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Ramsey.Johnson expressed surprise at how much room was left in his pickup’s box because he expected bigger suitcases “There were no packing rules; they did that by themselves” he said“And we only have one small cooler and one big cooler The small cooler has the food”Johnson said he has only two rules One is that the driver picks the music The other“If there’s too much talking I’m rolling down the window at 80 miles per hour” he saidAll except Morehouse are seniors so the other three regard the trip as their hockey swan song thusly worth the price Per person estimates on the cost for gas food hotel and tickets are between $800 and $1000“I’m excited” Morehouse said “It’s crazy to be going that far especially when we’re driving It should be exciting”Nine straight Frozen FoursFor the likes of Marv Leier having UND in this year’s Frozen Four field is a bonus The director of creative services for the UND TV Center Leier shows up come rain or shine or UND elimination “There are always a lot of UND fans there whether the team is in it or not” Leier said “When UND is playing however it’s just so much more fun and crazy”At age 54 he will be attending his ninth consecutive Frozen Four and 13th overall Because of the tradition hisWednesdaymorning commercial flight likely made for a more comfortable trip than what the students faced Unless the tournament is held in Milwaukee or the Twin Cities his group travels via airWhen UND has lost in the Frozen Four’s first round he has received offers up to $600 for his ticket for the championship game But he has declined them all The event is not just about your team but also a reunion of family and friends who share college hockey’s appeal he explained“We run into the same hockey fans that go every year” Leier said “We have thousands and thousands of good friends there”Those conversations are among the reasons that so many college hockey fans attend the Frozen Four even if their team doesn’t qualify “They’re especially intrigued by the old-school jerseys with the logo that we wear’ he saidHis first Frozen Four trip came in 1979 as a UND student and a member of The Farce a loosely organized booster group that entertained the crowd between periods“And now my wife (Cindy) gives me a pass so I can go spend time with my hockey friends all 20000 of them” Leier saidA Frozen Four regularDanny Cooper a 1979 UND graduate is another example of the team’s following The Air Force retiree drove solo on the 564-mile trip to Philadelphia from his home in the Cincinnati areaThat means he will be in the arena for 10 of UND’s last 11 Frozen Four appearances Since 1979 he’s only missed the tournament held in Lake Placid in 1984“Last century I was good luck; this century I’ve been bad luck” he said referencing UND’s five national titles from 1980 to 2000 and none since“We need to have another Frozen Four held at Providence where we’ve won three titles”This might hurt a little"The insured patients have to make it up Which means your insurance is going up" said John Strange CEO of St Luke’s in DuluthIn the complex machinery of health care economics many factors affect the cost of care and how it’s delivered And though providing charity care is both required of hospitals and a source of pride for them too much will put a strain on the bottom line"Because we’re a nonprofit we use that bottom line for new programs new equipment upgrading facilities and services and so it does ultimately have an impact on the programs we can bring to the community" Strange saidFree and discounted health care itself could come under the knife"There is the potential to reduce services offered for free" said Stefan Gildemeister health economics program director at the Minnesota Department of Health "There are no (legal) requirements beyond stabilizing patients"St Luke’s and Essentia Health both told Forum News Service they have no plans to further limit the care they provide to people who can’t pay If that remains the case while the number of uninsured people rises in the coming years it will put pressure on the health systems to find other sources of money and/or make cuts"The way we think of it when one source of revenue goes down you seek it out elsewhere — but that doesn’t always seem to play out in reality" Gildemeister saidUninsured underinsuredFor a brief moment the lines on the chart were at last heading in the right direction — down Minnesota hospitals were giving away less free care and chasing after less bad debt following years of watching these costs riseAccording to the Minnesota Department of Health uncompensated care peaked in 2013 at $321 million and started falling bottoming out at $268 million in 2015 Thanks in part to the Affordable Care Act more people were insured and paying their billsNow since federal tax reform passed earlier this year essentially eliminates the mandate to carry insurance fewer people will be insured and paying their bills in full experts anticipate The Minnesota Hospital Association which reported a rise in uncompensated care in 2016 warned earlier this year that because of the insurance requirement disappearing "hospitals and health systems anticipate further increases in both charity care and bad debt in the future"It’s not just the uninsured causing the rise in uncovered costs More people are carrying health insurance with massive deductibles and hospitals essentially are treating them as uninsured"Now charity care policies cover people who have insurance and higher incomes but higher deductibles" said Lawrence Massa president of the Minnesota Hospital Association "We’ve redefined a bit on charity care"In the face of the projected increased demand for charity care hospitals may need to redefine their policies again"It certainly puts pressure on needing to make up that lost revenue somewhere" Massa said "It’s built on a system that shifts costs"Local effectsFor the past several years Essentia Health has kept systemwide charity care costs right around $13 million according to annual reports Though this consistency seems to indicate