It's time for health care for Oregon's children

By Maribeth Healey of Portland, Oregon. Maribeth is the executive director of Oregonians for Health Security.

In recent years, much attention has been paid to the growing number of Americans who lack health insurance. Unfortunately, less attention has been paid to a startling and often overlooked fact: One out of every 5 uninsured Americans is a child. Through no fault of their own, these youngest and most vulnerable members of society lack coverage for the health services they need to develop into healthy and productive adults.

Today that changes in Oregon. Our lawmakers in the Oregon legislature will begin work on landmark legislation that will accomplish something we have never before managed to do in our state: make sure that every child in Oregon has health care coverage.

Sunday’s Oregonian shows the bleak results that come when a family cannot afford health care for their children.

Oregon legislators should meet 6-year-old Katelyn Owings.

Katelyn, who has a chronic respiratory ailment, is one of the state's 117,000 children without such coverage. Her hardworking parents make a little too much to qualify the family for government-subsidized care under the Oregon Health Plan but far too little to enable her dad to afford the $520 a month it would cost for the insurance his employer offers.

Katelyn’s family is not alone. More than 91% of Oregon’s uninsured children have at least one parent working, and the average annual family premium is more than $11,000. That’s out of reach for many working families and Oregon small businesses.

Recognizing this problem, and led by nurse and Senator Laurie Monnes Anderson, the Oregon Senate has directed laser-like focus to the problem of uninsured children in Oregon.

For more than a year Senator Monnes Anderson chaired the Senate Interim Children’s Health Care Committee. Rep. Mitch Greenlick has been working tirelessly his whole life to make health care more accessible and affordable for all Oregonians. And Governor Kulongoski made taking care of kids a cornerstone of his campaign and is following through on his pledge to Oregon families.

The result is the Healthy Kids Plan, which debuts today.

Across the state, families and health care advocates are cheering. Passing the Healthy Kids Plan is an important first step in making health care more accessible and affordable for Oregon families.

Karen Elliott, RN, a member of the Oregon Nurses Association Cabinet on Health Care Policy says,

I have been a nurse for 35 years. That means I have been waiting 35 years for a day like today. During the last 35 years, I’ve seen too much of what happens when families don’t have health coverage.

I have seen parents delaying care for a child with an ear infection because of no insurance coverage, ending up in the emergency room with a ruptured ear drum and sicker than they needed to be.

I have seen teens in school settings attending school with abscessed teeth or upper respiratory illness needing attention, but have no way to pay for a doctor visit.

I have seen new mothers avoiding well baby check-ups and immunizations due to lack of access to health care.

With the Healthy Kids plan, we can end Oregon’s this health care tragedy right away. It’s the right move for Oregon’s families and the right move for our state.

As the proposal works its way first through the process, some details may be changed, but here is the heart of the plan:

Our state has a moral obligation to protect our children, that much is certain. More than that, the Healthy Kids Plan is an important investment in our own futures and our communities. Children without adequate care today are more likely to need more - and more costly - services in the future.

We simply cannot afford not to support the Healthy Kids Plan. Please, join us today in standing in support of protecting all of Oregon’s children. Contact your lawmaker here.

  • Bruce Smith (unverified)

    I want to preface this comment by saying that I feel for the families and the children that it would help, but as the Healthy Kids Plan stands, I cannot support it. You say that we as a state have a "moral obligation" to protect our children, but from what I can see we are just passing the buck to smokers. What the column above doesn't mention is that the plan will be financed with an $0.84 per pack tax on cigarettes, which I believer is wrong. Smokers have no more duty to protect children than you or I.

    Oregon currently has a cigarette tax of $1.18, which was well above the national average last I checked. Although increases are usually marketed as going to smoking prevention, as it stands, only 3% of the $220 million collected in 2005 such programs, well below the CDC recommended minimum of $21 million. Instead, these tax revenues went mostly to the Oregon Health Plan and to the state's general fund, things which all Oregonians benefit from, not just smokers. (I'm sorry I don't have the figures for 2006, but I would bet that they are very similar).

