Penny Wise and Pound Foolish on Health Care Reform

By Camilo Marquez of Portland, Oregon. Camilo is the chair of the Portland Jobs with Justice Healthcare Committee and an advocate with Health Care for All - Oregon.

Oregon was the poster child for innovative health reform measures among the states, having received almost $2 billion in incentives from the federal government to streamline Medicaid expenditures. Now it is the bad boy, coming in last of all 50 states after its sorry Cover Oregon debacle. I do not have precise figures on how much money has been thrown at the effort to get an insurance exchange up and running, but it is safe to say it is in the hundreds of millions. Just go to the Lund Report and scroll down the articles and you will see how much has been wasted on efforts to promote “reform.” Insurance companies spent $39 million in the state to get people to sign up and we have less than 50,000 new covers to show for it, not to mention the millions paid to Oracle for the still closed internet portal. Now, we understand that Gov. Kitzhaber spent over $200,000 for a study to find out what went wrong.

Meanwhile, that amount would have been enough to fund a study authorized but not paid for by the legislature which would have answered the question of what is the best way to finance health care in the state, comparing several options (HB 3260 of 2013). That study is going begging to find sponsors and will not be completed in time for the 2015 legislature to consider. Of course, we could not expect the health industry stakeholders to be interested in seeing it funded because they most likely would not be the beneficiaries of such research. Comparable studies in other states have found that a publicly funded single payer system is the most cost efficient way to pay for universal health care. It would point to the elimination of private health insurance provided by profit making corporations which have lots of resources and lots of power and much influence over the legislature which balked at funding the study.

On March 21, OPB radio’s Think Out Loud program featured a discussion of the study of Cover Oregon requested by the governor. Sen. Elizabeth Steiner Hayward, member of the Senate Health Care and Human Services committee was among the guests interviewed and she gave an intelligent, thoughtful review of the report and its political implications. But at no point did she reflect on any of the fundamental issues in health care finance. The discussion was limited to how we can fix the Cover Oregon problem. No consideration was given to how fundamental reforms would have avoided the complexities, expense and waste of the reforms under the Affordable Care Act. A single payer universal health plan would have offered the simplest, uniform, equitable, affordable cost saving system, covering everyone and operating with the most efficiency for both cost and health. Instead, we hear from health reformers and politicians devoted to the implementation of the Oregon Health Transformation and Cover Oregon, “let’s see what happens with the Affordable Care Act; single payer is not politically feasible.” That’s what they said in Saskatchewan in 1950, but Tommy Douglas did not listen and now Canadians love their system and think we are out of our minds.

Gerald Friedman, Professor of Economics at the University of Massachusetts, has written widely on labor history and the economics of single payer. He will be in Oregon appearing at meetings across the state to share his knowledge and research on the benefits of single payer universal health care. He will be in Portland on May 17 and 19. On the 17th, he appears at a forum sponsored by APANO in the morning and in the afternoon at a conference on The Economic Benefits of Single Payer Universal Health Care for Low Wage Workers, Unions and Community Groups, 4-6 p.m. at the AFL-CIO Meeting Hall 3645 SE 32nd Ave. A full schedule is available at


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