Thursday, January 18, 2007

Oregon Takes a Lead on Health Care

While California gets most of the press for Health Care reform, Oregon seems to be moving forward with plans to dramatically restructure the State's health care system. And unlike in California it has a chance of passing in Oregon (California has some screwed up laws on budgetary matters allowing a minority to easily block the legislation). The debate is beginning in Oregon, and not just on the topic of whether universal health care is the best policy (it is), but rather about exactly what plan is best to do that, good serious proposals are being made and sent into committee in the Oregon Legislature, there seems to be a growing consensus that something needs to be done and that the health care system as it is today is unsustainable. Former Governor John Kitzhaber is leading this charge with the Archimedes movement.
Former Gov. John Kitzhaber rolled out a bold legislative plan for overhauling Oregon's health care system Wednesday, hoping to leverage a national debate on health care reform that will spread to the 2008 presidential race.

"The health care system today is unsustainable," he said. "It is remarkable we are utterly unable to change our direction."

The plan would pool roughly $7 billion from employer tax deductions for health care and from state and federal tax money spent on Medicare and Medicaid in Oregon. The pool then would be spent in a more efficient and rational system that would provide a "core benefit" of essential health services to every Oregonian, including the 609,000 who now have no health insurance, said Kitzhaber, a former emergency-room doctor, during a news conference in downtown Portland.
Kitzhaber's bill will go to the Senate Special Committee on Health Reform, said the Democratic co-chairs, Sen. Alan Bates of Ashland, and Sen. Ben Westlund of Bend. The committee will consider Kitzhaber's plan along with at least three other health reform plans: one developed by a Senate commission led by Bates and Westlund and others from the Oregon Business Council and the Oregon Health Policy Commission.

"What is most significant and shows the true depth of this (health care) crisis is the number of groups that have come together to propose solutions," Westlund said.
No plan will work if it does not contain costs, Kitzhaber said.

Like other plans before the Legislature, his would seek administrative efficiencies, include incentives to keep costs low and the quality of service high, and would guarantee Oregonians health care no matter where they work.

Its a shame Kitzhaber appears to have no plans to challenge Gordon Smith for the Senate seat in 2 years, but it does little good to dwell on that. What Kitzhaber recognizes that Ron Wyden doesnt is the section I put in bold from the Oregonian article. Wyden seems to think that we cant effectively control the costs but we can ensure access to health care for all. This concedes ground in the debate that doesnt need to be conceded, one of the most compelling reasons for health care reform is the runaway cost of care in the current system. Massachussetts, Vermont, and Hawaii have all drastically reformed their health care systems, if California and Oregon do it too then perhaps the US Congress will begin to really take this issue seriously and do something about a broken system. The Oregonian piece also mentioned that Kulongoski is backing a bill to guarantee coverage for all children, and if we're going to take baby steps toward this thing that's certainly admirable, but it fails to deal with the larger health care crisis in the State and the country choosing instead of focus on select social groups while ignoring the larger problems. If a universal plan cannot get through the legislature than Kulongoski's plan to cover all children would be nice, but if we can make health care in this State more efficient and change its fundamental structure we should.


Kari said...

Wyden seems to think that we cant effectively control the costs but we can ensure access to health care for all....

Hey Cwech. I think you're mischaracterizing Wyden's plan here.

First, full disclosure: I'm working for Senator Wyden to help him roll out a website, Stand Tall for America, to help promote his health care plan and other things.

To the topic. For starters, his plan contains tough controls on administrative costs.

More importantly, the cost containment in his plan comes from the fact that with individuals buying their own health coverage, they're going to be very price-sensitive and able to act on that sensitivity.

Right now, there's barely a free market for health care. Most people get coverage through their employer. If you're Nike or Intel or Linfield College, it's a massive shock to your organization to change health insurance companies. They'll have to staff up their HR departments, and some employees will always revolt. ("But I love my doctor"!) So, major employers rarely change health carriers. They're basically stuck -- and so the insurance companies can just jack up prices every year.

Under Wyden's plan, the health insurance market would be a lot like the car insurance market (except everyone in a community would have the same rates, and they couldn't deny anyone.) You'll see billboards and TV ads - "Buy Blue Cross, just $425 a month!" Consumers will choose health coverage based on price - which will be OK, because the minimum plan will be very comprehensive. With that price sensitivity, the insurance companies will be forced to reduce their costs - but not by denying people care.

Hope that helps. C'mon over to Stand Tall for America for lots more info, including links to news and blogs (including critics.)

Cwech said...

Hey Kari, thanks for the info. I'm doing my best to get a sense of what Wyden proposed and what the effects of it will be. Its not a simple plan, and what I've written here is the general impressions of the proposal that I've picked up. Really I'm just glad that a national discussion is forming around this issue.