    Proponents usually justify these expenditures by creating statistics which claim that smokers create a tremendous financial burden on the state in the form of healthcare costs, but when all factors are taken into account (i.e. the shorter life expectancy of smokers, etc.), the per pack amount borne by the tax-payers is about $0.30 (that figure comes from a reputable congressional report from 1994, so adjusted that might be closer to $0.40 today, still well below the the current state tax).

    What is more, funding the Healthy Kids Plan with a cigarette tax creates a moral dilemma. Again, the proponents also tout the fact that increased cigarette taxes lead to fewer smokers, but is that what they really want? Imagine if six months after this plan was put into effect every Oregon smoker quit smoking; there would be no more cigarette tax revenues, and by extension, no more healthcare for needy kids. I realize that this scenario is extremely improbable, but I personally don't think it is right that our government have choose between tax revenues and the health of its citizens. You may call that claim prepostrous, but Kulongoski himself was quoted in 2002 as saying that an increase in the cigarette tax would be foolish because it would discourage consumption (thereby lowering tax revenues).

    So that's why I don't like this plan as it stands. I think that if the state chooses to provide healthcare for Oregon's children, the burden should be borne equally by the populace, not an underrepresented minority. You nonsmokers out there ask yourself-are you fulfilling your moral obligation to Oregon's children by passing the resposibility of paying for their healthcare to smokers?

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    You nonsmokers out there ask yourself-are you fulfilling your moral obligation to Oregon's children by passing the resposibility of paying for their healthcare to smokers?

    Um, yes?

    Imagine if six months after this plan was put into effect every Oregon smoker quit smoking....

    Hot damn. We should be so lucky.

    Last thought, Bruce: You've now established a compelling argument against one revenue mechanism. What's your alternative?

  • Ed Bickford (unverified)

    This proposal's underhanded funding mechanism betrays it as an underpowered attempt to remedy a clamity. The wreck of the social service agency that is our health-care system today is that calamity; it is like being on a sinking ship trying to take care of your family these days. Have we really reached the point of desperation where we are packing our children into the inadequate lifeboats and setting them adrift? That does leave us to go down with the ship, you know!

    I'd like to see a discussion of the bold plan of Dr. Kitzhaber's "The Oregon Better Health Act", which sounds like the kind of cutting-edge, pioneering activism that Oregon has earned respect for doing in years past. We can do better than this further investment in a bankrupt health-care scheme.

  • Karl Smiley (unverified)

    Making smokers finance this plan is an irresponsible cowardly cop-out. We need to fix our health care system in a fair and equitable way. We ALL need to take responsibility for providing a base of health care for all. Making those "nasty smokers" support it with a "sin" tax is really lame. Why should they be the only "responsible" ones?

  • Steve (unverified)

    If "Oregon's children" what health care, why don't they just get a job like everyone else?

  • BlueNote (unverified)

    I guess this is a good thing, but . . .

    My concern with the effort to provide health care coverage to children (only) is that this will only delay adoption of a health plan that will provide universal coverage.

    It is good that every child will have access to paid health care. However, when the child's mother or father must remain at home coughing up blood because the parent cannot afford to go to the doctor, that is arguably just as big a threat to the welfare of the child as being uninsured.

    Also, from a political standpoint, once the cute and innocent uninsured children are taken out of the mix, the legislature will have much less incentive to adopt a health care system to provide coverage to the less-cute and less-innocent unemployed, working poor and the growing number of middle class folks who can't afford health insurance coverage.

  • Patty (unverified)

    The Healthy Kids Plan does not preclude, slow down, or dim the possibilities of broader health care reform and it's heartless to make children wait while we grownups work things out. As Dr. Kitzhaber has said repeatedly that the Healthy Kids Plan should pass, and quickly. The metaphor he uses is that, while our health care system as a whole is sinking, our children are drowning. And must be given a life raft NOW.

    The tobacco industry has developed some good sound bites around the unfairness of targeting smokers. You'll notice that every lawmaker who opposes the Healthy Kids Plan has said the same thing. They've received their scripts. But don't fall for it. The Healthy Kids Plan is not about targeting an unloved population, i.e. smokers. It's about recouping a small portion of what the state pays as a result of smoking.

    According to the Campaign for Tobacco Free Kids, the health care costs of smoking to the state are $11.16 for each pack of cigarettes. Oregon's tax is $1.18 per pack. That means the cost to our state’s health care economy from smoking and the use of tobacco products amount to one billion dollars in expenditures per year, of which some $250 million are costs to the state’s Medicaid program.In other words, taxpayers.

