“We’re Paying for Sickness, Not Health”: Charlie Mandile on Medicaid and the Future of Community Care

When HealthFinders Collaborative Executive Director Charlie Mandile took the mic at The Effect of Medicaid Changes on Our Community forum, he began by remembering that HealthFinders itself was born “in a room just like this” back in 2002—when neighbors gathered after mass at St. Dominic’s to ask how they could solve health care for their community. 

From that origin story, Mandile laid out three central points: the human impact of Medicaid, Minnesota’s progressive public insurance system, and why—even with all its innovation—“this is still the wrong approach for our communities.” 

Mandile described Medicaid as “life-changing” for hundreds of families HealthFinders helps each year. “Someone who is uninsured and living with pain or a life-threatening infection can see a dentist and, suddenly, that burden is gone,” he said. “They can go to work, care for their family, and get on with their lives.” 

He praised Minnesota’s leadership in creating one of the country’s most forward-thinking Medicaid systems, noting that it funds community programs, healthcare innovation, and care for people with disabilities and substance-use disorders. Yet even here, he said, inequities persist—and paperwork barriers, program cuts, and shifting costs to counties all threaten to unravel the progress. 

Mandile’s most urgent message came at the close: despite the value of Medicaid, the system itself is misaligned with community well-being. “We’re paying way too much for something that isn’t meeting our needs,” he said. “The fundamental dynamics of paying for sickness rather than investing in a community’s health—that’s what needs to change.” This is the innovation HFC is pursuing with projects like the school-based health center, the housing and health hub in Owatonna, and ensuring nobody goes without care.  

He urged Minnesotans to look beyond the clinic walls: housing, transportation, and mental health all shape whether people can be healthy. “At HealthFinders, we’ve been building a model that invests in those things—care rooted in community,” Mandile said. 

“Don’t forget the personal impact,” he added. “We have a progressive system, but we need to invest in health rather than pay for sickness.” 

🔗 Listen to the full conversation from KYMN radio. 

The event was hosted by the League of Women Voters of Northfield & Cannon Falls, and Isaiah MN. Speakers at the event included:  

• Zander Abbott, CEO of Northfield Hospital 

• Tom Nielsen, of the Northfield Retirement Community 

• Sandi Gerdes, Executive Director of Laura Baker Services Association 

• Charlie Mandile, Executive Director of Health Finders  

• Galen Malecha & Mike Johnston from Rice County.