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.
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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.
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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.

Westlund to Take on Gordo?

Today Blue Oregon welcomed State Senator Ben Westlund to the Democratic Party.

State Sen. Ben Westlund, the Central Oregon legislator who left the Republican Party in February and flirted with an independent campaign for governor, will officially join the Democratic Party today.

The switch in allegiance was sparked by a realization that his politics mesh more with Democrats than Republicans, Westlund said in an interview Monday.

There has been speculation before that Westlund hopes to take on Senator Smith in 2008. This would be the perfect preliminary move to doing so. By switching Parties Westlund puts to rest any concerns that he's "not really a Democrat" and generates stronger support than he would otherwise get in the Democratic primary. We already know that Westlund has ambitions for higher office as is demonstrated by his brief bid for Governor in 2006 (he dropped out early while polling under 10%). Then there's the fact, as Russel Sadler pointed out in Blue Oregon, that Westlund would take Smith's fake image as a "maverick" and as a "moderate" and turn it upside down, because here we have someone unambiguously both a maverick and a moderate, who grew so disinfranchised with his Republican Party that he couldnt remain in the caucus any longer.

That leaves Ben Westlund who, I suspect, is about to do that most spectacular of political maneuvers -- a Wayne Morse double reverse with a twist.

Morse was elected to the U.S. Senate as a Republican in 1944 and reelected in 1950. He had a falling out with Republicans over foreign policy and McCarthyism and declared himself an Independent in 1952.

Morse became a Democrat in 1955 and was reelected in 1956 and 1960, before Bob Packwood, another Republican maverick, defeated him in 1966.

Westlund won a State Senate seat from Central Oregon as a Republican. He quietly tried to end his party’s fake “surplus” rebates and their reckless “borrow and spend” policies. He was threatened with a purge from the party when he ran for reelection.

Westlund got the message, became an independent and ran for governor instead. When polls showed he could not win, Westlund gracefully retired from the field. Some grateful Democrats are now urging him to join their party and run for Smith’s Senate seat in 2008.

Given the voters’ rebuke of the Republican Party and Smith’s orthodox partisan voting record, Smith can no longer hide in Mark Hatfield’s maverick cloak. Smith is no maverick. Ben Westlund is. And Oregonians love their mavericks.

Finally, while Westlund's office insists that he is not thinking about running right now (while not denying that he might think about it later). Their recent statement can't really be taken seriously.

When asked via e-mail, '06 GOV candidate/state Sen. Ben Westlund (I) political adviser Stacey Dycus writes: "Democrats have been asking Ben to run against" Sen. Gordon Smith (R), "but he really hasn't considered it. People have also asked him about" Treas. and re-election to state Senate. "Right now, he's not thinking about his next election, he's thinking about a well-deserved vacation and the next session. ... He is an independent and all I can tell you is that his heart and mind is closer to the views held by Democrats, but he has no plans to change registration. If asked, he may caucus with the D's this session"

Clearly he did have plans to change his registration. Westlund is likely our 2nd best candidate to defeat Smith. Unfortunately, our best candidate seems to have no interest in running. Westlund might have a shot, but I think Kitzhaber would be very likely to take Smith down. In the absence of a Kitzhaber run, Westlund is a great candidate who can control the real center and contrast it against Smith's conservatism disguised as moderation. I think Westlund is preparing to run, and I hope he does.

Oregon on the Road to Universal Health Care

An Oregon State Senate panel yesterday backed a proposal for Universal Health Care in which individuals and employers would contribute to a pool which all residents of Oregon would be granted access to. Private insurance companies would then compete for the ability to cover the people paid into the pool.

The commission's draft bill lacks crucial details, such as costs, but it does outline a broad proposal for dramatically changing how Oregonians would buy and receive health care.

"We are trying to do something that has not been done in this state or this country before," said Sen. Ben Westlund, an independent from Bend who co-chairs the Senate Interim Commission on Health Care Access and Affordability. "All eyes are once again on Oregon."

Commission leaders, who met Friday in Wilsonville, say the plan would give every Oregonian a health card that could be used to buy a complete health care package -- including dental, mental health and vision coverage -- for less than most businesses and individuals now pay.

In addition to the goal of expanding access, the plan includes features to control costs and improve quality. The same three goals for comprehensive reform are being pursued by the Oregon Health Policy Commission, the Oregon Business Council and former Gov. John Kitzhaber's Archimedes Movement.
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The Senate commission's plan would require all employers and individuals to contribute money to a common pool called the Oregon Health Care Trust Fund. Residents who earn less than 250 percent of the poverty level would not have to pay to be in the plan. The fund also would include public employee and federal Medicaid contributions.
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The plan would collect money, possibly a payroll tax, from businesses. Large companies with self-insurance plans would have their contributions reimbursed.

An 11-member Health Care Trust Fund Commission or board, appointed by the governor, would adopt regulations and administer the trust. Businesses and individuals could choose health plans, which would be paid through the trust with rates set by the trust commission.

The Senate group decided that the trust commission should function like a corporate board, with an executive director and staff. Much of the debate Friday was over who should be represented on the board.

The plan would cover all Oregonians, including the more than 600,000 who now lack health insurance. Individuals who choose not to participate in the plan would lose their personal state income tax deduction. All participants would be required to write an advance directive, describing the level of care they would want at the end of life.

The directive is one of many features in the plan designed to contain costs and improve quality. Insurers, for example, would compete for health-card holders. The state also would increase competition by requiring hospitals and doctors to reveal their charges and costs.

I'm still skeptical that universal health care can really succeed on a State level, but when the Federal Government fails to act, States like Oregon, Hawaii, Massachussetts, and Vermont have no choice but to act. I look forward to seeing how this works out if it passes, but this is definately a step in the right direction.