Oregon gets ready to take the lead again

Carla Axtman

With the gubernatorial election in Oregon finally over, John Kitzhaber will transition to take the reins of Oregon's governorship. One of the key elements that Kitzhaber brings to the table is a broad and deep understanding of the health care system, and an ability to build on his work from his first whack as governor with the Oregon Health Plan.

This nugget of Kitz's leads the Washington Post's Dylan Matthews (blogging at Ezra Klein's blog) to shine a spotlight on Oregon:

While everyone is busy arguing over whether Republicans won bigger in the House because of health-care reform, arguably the most consequential race in the country for health issues has finally been called. John Kitzhaber (D), who was governor of Oregon from 1994 to 2002, has been elected to a third term in that office.

Kitzhaber, a former ER doctor, was best known during his previous terms as governor and during his time in the state senate for helping create the Oregon Health Plan (OHP), which was among the first state attempts to experiment with federal Medicaid money to provide broader care. Rather than set up a traditional Medicaid program, OHP aimed to provide fewer, higher-value services to more residents. The system worked well at first, cutting the uninsurance rate from 18 percent in 1992 to 11 percent in 1996, but then started to unravel when an expanded version was passed in Kitzhaber's last year in office.

Oregon has a unique opportunity to expand and create a health care model using the new federal health care legislation dollars--and Kitzhaber is uniquely situated to take the lead. Once again, our state will likely show the way for other states when it comes to innovative, money saving ways to implement good government.

The Republicans in the Oregon Legislature, who will certainly be feeling their oats after cutting into Democratic majorities in the Senate and tying the House, should tread carefully here. I suspect the Oregon electorate will be in no mood for gridlock when it comes to this.

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    I am hopeful that expanding the Oregon Health Plan can prove to be a model of an affordable public option that is replicable across the country. There are now 51 million Americans without any health care coverage. Despite the whining the corporate insurers are going to milk us dry and get record profits. More and more employers, public and private are going to drop employer based coverage, so the pressure for the public option, whether it's Medicare or some version of the Oregon Health Plan, Medicaid based, is going increase. And the polling shows that the main criticism of the American Affordable Health Care Act is that it didn't go far enough.

    Additionally Kitzhaber has rightly stated that it isn't just financing where reform is needed, but in the delivery of care, to cut costs and improve outcomes. I do believe the Obama administration will be working closely with Kitz on this issue.

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    Having Kitzhaber at the helm during implementation of federal health care reform represents an incredible opportunity for Oregon and the rest of the country. Especially when you consider the leadership role that Senator Wyden has earned, and the fact that we have Steve Novick doing strategic work on this stuff for the Oregon Health Authority.

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    This is one reason the Pioneer is on our capital dome.

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    Oregon is already close to having a functional health care exchange. See my older post at http://www.blueoregon.com/2010/04/a-plan-for-an-oregon-health-insurance-exchange/ for an idea on how it could happen, even with a split House.

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    I have always been willing to support state-sponsored health programs (like OHP) over federal programs. I would rather see federal dollars go to help states set up individual plans, rather than a nationwide system.

    My mother, 63, and recently unemployed, can't afford a private policy because of pre-existing medical conditions. There is a state program in Colorado where she lives that is providing her with some decent coverage, including coverage for cataract surgery.

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      Good thing the last Congress just outlawed "pre-existing conditions". As long as the new Congress is unable to "repeal and replace" the health care law, your mom should be good to go in a short while.

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    I think Oregon, and the US more generally, will benefit greatly going forward from Gov.-elect Kitzhaber's leadership on health issues.

    That said I worry that he will over-focus on health issues and not spend enough time and effort on other important issues - like the economy and education. IMHO, if he fails to move Oregon toward a more international export oriented economy (and toward an education system to support such an international export economy), he will in the longer flow of history be ranked as a poor leader. The big and expanding economic opportunities now and for the foreseeable future are abroad (China, India and Brazil, for examples). If he does not lead Oregon to compete better in those markets, I think ultimately he will not be ranked as an effective governor no matter what else he accomplishes.

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      Alas, we are lucky enough to have Ted Wheeler operating in the Administrative Branch as well, so Kitzhaber has the opportunity to share leadership tasks with other capable players.

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    Every cycle the party animules tell us that the result is critical to life as we know it. Then the Governor does nothing. TK is an outstanding example. Will BO go on record saying that Kitz will be different?

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