Kitzhaber's health care redesign passes Senate, moves to House

KOIN:

SALEM, Ore. (AP) — Turning back a Republican effort to limit liability in medical malpractice cases, the Oregon Senate on Tuesday advanced Gov. John Kitzhaber's proposal to redesign Oregon's health care system beginning with the Oregon Health Plan.The Senate was the steepest hill for Kitzhaber's initiative, and approval there on a 17-13 vote smooths its path into law. The measure next goes to the House, where it is likely to have more support.The measure would overhaul the health care system to improve coordination of care and reduce hospital stays — an approach that proponents say would lead to healthier patients and lower costs. It's an attempt to control health care costs that are growing faster than state revenue and threaten to limit funding available for schools, police and other government priorities.A state-funded report says the plan would save at least $3.1 billion over five years."This bill transforms for the better the way our state delivers care for those in need," said Sen. Laurie Monnes Anderson, D-Gresham.The measure passed after Sen. Betsy Johnson, D-Scappoose, dropped her objection. She had been a swing vote, joining Republicans in a pledge to block the measure unless proponents added new limits on medical malpractice for health care providers involved in new organizations responsible for coordinating care.Johnson said she changed her position after she was convinced that the legal issues were too complicated to address immediately.Republicans said liability limits would drive down costs by reducing malpractice insurance premiums and reducing defensive medicine. The state is asking health care providers to transform the way they work, and potentially take on more liability, without providing a cap, said Sen. Frank Morse, R-Albany."It's just not fair," Morse said.Kitzhaber and Senate Democrats fought back against the GOP proposal, saying the medical liability is complex and should be studied in more detail. The measure would create a task force to study the issue and recommend changes the Legislature could implement next year. Republicans dismissed that provision, saying there's no guarantee the Legislature would ever take up the issue.Lawmakers last year approved the concept for Kitzhaber's initiative, telling him to work out the details and return for approval. Senate Bill 1580 would approve an implementation plan worked out over much of the last year.Kitzhaber wants to create coordinated care organizations that would be responsible for overseeing mental, physical and dental health care. The organizations would focus in particular on patients with chronic diseases, mental illnesses and addictions, who account for the largest share of health care spending. Proponents hope they can lower costs by focusing intensively on properly managing those conditions so patients can avoid seeking expensive care in the emergency room.The changes would apply initially to 600,000 people who get state-supported health care, most of whom are on the Oregon Health Plan, the state's version of Medicaid for low-income patients. Proponents hope to eventually expand the model to state and school district employees and the general public.Because Congress picks up more than 60 cents of every Medicaid dollar spent in Oregon, the Obama administration has expressed interest in helping with upfront costs to smooth the path for future savings, Kitzhaber has said. Critics warn that Washington hasn't provided any guarantees and nothing is in writing.Skeptics worry the proposal is being implemented too quickly, that there's not enough money to make it work effectively or that it creates incentives to deny care. Proponents say the bill addresses those concerns.Kitzhaber and his allies in the Legislature say the overhaul would put Oregon at the forefront of national health reform efforts. Successful implementation here would show the potential for cost savings and provide a path that other states or the federal government could follow, they say.While universal in their demands for liability limits, GOP lawmakers were split on the merits of Kitzhaber's underlying proposal. Some said it would help improve patient care and lower costs. Others were opposed, saying it might lead to health care shortages."It will not work. It is going to fail," said Sen. Fred Girod, R-Stayton.___Copyright 2012 The Associated Press.

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