Oregon's Public Health Care Policy Debate
Oregon's Public Health Care Policy Debate
The federal government of the United States of America and the American private health insurance industry have FAILED to provide affordable health care to Oregonians and Oregon's public institutions. As a result of these failures Oregon is facing a moral and economic health care crisis based on the following conditions:
1. Huge numbers of Oregonians have no health insurance.
2. Huge numbers of Oregonians pay for such costly health insurance that they can afford little or no actual health care.
3. All of Oregon's public institutions are facing skyrocketing and unstoppable increases in health care costs which significantly diminish the quality and quantity of services that need to be provided to the public.
The Oregon Community Health Care Bill is the solution to Oregon's moral and economic health care crisis because it:
A. Is the most market driven health care plan in America.
B. Removes the burden from businesses of providing health care and places it on the state of Oregon.
C. Reduces health care costs to public institutions in Oregon by 20%.
D. Provides actual health care not just health insurance.
E. Eliminates the term, "preexisting condition." If the procedure is covered you're covered.
F. Provides affordable health care - on a sliding scale according to income - as good as that received by any public employee in Oregon to anyone willing to make a commitment to Oregon for one year as a registered voter.
The Oregon Community Health Care Bill will be the touchstone for the health care debate until close of the 2009 Oregon legislature.
The 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 2006 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 2006 divided by the number of individuals covered in each public entity in 2006. [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 2008 a payment into the Oregon Health Plan fund of $75,000,000 plus the amount contributed in 2006. 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.
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A History of Oregon Health Watchers Commentaries, Reports, Relevant Emails Etc. From December 6, 2004 To The Present
Oregon's elected political class of 2009 MUST campaign with the health care reform package of their choosing in order to have the credibility to act on health care reform when they take office
Regardless of what public office they are running for the issue of health care is connected to it. The single most important question relating to our state's moral and economic health care crisis is below. In addition to the US Senate, statewide contests, several city council and county commission races, every candidate for the Oregon legislature has been asked to answer this question
Jeff Merkley Supports Senate Bill 329 and a Billion dollars in new taxes to pay for it most of which will go to the failed private health insurance industry
The cowardly Democratic "leadership" in the Oregon Senate got in bed with Republican Social Darwinists in the Oregon House sending the Oregon Democratic Party into dissension and disarray over health care reform at the recent close of the special legislative session. Flipping a very big bird to Representative Mitch Greenlick the Democrats in control of the Oregon Senate said, "no way" are we going to allow Oregon voters to have a say on a fundamental public policy issue, namely: Should Oregonians have a constitutional right to health care?
If the Democrats controlling the Oregon Senate are afraid the public will oppose a constitutional right to health care then how in the world do they expect to sell a BILLION dollar tax increase to pay for SB329 during the 2009 legislative session?
Dear Senator Carter and Representative Kotek:
Your refusal to submit the Oregon Community Health Care Bill, even as an action that costs you nothing as a mere token courtesy to your constituents, especially long time political activist and former staff advisor to the late senator Bill McCoy, Richard Ellmyer, and Portland city commissioner Sam Adams, was indefensible. It can only be explained as an undeclared, stealth commitment with the expectation of substantive rewards from the failed private health insurance industry or abandonment of your responsibility to protect your constituents by submission and cowardice in the face of the power of the failed private health insurance industry. It is either a selfish choice or a serious character flaw which makes you unworthy of elected office.
John Frohnmayer, candidate for US Senate and former head of the National Endowment For The Arts, demonstrated his courage, honesty, intelligence and leadership skills when he announced at a press conference at the state capitol in Salem on December 17 that he supports the Oregon Community Health Care Bill at the state level and a single payer solution at the national level to resolve the moral and economic health care crisis we face in Oregon and America. Bravo and thank you John Frohnmayer.
John Frohnmayer, candidate for United States Senate, is supporting the Oregon Community Health Care Bill in Oregon and a single payer system at the federal level. These two compatible and complimentary positions on health care reform set John Frohnmayer above all of his competitors. Both of these approaches to health care reform reject the failed private health insurance industry as a model for the future. Despite the fact that a majority of Oregonians would agree that the private health insurance industry has failed and will continue to fail to solve Oregon's moral and economic health care crisis, it still takes an enormous amount of courage for John Frohnmayer to stand up for this kind of fundamental change and speak truth to power.
On May 15th elections for School Boards will be held throughout our state. Successful candidates will be hired by voters to exercise a legal and fiduciary duty to taxpayers to spend large sums of public money in the best interests of the tax paying community. A significant portion of public funds spent by School Boards will be dedicated to public employee health insurance costs. Those payments have a direct connection to the moral and economic health care crisis that affects Oregonians and Oregon's public institutions.
Dear House Speaker Merkley and Senate President Courtney:
The current legislative debate over health care reform in our state does not include our view that the profit oriented private health insurance industry must not be the model upon which a solution to Oregon's moral and economic health care crisis should be based and that Oregon elected officials - public employees - voters and taxpayers must have equal access to the same level of health care not a perpetuation of our current multitiered health insurance class system.
