>> ERIC: WE HAVE A FULL SHOW FOR YOU TONIGHT TO KICK OFF THE HOLIDAY SEASON.

CHORAL GROUP CANTUS IS IN THE HOUSE, KEVIN KLING IS HERE WITH A HOLIDAY STORY FOR US, WE'LL THROW IN SOME SPORTS, PLENTY OF POLITICS AND MORE.

>> CATHY: WE START TONIGHT WITH HEALTHCARE NEWS AROUND THE STATE.

IT'S BEEN A BUSY WEEK FOR "STAR TRIBUNE" REPORTER JEREMY OLSON WHO HAD MORE THAN ONE FRONT-PAGE BYLINE IN THE LAST SEVERAL DAYS, INCLUDING THE BIG EXPANSION PROPOSED DOWN AT MAYO CLINIC AND YESTERDAY'S FRONT-PAGE NEWS ABOUT RISING HEALTHCARE COSTS FOR PRIVATELY INSURED MINNESOTANS.

JEREMY, WELCOME BACK.

>> YEAH, HAPPY TO BE HERE.

>> Cathy: GOSH, YOU HAVE HAD A BUSY WEEK.

LET'S TALK ABOUT THE RISING COST OF HEALTHCARE.

HEALTHCARE COSTS FOR FOLKS WITH PRIVATE INSURANCE WENT UP IN 2022 BY 7%, 12% IN 2021.

GOSH, WHAT'S DRIVING THE INCREASES?

>> WELL, IT'S CLEAR THAT PRESCRIPTION DRUGS ARE A BIG PART OF THE DRIVER RIGHT NOW, AND IT'S HARD TO TALK ABOUT PRESCRIPTION DRUGS RIGHT NOW WITHOUT TALKING ABOUT WEIGHT LOSS MEDICATIONS, THE NEW CLASS HAS BECOME VERY POPULAR, IT'S HAD RESULTS.

THE PROBLEM IS, YOU HAVE TO TAKE THOSE DRUGS FOREVER, THEY THINK, TO MAINTAIN THE BENEFITS.

AND THEY'RE COSTLY RIGHT NOW.

NEW DRUGS ALWAYS ARE.

BUT THESE ONES PARTICULARLY SO.

AND THEY ARE BUSTING SOME BUDGETS FOR HEALTH INSURANCE COMPANIES AND INDIVIDUALS IN THEIR POCKETBOOKS.

>> Cathy: BUT IT CAN'T POSSIBLY BE JUST DRUG COSTS, THOUGH?

>> OH, NO.

I MEAN BEING STAFFING IS A BIG ISSUE IN CLINICS, IN HOSPITALS, YOU'RE HAVING TO PAY NURSES MORE, DOCTORS MORE TO GET THEM IN THE DOOR BECAUSE THEY'RE HARD TO FIND RIGHT NOW.

AND THOSE SHORTAGES OF WORKERS ARE CAUSING TROUBLE ALL OVER THE HEALTHCARE LANDSCAPE, BUT THEY ALSO ARE MAKING IT MORE EXPENSIVE TO PROVIDE CARE.

>> Eric: IMPACT ON PREMIUMS?

>> OH, ABSOLUTELY.

THERE'S NOTHING THAT INCREASES INCREASES, WHEN YOU SEE YOUR HEALTHCARE COSTS GO UP, YOU'RE SURE TO SEE YOUR PREMIUMS GO UP, AND, I MEAN, THERE HASN'T BEEN MUCH RELIEF ON PREMIUMS IN THE PAST YEAR SO THEY'RE ALMOST SURE TO GO UP AGAIN.

>> Cathy: HEALTHCARE COSTS ARE GOING UP, YET, HOSPITALS ARE BLEEDING MONEY.

EXPLAIN THAT A LITTLE BIT.

>> INTERESTINGLY, IN THE LATEST TOTAL COST OF CARE REPORT -- HOSPITALS DIDN'T ACCOUNT FOR THE INCREASE.