a target for these costs the organization says it does not budget a set amount for free and reduced-cost care"We have a financial assistance policy which is not in any way restricted" said Kevin Boren market finance leader for Essentia Health East "So all people who apply for financial assistance are evaluated based on standard criteria"Hospitals are legally required to treat emergency care regardless of ability to pay The law describes an emergency medical condition as "manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual’s health (or the health of an unborn child) in serious jeopardy serious impairment to bodily functions or serious dysfunction of bodily organs"Everything else is up to the provider’s discretion"Rarely elective procedures may be postponed until a payment method can be agreed to by the patient" Boren said "This usually occurs if the patient refuses to fill out any aid application or payment plan"Will more uninsured patients mean less flexibility for non-emergency care"As the individual mandate gets repealed in the future we’re just watching that situation and it’s really quite frankly uncertain how it will roll out what the implications will be" said Mike Mahoney public policy leader for EssentiaAt St Luke’s data shows charity care has drifted below $3 million over the past few years But in 2017 the CEO said charity care and bad debt "jumped dramatically" due to big deductibles leaving patients underinsured"They just don’t have the wherewithal to pay" Strange saidDespite the projected increase in uninsured and underinsured Strange maintains there are no plans to change policies for treating those who can’t pay "for the foreseeable future"More changes comingIf anything Strange sees bigger clouds on the horizon"If you look at the majority of the coverage that was gained in Minnesota most of it was Medicaid" Strange said "Those patients will be covered The number of people that actually got insurance I don’t think grew as fast It may have an impact but it may not have that big of an impact"Indeed only about 6 percent of Minnesotans — and 5 percent of Duluthians — are uninsured though the number is already on the rise Census data show Duluthians are more likely (35 percent) to depend on public health benefits than the state at large (30 percent) in part due to the city’s poverty rate being double that of the state average and the population skewing slightly olderThe problem is Medicare and Medicaid don’t pay their own hospital bills in full"We get told what we’re going to get paid And what we’re paid has no relationship to what it actually costs" Strange saidMinnesota hospitals had $24 billion in costs that weren’t covered by Medicaid and Medicare in 2016 according to the Minnesota Hospital Association For Essentia’s regional operations the shortfall accounted for about 10 percent of expenses that yearThough the president’s budget called for cuts to health care entitlements Congress recently passed a spending bill that largely leaves those programs alone Mahoney at Essentia had warned such cuts could have resulted in higher costs and fewer services"If all those recommendations were to go into effect it would not only negatively impact our financial stability but it would have a significant impact on access to care in rural communities" Mahoney said "It would make us look at services lines specifically and determine what exactly can we maintain in the interest of the patients we serve"Regardless of any potential changes in the long run everyone will end up paying more for health care simply as a matter of course says Gildemeister the state health economist"We just see year over year the price for the same baskets of services does increase and it tends to rise faster than the economy and wages" he said "That underlying trend of the price of health care and the cost of health care services — nothing has changed with that"She does not know what it’s like to have a conversation with Donald because she was 18 months old when he enlisted in the Army Baer’s unit was defending the airport and main road into Taejon now known as Daejeon when he went missing July 20 just over two weeks after he arrived in the country He was 20 years oldBaer who grew up in Brainerd was missing in action and presumed dead for more than 60 years until September when the Defense POW/MIA Accounting Agency announced they had positively identified his remains It took 15 years of research and advocacy by Baril and the rest of the family before a positive match could be made The situation required her to be a historian and an investigator at the same time — all to find out the fate of a man she never really met"I really did not know him but I certainly felt the loss that my parents and older siblings did throughout the years" Baril saidThe searchAs Baril tells it the search for Baer’s remains began in 2001 when she heard a National Public Radio story about the Department of Defense asking families of missing soldiers to submit DNA so the remains of their missing relative could be identifiedThe family submitted DNA to what was then the Defense Prisoner of War Missing Personnel Office or DPMO While the the Baer family was still searching the DPMO merged with the Joint POW/MIA Accounting Command JPAC to form a new agency the DPAA It’s one of the many bureaucratic hurdles the Baers had to surmountBut submitting DNA prompted Baril to go online to find out more information — and find it she did It turned out the Army had classified Baer not only as missing in action but as a prisoner of war as well She also discovered the DPMO hosted events called "family updates" — information sessions where the families of missing soldiers could meet with DPMO officials and find out more about the recovery processBaril lives in Marion Ill,-Sept.Facebook activated its Safety Check feature on Sunday in the wake of the deadly shooting at an Orlando nightclub Facebook Fifty people were killed and 53 were wounded when a gunman, parking themselves outside of an aftermath and vainly attempting to bring the drama of an event that they missed to life.