Meet The "A" Team
Sam Adams - Portland City Council
James Auburn - Mayor of Port Orford
Jeff Cogen - Multnomah County Commission
Carlos DeBritto - Phoenix City Council
Edwars "Chip" Enbody - Hubbard City Council
Darrell Flood - Mayor of Lafayette
Bill Hall - Lincoln County Commission
Jim Needham - Mollala City Council
Jesse Penna - Irrigon City Council
Sue Walker - Mayor of Nyssa
Wayne Walker - Mitchell City Council
The health care reform ideas of Kitzhaber et. al. continue to rely on the failed private health insurance industry model. This model offers no relief to Oregon's public institutions and Oregon's taxpayers who distressingly observe fewer public services being delivered to them year after year as far as the eye can see.
Your answers to these questions will form the foundation for your approach to discussing, debating and finding the solution to Oregon's moral and economic health care crisis which is to bring affordable health care to Oregonians and Oregon's public institutions.
There is ONLY one way to make health care affordable (not "lower cost" whatever that is) to Oregonians AND Oregon's public institutions and that is to remove the private health insurance industry as a model and player from the solution. This proposal does not do that. It must fail.
It doesn't matter which political party controls any part of our federal government. Neither the congress nor the president nor the private health insurance industry are institutionally capable of solving Oregon's moral and economic health care crisis by bringing affordable health care to Oregonians and Oregon public institutions.
It doesn't matter that the Democrats will control our state government. They are just as beholden to their special economic interest groups, visionless and afraid to tackle the failed private health insurance industry as Republican legislators. Democrat and Republican legislators are personally unmotivated because all of them are protected by the best health insurance coverage that Oregon taxpayers can provide. Not a single Democrat in the 2007 legislature nor Ted Kulongoski, the Democratic governor, has a health care plan which is competitive with the Oregon Community Health Care Bill. The highly probable FAILURE to bring affordable health care to Oregonians and Oregon's public institutions during the 2007 legislative session will now be the UNEQUIVOCAL, INDISPUTABLE and UNDENIABLE responsibility of the DEMOCRATS.
The city of Portland has delivered $12,000,000 LESS in public services since Tom Potter took office. By the time his term is up that figure will have risen to $25,000,000 in undelivered public services. And yet, with the exception of commissioner Sam Adams, neither Potter nor any other member of Portland's city council has either a plan or even the slightest interest in reducing the skyrocketing and unstoppable annual rise in our city's health care costs.
Fewer Statistics More Relevant Questions Moves The Health Care Debate 8-30-06
There is ONLY ONE health care question on the public table. Is there anyone who will present legislation that can compete with the Oregon Community Health Care Bill?
There is no need to wait until August 2007 to find out if our next legislative assembly will bring affordable health care to Oregonians and Oregon's public institutions. The results are already in. The 2007 legislative assembly will fail.
There are a number of reasons why the federal government, the private health insurance industry and the Oregon legislature have been unable to provide affordable health care to Oregonians and Oregon's public institutions. At the top of the list is the prevailing, currently acceptable rejection of the "Common Good."
Write in HEALTH CARE next to every candidate that is running unopposed and for every position that you would otherwise leave blank.
The gubernatorial health care debates are over and there is a clear winner - Pete Sorenson.
The generously health care covered members of Portland's City Club were so disinterested in the moral and economic health care crisis facing our state that despite being told by political professionals in their own forum that health care would be the leading issue in the governor's race, not a single question on health care was asked to any of the three Republican candidates for governor that recently debated before them. Shameful.
Jim Hill's fantasy solutions to Oregon's health care crisis: try to persuade the legislature to increase funding to the Oregon Health Plan and pray with John Kitzhaber that the federal government - currently defined as George W. Bush, Dick Cheney, Dennis Hastert and Dr. Bill "Terry Shivo is Not in a vegetative state, the video told me so" Frist - will bring affordable health care to Oregonians and Oregon's public institutions before hell freezes over.
The elected leaders of Oregon's largest city have broken new ground in public administration by officially adopting the faith based technique called management-by-hope. A distinction without a difference from management-by-prayer. President Bush, those who derisively refer to the "peoples republic of Portland," teachers and students of political science around our state please take note. Portland City Commissioners joined their elected colleagues at the Portland School Board who also believe that their job is primarily to make sure that those bargaining units that helped them get elected get the best health care coverage taxpayer's money can buy. Portland's city council and its school board are not moved by the fact that together they will face $50,000,000 in INCREASED health care costs during mayor Potter's term in office. Portland's city council and its school board do not discuss their responsibility nor the details of $50,000,000 in lost services.
If you thought that facing $25,000,000 in INCREASED health care costs for Portland during his term as mayor or sitting in the Oregon governor's chair for the next four years while watching public jurisdictions throughout our state spend $625,000,000 in INCREASED health care costs would prompt a liberal Democrat and a conservative Republican to propose action to deal with these crises, you would be wrong.
