Trade Inventories and Sales report for May 2010, spring inventory levels are the lowest they’ve been in ten years. Manufacturers and retailers are very cautiously managing supply. Big-ticket items aren’t moving so manufacturers aren’t eager to make goods that retailers can’t sell. All of it is driven by recession-sensitive consumers’ reluctance to buy.

Insight doesn’t lessen my exasperation but it does temper my expectations. We built a consumer culture around instant gratification. Now, in this prolonged recession, we’re paying a steep price for the high cost of wanting and getting. Surviving a refrigerator loss and surviving a persistent economic recession are two very different things but they both point toward a similar lesson: a growing economy yields more opportunities than a shrinking one. It came free with my new fridge.

The West Central Tribune

Into this bleak picture stepped the Kandiyohi County Board of Commissioners. Its smart approach recognizes that prevention and insurance, though costing something in the short run, can save money in the long term. Commissioner Richard Larson acknowledged as much, saying that by not paying the premiums for these individuals, a number of whom are mentally ill, “It’ll bite us in the backside.” Larson called the decision a “no brainer,” and Kandiyohi County Family Services Director Jay Kieft said it would cut down long-term expenses for the community.

Unfortunately, for many conservatives, this isn’t a “no brainer.” By focusing only on immediate and individual costs without factoring in long-term and community savings, they conclude that a dollar spent on most types of social services is a dollar wasted.

Many conservative critics of the federal Affordable Care Act (AFA) complained that it focused too much on access without paying attention to cost. Yet as Kandiyohi County’s decision makes clear, above and beyond the cost savers written into the law, the AFA lowers costs by the very nature of expanding health insurance access.

This really isn’t that surprising: If you’re without insurance and you develop a bad cold, you probably skip going to the doctor. But when that cold becomes a full-blown case of pneumonia that requires you to be rushed to the emergency room, your expenses skyrocket.

Admittedly, part of the problem is the way progressives promote  increased access: We often emphasize the moral reasons for expanding coverage without giving enough attention to the economic benefits.

Tom Schaller points to a 2007 study by the Milken Institute which found that from 2003 to 2023, without any reform, $7 trillion dollars of GDP would be lost due to chronically ill workers taking sick days, showing up onsite but performing subpar work, and simply through living shorter lives. A 2009 analysis by the Center for American Progress concluded that lost productivity from the uninsured based on these factors cost Minnesota $2.62 billion in 2009 alone—and Minnesota was in the middle of the pack.

By increasing insurance coverage and allowing for better preventive care for many Minnesotans, we can begin reducing these costs. Kandiyohi and other counties making similar decisions are leading the way with their smart, progressive decisions that move Minnesota forward through a focus on long-term rather than up-front costs. It’s a county-level step toward a healthier and more productive state and country.