THEY'RE A PART OF IT.

BECAUSE OF THE STAFFING SHORTAGES, BECAUSE OF SOME OF THE ISSUES THAT THEY'RE FACING, INCLUDING A SHORTAGE OF NURSING HOMES, THEY CAN'T MOVE PATIENTS OUT.

THEY GET STUCK WITH THOSE PATIENTS.

SO THEY'RE NOT ABLE TO TAKE CARE OF AS MANY PATIENTS.

THEY'RE NOT MAKING UP AS MUCH MONEY, DRIVING UP REVENUES.

THEIR PROBLEMS ARE HAVING A DIRECT EFFECTS ON THAT.

>> Eric: IF COSTS ARE TO BE LOWERED, WHO HAS TO GET LESS?

WHO HAS TO BE PAID LESS, GET MORE MONEY?

WHAT'S THE EQUATION GOTTA BE?

>> I'M SURE A LITTLE IT OF ALL ABOVE.

THE BIG DRIVER RIGHT NOW IS CHRONIC DISEASE, OUR OBESITY RATES HAVE SUBSTANTIALLY INCREASED, OUR DIABETES RATES HAVE DOUBLED IN THE PAST DECADE OR SO.

I THINK ABOUT 10% OF MINNESOTA ADULTS NOW SAY THEY HAVE DIABETES.

AND YOU HAVE TO MANAGE THOSE DISEASES.

IF YOU DON'T MANAGE THEM EFFECTIVELY PEOPLE GET ICKER, THEN YOU HAVE DISABILITIES, THEY HAVE EYE PROBLEMS, THEY HAVE IDNEY PROBLEMS.

AND THOSE ARE EXPENSIVE.

AND RIGHT NOW WE'RE NOT DOING A VERY GOOD JOB MANAGING THOSE.

>> Eric: WOULD HEALTHIER LIFESTYLES HELP >> OH, WITHOUT A DOUBT.

I MEAN, HEALTHIER LIFESTYLES, BUT SOME OF THAT IS ABOUT THE CHOICES THAT ARE BROUGHT TO YOU.

SOME PEOPLE DON'T HAVE ACCESS TO FRESH FOOD, DON'T HAVE ACCESS TO EXERCISE OPPORTUNITIES, ESPECIALLY SOME LOW-INCOME, URBAN NEIGHBORHOODS.

THERE'S BEEN EFFORTS TO CHANGE THAT.

BUT THERE STILL ARE A LOT OF INEQUITIES AND THOSE THINGS ARE DRIVING THOSE.

>> Cathy: LET'S TALK ABOUT THIS MAYO CLINIC EXPANSION, IT'S HUGE, $5 BILLION.

BUT IT'S NTERESTING TO ME BECAUSE THEY'RE GOING TO BE USING A LOT OF A.I.

AND ROBOTICS IN THIS NEW HEALTHCARE CENTER.

HOW DOES THAT WORK?

>> YEAH, THEY REALLY WANT THE HOSPITAL TO BE SYNCED UP TO YOUR WIRELESS PERSONAL HEALTH DEVICES SO THEY KNOW OUR ENERGY LEVELS, HEARTBEAT, THINGS LIKE THAT.

AND THEY WANT THESE NEW HOSPITALS TO BE NEIGHBORHOODS, BASICALLY WHERE YOU GO INTO THE HOSPITAL AND YOU GET ALL YOUR CARE THERE.

YOU DON'T HAVE TO WANDER AROUND THE MASSIVE MAYO CAMPUS TRYING TO FIND THE IMAGING SUITE OR THE CONSULTANTS, THINGS LIKE THAT.

SO THEY THINK IT'S THE NEW HOSPITAL FOR THE NEXT GENERATION, THEY THINK WHAT THEY LEARN THERE IS GOING TO TEACH OTHER HOSPITALS HOW TO DO IT RIGHT.

