The Oregonian's recent prominent headlines reported that public employees who are cops, firefighters and teachers were taking far more than their share of the public purse to the detriment of those who pay their salaries. Over the next four years the Portland City Council and the Portland Public Schools Board are poised to authorize the expenditure of about $50,000,000 in INCREASED health care costs. That means $50,000,000 less on kids' educations and city services. To a lesser yet still significant degree, this deplorable and unsustainable situation can be found throughout Oregon. It has got to stop.
http://www.oregonlive.com/news/oregonian/index.ssf?/base/news/1120298512248161.xml&coll=7
http://www.oregonlive.com/news/oregonian/index.ssf?/base/exclude/1120903666184100.xml&coll=7
http://www.oregonlive.com/news/oregonian/index.ssf?/base/exclude/1120903666184100.xml&coll=7&thispage=4

http://www.oregonlive.com/letters/oregonian/index.ssf?/base/editorial/112116297064490.xml&coll=7&thispage=1

The cops, firefighters, teachers and other government bargaining units are no different than Enron, oil companies seeking access to drill in Alaska or any other group with a lobbyist looking for a special interest advantage from the government. But as is often the case in politics your gain is my loss. Public employees in Oregon with tax payer supported health insurance have there substantial health care benefits at the expense of the rest of us.

As the public discussion of public benefit packages heats up throughout our state let's make sure we separate health insurance costs from pension costs. Control of health insurance costs rests primarily with elected school boards, city councils and county commissions. The only reason the teachers and Portland city employees get an increase of $50,000,000 in health care benefits over the next four years is because the Portland School Board and the Portland City Council said sure, fine, O.K. with us. If you want to fix this broken system then you MUST change or persuade those with statutory power to stop giving away the store. You can't stop bargaining units from lobbying for a much as they can get. But you can change the health care system so they STOP ASKING.

The answer is the Oregon Community Health Care Bill* [See Below]. It has the potential to reduce the health care costs of every public institution in Oregon by twenty percent and provide both portable and affordable health care to every Oregonian. It can put public employees in the same health care boat with the rest of us ending the need for elected officials to choose between those groups that gave them lots of cash during their last election or serving the needs of all of the voters and citizens within their constituencies.

On October 29, 2005 the Oregon Community Health Care Bill Forum** will provide an opportunity for sixty Oregonians to begin the process of taking control of health care costs in our state. Elected officials from throughout Oregon should be especially interested in participating. Angry, frustrated Oregonians should come and find out how to direct that negative energy into a positive force for change.
** http://www.goodgrowthnw.org/OctoberForum.html


Richard Ellmyer
President, MacSolutions Inc. - A Macintosh computer consulting business providing web hosting for artists and very small businesses.
Writer/Publisher - Oregon Health Watcher commentary* - Published on the Internet* and distributed to 6000 readers interested in public health care policy in Oregon.
Portland, Oregon
* http://www.goodgrowthnw.org/health.html


*Oregon Community Health Care Bill
Whereas every Oregonian should have the right to affordable health care,
Therefore be it resolved that the following revisions are made to the Oregon Health Plan:

1. The Oregon Health Plan shall allow state, county, regional and municipal governments as well as all public educational institutions in the state of Oregon to pay to enroll their employees.

2. Governments and Public Educational Institutions shall pay 80% of the premium paid in 2004 for an individual covered by their previous health insurance providers times the number of individuals covered for the first year of membership. The individual rate shall be determined by dividing the total amount paid for health insurance in 2004 divided by the number of individuals covered in each public entity in 2004. [Total number of employees times 2.5 shall be an acceptable default if precise numbers are unavailable.] The 80% rate shall continue until such time as a government or public educational institution formally requests an increase or decrease in the rate for that entity. A majority of paying member organizations of the Oregon Health Plan shall agree to the proposed increase or decrease before it can become the effective new rate for the requesting jurisdiction. It shall be the goal, over a period of time, to achieve equity of individual payments among all participating organizations.