    The Healthy Kids Plan is a step in the right direction not only for uninsured kids, but for the financial future of our state. Smoking is putting an economic strain on the state. And thanks to the fact we are the only state to have actually DECREASED the cigarette tax in the last decade, smoking is increasing in Oregon while decreasing across the country.

    Also, don't forget the savings that will come when kids start getting preventative care instead of having to go to the emergency room.

    The Healthy Kids Plan is a smart move.

  • Ed Bickford (unverified)

    The funding mechanism proposed for this initiative is a stupid political move; it will tar the D's with the brush the R's have brandished long and hard: Democrats resort to unfair taxation schemes to solve funding dilemmas. It's an incommensurate punishment for making bad health-care decisions to fund health-care this way, and you will not overcome that salient fact. I find it no surprise it is driving the debate; no conspiracy theory is required.

  • Carrie Ann (unverified)

    Am I missing something? Let's see...

    Working parents who can't afford to buy health insurance for their children


    People who would have to pay extra to voluntarily engage in behavior proven to be detrimental to their own health and that of the general public


    Personally, I'm not too worried about the D's - they're big kids and can handle a little pressure. Clearly, their party did something right last November. And I doubt they're paying much attention to those who would benefit from continuing the bitter partisanship and rancor of previous legislative sessions.

    I'm more worried about those 117,000 children without health insurance... and not terribly impressed by people who preface their comments with support for the the idea of covering kids, then wring their hands with concern over the proposed revenue stream...

    Perhaps we could get opinions on the actual Healthy Kids Plan instead?

    Anyone who has a better idea for funding -or a good reason why CHILDREN should continue to go without- should submit it in writing to the House Committee on Health Care. I'm sure we're all curious to see what that would be.

  • Ed Bickford (unverified)

    Yes, you are missing something, a sense of political realities. What survives a campaign is not the end you pursue but the means by which you pursue it.

    One election that goes our way does not erase all disagreeable opinions of the party that kept it in the minority after many previous elections, especially since the recent election was as much a referendum on the failures of the opposition party as it was anything else.

    It is the cheap and easy funding mechanism that will generate any buzz, and that's just reality.

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    Am I missing something? Let's see...

    Working parents who can't afford to buy health insurance for their children...

    Yeah, you're missing something. Why shouldn't working parents earn enough to provide health insurance? Why isn't health insurance required? We make car insurance mandatory...but we don't have to insure our kids?

    So who should pick up the tab for employers who pay so little that their employees --and families-- go unprotected? Other employers? Society overall? The State General Fund? Smokers? Drinkers?

    The email I got from the campaign today says: "We must start investing in our children today. If we don't, we will all end up paying more tomorrow."

    "We" is all of us. "We" isn't smokers. Let us take this responisbility seriously.

    it's heartless to make children wait while we grownups work things out.

    Absolutely. Let's make this priority number one, and fund it out of the General Fund. Period. Let's not muddy the water with controversial funding mechanisms. Let's just get this done. Now.

  • Nina (unverified)

    The OLCC just raised its prices 20% across the board. That revenue goes into the general fund. Perhaps this would be enough revenue to fund health care for our children, if not for us all?

    Idealistic visionary that I am, assuming the OLCC is willing to do such a good deed.........

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    Why did the OLCC raise prices? What was the justification?

  • JJ Ark (unverified)

    I have to go with Frank. Fund it out of the general fund.

    The funding mechanism proposed is just plain faulty, and built upon crappy logic, by the proponents own admission:

    According to the Campaign for Tobacco Free Kids, the health care costs of smoking to the state are $11.16 for each pack of cigarettes. Oregon's tax is $1.18 per pack. That means the cost to our state’s health care economy from smoking and the use of tobacco products amount to one billion dollars in expenditures per year, of which some $250 million are costs to the state’s Medicaid program.

    in other words, we can't HOPE to recover the costs, so why the heck are we even trying to base funding on this flawed construct??

    Sorry, but a stable funding base would be more in line with my thinking. Perhaps the cell phone tax?