>> Cathy: O THE HEALTHCARE PROVIDER COMES TO YOU, SAY, IF I HAVE HEART TROUBLE, I'M GOING TO BE IN A LITTLE AREA, CARDIOLOGY, WITH OTHER PATIENTS AND THE PHYSICIANS WILL COME TO US?

>> YEAH, YEAH.

FAIRLY SIZABLE AREA, BUT THE SIZE OF THE HOSPITAL, IT'S GOING TO BE MASSIVE, BUT IT'S GOING TO BE CALLED A NEIGHBORHOOD, PATIENTS WITH LIKE SERVICES HAVE ALL THE SERVICES COME TO THEM.

AND THEY THINK THE CONTINUITY IS GOING TO HELP.

>> Cathy: HOW DOES THAT FIT IN WITH THE MEDICAL DESTINATION CENTER THAT THEY'RE TRYING TO GET LAUNCHED?

>> 185 MILLION IN PUBLIC DOLLARS WAS COMMITTED A DECADE AGO TO MAKING ROCHESTER A PERMANENT DESTINATION PLACE FOR HEALTHCARE.

AND MAYO SAYS THIS $5 BILLION PLAN IS THE FULFILLMENT OF THEIR END OF THAT PROMISE TO BUILD THE HOSPITAL TO MEET ALL THOSE PUBLIC INCREASES -- IMPROVEMENTS THAT ARE HAPPENING.

>> Eric: SEEMS LIKE THERE'S A BIG PRICE DIFFERENCE ON THE SAME PROCEDURE DEPENDING ON WHERE YOU GET THE TREATMENT.

IS ANY OF THAT LINKED TO QUALITY OF CARE AT ALL OR IS IT JUST WHAT THEY CAN GET AWAY WITH?

>> YEAH, DEPENDS ON WHO YOU ASK.

THE DIFFERENCE IN PRICE RIGHT NOW, OR THE DIFFERENCE IN COST OF CARE AT A PLACE RIGHT NOW SEEMS TO BE WHAT PEOPLE ARE CHARGING.

USED TO BE A LOT OF CLINICS THAT WOULD ORDER A LOT OF EXCESS TESTS, THEY WOULD BE VERY EXPENSIVE BECAUSE THEY WERE WASTEFUL.

THAT WASTE HAS BEEN ROUTED OUT, EVERYONE IS ORDERING THE TESTS MORE OFTEN NOW, BUT THE DIFFERENCE IN PRICE SEEMS TO BE IN HOW MUCH CLINICS ARE CHARGING, HOW MUCH THEY'RE REAPING OR GETTING FROM THE INSURANCE COMPANIES, AND MAYO CLINIC IS ONE F THE MOST, ACCORDING TO THE MINNESOTA COMMUNITY MEASUREMENT, MAYO CLINIC IS THE MOST EXPENSIVE RIGHT NOW IN MINNESOTA.

>> Eric: WHERE ARE WE ON STATE OR FEDERAL ACTION THAT MIGHT AFFECT HEALTHCARE COSTS, ANYTHING ON THE HORIZON?

>> OH, BOY, YOU KNOW, ONE OF THE THINGS THAT HAPPENED THIS LAST SESSION WAS THE TALK ABOUT HEALTHCARE AFFORDABILITY BOARD.

THEY WERE GOING TO CREATE A STATE BOARD THAT WAS GOING TO PENALIZE HIGH-COST HOSPITALS.

NOW, YOU TIE THIS ALL TOGETHER, IF YOU RECALL, MAYO DIDN'T LIKE THAT, THEY SAID, IF YOU DO THAT, WE MAY TAKE OUR $5 BILLION PROJECT AND GO ELSEWHERE.

THE BOARD DBTD -- DIDN'T HAPPEN THE WAY THEY ERE PLANNING IT.

MAYO WON THE DAY.

THESE ARE COMING.

IT SEEMS LIKE REFORMS LIKE THAT ARE AREN'T GOING TO BE NECESSARY BECAUSE THE COSTS KEEP GOING UP AND UP.