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.

Panel Recomends Civil Unions

An Oregon task force on equality appointed by Gov Kulongoski has recomended that the legislature adopt civil unions for gay and lesbian couples much like what Vermont did while Howard Dean was Governor, and New Jersey did a week ago.

I thought (as much as I hated the measure) that this might violate the constitution as amended by Measure 36 in 2004. However, I went back and read the text and there appears to be a loophole for civil unions.

It is the policy of Oregon, and its political subdivisions, that only a marriage between one man and one woman shall be valid or legally recognized as a marriage.

By specifying "as a marriage" there is a narrow door opened for civil unions. In a Democratic legislature I expect this will at least get a chance on the floor. I dont know if the votes exist to pass it, but at least this will get an opportunity to be debated. This would be a great positive step towards gender equality in Oregon. Kulongoski deserves a lot of praise for his willingness to move forward on this. Other States that have done this have been forced to by the courts, Vermont, New Jersey, and even Massachussetts with their more sweeping reform. Kulongoski is acting out of sheer political will and desire for equality, this goes above and beyond what other States have done if we can pass it, because other States have been forced to action by the courts.