  • Nina (unverified)

    Why did the OLCC raise prices? What was the justification?

    i'm not sure. i'll see if i can find out. i was given this information by someone who works in the industry. i'm assuming they do not need to justify their reasons just like you do not see most retailers explaining (openly) to their customers why their prices increase. 20% is a large amount though. i checked out their website and did not see anything mentioning the increase. i did see that for operating year 2005/2006 their net revenue was 191.80 million and of that, 139.70 million was distributed amongst a variety of funds (i was incorrect when i said all revenue goes into the general fund. only a little more than half does.). where that 50 plus million has gone is anybody's guess.

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    I have to go with Frank. Fund it out of the general fund.

    Thanks, JJ, but I'm afraid we're off message.

    Oh, yes, it's all about the children and investing in our future...but if we can't fund this on the backs of tabacco smokers, well, then, screw it.

  • Sarah Bacon (unverified)

    For those of you that missed my testimony at Mondays hearing, here it is.

    One evening in early 2001 I took my 14-month-old daughter Molly, who had been fighting a cold for a few weeks, into the emergency room because she had begun vomiting. I was young, only 22, but I did know that children with colds didn't vomit. After a two-hour wait, we finally made it into an examination room.

    The doctor asked me if we had insurance. We did not. The doctor ordered a chest x-ray and breathing treatment for Molly, gave her a prescription for an ear infection, and sent her home. Her oxygen saturation level, which had dropped to 84% during our visit, had risen to 95% and the doctor decided that there was nothing more he could do for her.

    Molly and I went home with after care instructions that said to take her to her pediatrician if she got worse.

    Molly didn't get worse, but she didn't get better either. Five days later, Molly had a seizure and went into cardiac arrest. She spent 24 hours hooked up to a ventilator while tests were run to make sure she was in fact brain dead and another 24 hours waiting for the organ procurement team to prepare to harvest her organs.

    While she was under the care of the procurement team, she was tested for Respiratory Syncytial Virus. It came back positive. It was also found that she had been bleeding in her brain for at least a week, maybe 10 days. That’s what caused the vomiting the night we went into the emergency room.

    Molly didn't have insurance. I was a single mother and worked as a server at a high-end restaurant. This afforded us too high of an income to qualify for the state insurance program. Every month, I would scrape together the money needed for her well baby check-up and immunizations. I would often eat only one meal a day so I could afford healthy food and quality medical care for Molly.

    I believe my daughter did not get all the tests she needed to keep her with us because she didn’t have insurance. It’s that simple.

    This day in age, it is unnatural to bury your child. When a child dies, it doesn't just affect the parents, grandparents, aunts and uncles. It affects every person that ever knew the child and every person those people will ever meet. My sister, father and I have all moved to new cities and tried to start new lives. It will be seven years since her death next month and we are still haunted by the memory of a child that did not turn seven in December and the $432 test that would have made it possible to avoid the six year anniversary that will occur next month.

    Everyone agrees that we need to make sure all children are able to receive quality, affordable health care. Why are we squabbling over where the funds come from and whether adults are covered?

    Don't get me wrong, I'm a huge fan of covering all Oregonians, not only the children. And yes, I agree that a universal health care plan would be ideal. But by making children wait for the perfect plan, we are asking them to suffer and die for the selfishness of adults who want to use their cute innocent faces to gain coverage for us all. The Healthy Kids Plan is a building block for a universal health care system. It is not the end of the fight for health care, but the beginning. This plan can be integrated into a universal health care program that includes funding from other sources.

    I still don't have health insurance and many of my employed friends go without as well. Early last year, I held a close friend while she died, uninsured, of cancer in my living room. As hard as that was, I am still not willing to ask other families to go through what we did in a hope that their kids faces will be the currency used to buy me into a universal health care program.

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    Why are we squabbling over where the funds come from and whether adults are covered?

    Because we need real, sustainable changes. If we believe funding health care for children is important, we should be making its funding a priority, not a gimmick. And we need to do more to deal with the systemic problems of the health care crisis.

    Ex-Governor Kitzhaber has written: "...covering all children is an important goal and worthy of support. But we also need a way to ensure that expanding coverage to kids is financially sustainable over time. Simply expanding insurance coverage does not reduce the escalation in costs that lies at the root of the problem."

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