We, Oregonians, can not solve the problem of providing affordable health care to all Oregonians until we stop being subservient to the demands of the health insurance lobbyists.

American Pulitzer Prize winning author of ninety books and candidate for governor of California winning 44% of the vote in 1934, Upton Sinclair, observed, "It is difficult to get a man to understand something when his salary depends upon his not understanding it."

Three Oregonians, Ted Kulongoski, Margaret Carter and Gary Hansen, that presumably work to solve problems for all of us who make Oregon our home, have so far chosen to ignore the issue of affordable health care for individual Oregonians. They have also chosen to avoid dealing with the uncontrollable rising costs of public employee health insurance premiums. Whether they are protecting special interests in the insurance industry or are afraid to lose their generous publicly paid health insurance or they think their jobs only require warming a seat in Salem while collecting a public paycheck without making serious waves is unclear. Perhaps mere laziness is the answer. Nevertheless, it's time to test the remaining eighty-eight players in this game.

I call upon every member of the Oregon legislature to cosponsor bills in both House and Senate which include the draft language below.

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.

Please keep in mind that this draft language is just the beginning NOT the end of our introspective statewide debate on the moral and economic necessity for our state of Oregon to provide affordable health care to all of its citizens.

Those of you who support this idea must be prepared to act. First, you should distribute paper copies or forward this email to every Oregonian you know, especially those who are without medical coverage or those on the edge of losing it. Next, talk to everyone in your family, your workplace and your neighborhood about it. Finally, contact your mayor, your school board, your county commissioners, your governor and your state legislators and tell them ALL Oregonians are on board the same ship of state and must be treated fairly when it comes to health care. Tell them to either introduce, cosponsor or support a bill that includes the draft language above. Without a bill that includes the concepts for change listed above there will be no serious consideration nor solution to the problems of providing affordable health care to all Oregonians and reducing the skyrocketing health insurance costs for employees of every Oregon government and public educational institution.


Richard Ellmyer
Portland, Oregon

P.S. It is more useful to this process for you to copy me on correspondence that you have sent to elected officials rather than merely hit the reply button and tell me you think this is a good idea. TELL THEM. Copy me.

Please don't waste your time or mine by writing to me about the difficulties of implementing such a plan. I already know, thank you. I am ONLY interested in connecting with those who recognize the necessity to change our health care system in Oregon AND are willing to fight for it.

Politics is always a contact sport. It is often a blood sport. If you are not prepared to bleed and draw blood then you must get off the field.

Media folks have my permission and encouragement to publish this commentary.