3. The Oregon Health Plan shall allow any person who has been a registered voter in Oregon for at least one year to pay to become a member. 18 year olds registering for the first time are automatically accepted. All children 17 and under are automatically qualified provided they are the dependents of at least one adult in the household who is a registered member of the Oregon Health Plan. The cost to join will be determined by a sliding scale based on taxable income and number of dependent children 17 and under. 

4. The Oregon Health Plan shall allow Oregon businesses to enroll their employees provided that each employee submitted for enrollment meets the standards for individual enrollment mentioned in section 3 above.

5. The Oregon Health Plan shall not allow smokers to join. This includes government sponsored as well as individual applicants. However, the Oregon Health Plan shall respond to every Oregonian that asks for help to quit smoking. A special non-member category shall be established to support smokers who want to quit. The cost to participate in this program will be determined by a sliding scale based on taxable income. A limited list of medical procedures intended specifically to enable a patient to stop smoking shall be the only medical procedures available to Oregonians who are smokers, that is those who smoke an average of five or more cigarettes per day. Upon certification by a physician that an individual has successfully quit smoking for one year that person may apply for membership in the Oregon Health Plan. Serious penalties shall be imposed upon those who are untruthful about their smoking habits when making application to the Oregon Health Plan or at any time they are a member.

6. The legislature shall budget for 2006 a payment into the Oregon Health Plan fund of $75,000,000 plus the amount contributed in 2004. An additional $5,000,000 shall be added to this budget item each year until the amount equals the total of all payments made by participating members.

7. The legislature shall transfer into the Oregon Health Plan fund all revenues in excess of the 2% state revenue forecast thereby eliminating the so called Oregon kicker.

8. The Oregon Health Plan shall be the exclusive health plan for a) The governor and every employee in the executive branch of state government under his authority, b) Every employee of the judicial branch of state government c) Every member of the state legislature and all of their staffs.

9. Allowing for procedures specific to male and female anatomies, everyone enrolled shall have exactly the same benefits. No exceptions.

10. Payments by governments and individuals into the Oregon Health Plan shall remain in an Oregon Health Plan account which shall be the source of payments to physicians, hospitals etc. for allowable procedures.

11. Oregon Health Plan financial managers may only invest in low risk financial instruments with a prudent amount of available capital. All investments shall be made only in Oregon.

12. The Oregon Health Plan may be administered by contract with a private business or by a state government agency depending on which is deemed more likely to deliver the most cost effective high quality service to Oregonians.

13. Every two years the number of procedures covered by the Oregon Health Plan shall be reevaluated and shall include more or fewer procedures from the existing list as determined by the amount of money available in the Oregon Health Plan fund to pay for them. It is the goal of the Oregon Health Plan to annually spend on benefits what it annually receives in revenues.

14. Mental health, dental, optometrical, chiropractic and acupuncture shall be included in potential procedures of the Oregon Health Plan especially those of a preventative nature.

15. Every five years the list and rankings of procedures shall be reevaluated.

16. Every listed procedure shall have a capped price. Members may seek medical care from any licensed health care provider in the United States of America. Members who choose health care providers that charge less than the capped price for any procedure shall receive a credit toward their health plan premium valued at the difference. Members choosing health care providers charging more than the capped price must make up the difference themselves. Every bill sent to the Oregon Health Plan for payment must be signed by the member involved in the medical procedure appearing on the invoice before payment can be made.

17. Health care providers licensed by the state of Oregon shall accept Oregon Health Plan patients for approved procedures.

18. Patients that choose to participate shall have the opportunity to critique the care given by their health care providers directly into an online database. 10% of the health care providers with the highest patient satisfaction ratings per year will receive a $10,000 cash incentive bonus. A minimum number of 300 votes or 60% of a health care provider's patients will be required to qualify. 

19. No member of the Oregon Health Plan may sue a health care provider for malpractice of a procedure allowed under the Oregon Health Plan without the express approval of five members of a nine member committee established for the specific purpose of determining the legitimacy or frivolousness of the proposed legal action. That committee shall be comprised of five permanent members serving four year terms namely, two retired judges, two retired physicians and the governor. The remaining four shall be chosen at random from the Oregon legislature each quarter prior to that quarter's meeting.