This week, the legislature begins consideration of one of the more intractable public policy issues confronting Oregon--how to provide health care to 600,000 uninsured citizens. The Senate Special Committee on Health Care Reform begins considering four serious proposals that come from: the co-chairs of the committee, Alan Bates and Ben Westlund; John Kitzhaber's Archimedes Movement; the Oregon Health Policy Commission; and the Oregon Business Council.
The resulting draft bill will include the best elements of each, said Bates, an Ashland Democrat. While the bill's goal has broad bipartisan support, it also faces potential sticking points....
"The health care system we have now is inefficient and often fails to ensure good outcomes," the Health Policy Commission said this month in a 55-page report. "Increasingly unaffordable health care jeopardizes Oregonians' health status and the state's economic future...."
The legislation is written in broad conceptual terms rather than nitty-gritty detail. Key decisions would come later as a proposed Oregon Health Fund Board designed the benefits package.
The four plans have several elements in common, including:
- The requirement to control costs through bulk purchasing, preventative care, chronic disease management, improved recording-keeping, etc.;
- Plans to get approval to spend federal dollars in new ways;
- Phased change;
- Reliance on private insurers;
- Subsidies to low-income Oregonians.
The first legislative proposal is Senate Bill 239, which Bates and Westlund have been promoting across the state.
The system envisioned in SB 329 would establish a basic benefit package for all Oregonians. Pre-existing conditions would be covered, Bates and Westlund observed, "because everybody's in...."
The first step toward creating the new system would be passing legislation this session to create the health trust, which would then create the benefit package that would be available to all Oregonians.
Private employers could offer their own insurance independently, but they would be encouraged to join the program to increase the size of the insurance pool, and the benefit package would be rich enough to entice employers to enroll their workers.
A number of unanswered questions remain: how to control medical inflation; what will happen to the Medicare benefit under the Oregon plan; and how to handle undocumented workers. Still, Bates and Westlund are hopeful to have a bill to the full Senate by mid-April.
Oregonian's comparison of the four plans (.pdf)
BlueOregon post on SB 27, an alternative to SB 329
Archimedes Movement, Governor Kitzhaber's group
Hope for a Healthy Oregon, info from Senators Bates and Westlund
Oregon Health Policy Commission Road Map for Health Care Reform (.pdf)
Text of SB 329