The latest evidence that our public treasuries are bleeding to death, to the point that a "patient" may die, was revealed in a recent story in the Oregonian reported by Shelby Oppel Wood.
President George W. Bush would be impressed with the lockstep loyalty commanded by law firm Ater Wynne for its public leader and gubernatorial candidate, Ron Saxton. This blind obeisance begs the question: Are Ater Wynne's clients also required to swear allegiance to the archaic health care policy advocated by Ron Saxton that is obediently embraced by Saxton's lawyer colleagues at Ater Wynne?
"Effective, affordable health care should not be a 'perk' that's available only to the very rich," Kulongoski said.
What our governor should have said was, "Effective, affordable health care should not be a 'perk' that's available only to PUBLIC EMPLOYEES like Kulongoski, every Oregon Legislator and the very rich."
The GOAL is to solve these moral and economic problems which have been caused by a failure of the federal government and the private insurance industry ASAP.
Health care benefit negotiations are no longer a private matter between a few civil servants discussing how much of the public treasury should be spent on those sitting at the table. Every health care benefit package negotiated by every public jurisdiction affects every Oregonian's ability to find affordable health care. Candidates for public office that believe health care should be a matter of charity not government, elected officials that believe the federal government will solve Oregon's health care crisis and bargaining units that believe that they deserve better health care protection than the taxpayers who pay for that health care must all be exposed and held to account in the court of public opinion. You, my dear readers, are that court.
"The overall cost of health care has doubled in the last 12 years and still is rising at four times the rate of inflation. Today there is no graver threat to American business competitiveness than the exploding cost of health care."
And yet, in Oregon, all the evidence from the business community points to maintaining the status quo. Why is that?
The next time, "they" talk about health care solutions coming from the federal government will someone, anyone, Sam?, please ask "them" to outline the scenario "they" envision for success and the players who will bring about that success and when
Now that John Kitzhaber has finally left the stage where does that leave us with regard to Oregon's, NOT America's, health care crisis and the plans of Oregon's gubernatorial candidates to solve our problem?
Oregon's governor, our governor, my governor, MUST pay attention to Oregon and solve its health care crisis. If John Kitzhaber wants to reform the American health care system he should run for President.
As your organization, group or family discuss the Oregon Community Health Care Bill keep this in mind. There is no such thing as a preexisting condition. If the procedure is covered you're covered.
The following question was asked to about 1500 elected officials in Oregon including school board members, city councilors, county commissioners, legislators etc. An astounding 98% indicated that they DISAGREED that the following assertions were problems that needed to be addressed.
On September 22, 2005 I spent about an hour of cordial, intense sometimes spirited conversation with Portland's mayor, Tom Potter, focusing on public health care policy. I also had an email exchange on the same subject with an official connected to the Republican party of Clackamas county in which he chose to play the role of an attack dog talk radio host. Each of these discussions was instructive in its own way. Taken together, three dramatically dissimilar viewpoints on public health care policy emerge.
So the critical question arises, does Bob Caldwell and his peers and colleagues in the Oregon press corps have a MORAL and CIVIC DUTY to tell their readers, listeners and viewers about the Oregon Community Health Care Bill so that their audiences become informed citizens and voters who can knowledgeably engage in a public debate as well as question and challenge any public official or candidate running for public office in Oregon with regard to his or her support for affordable health care for both individuals and public institutions in our state?
Below is a sample of a letter recently sent to more than fifty of Oregon's top companies*. Similar letters went to about two dozen Portland metro area chambers of commerce and neighborhood business organizations. A significant number of Oregon's business leaders have now been invited to participate in solving Oregon's moral and economic health care crisis.
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.
The war to win affordable health care for every Oregonian and reduce the cost of health care to every public institution in Oregon by twenty percent begins in ernest on October 29, 2005 from 1-3 PM at the Historic Kenton Firehouse in Portland*. On that day sixty Oregonians will gather to participate in the Oregon Community Health Care Bill Forum. You might be one of them.
There can be no affordable health care for all Oregonians nor can the skyrocketing and uncontainable health care costs for Oregon's public institutions be brought under control until a significant majority of public employees in Oregon, especially paid elected officials, share a common health care policy within a single insurance pool which is also open to public participation. This can be accomplished by the Oregon Community Health Care Bill.
My wife and I met in 1969 while teaching at East Orange High School. We moved to Oregon in 1971. Since that time we have voted for every bond, levy and tax increase that involved schools, libraries, parks, etc. However, that decades old pattern is about to change dramatically. Personal necessity has brought affordable health care to the top of our list of priorities. We will no longer vote to maintain or increase any levy, bond or tax for any public entity which does not fully support the Oregon Community Health Care Bill or a similar bill which provides affordable health care for all Oregonians and can reduce government/public education health care costs by twenty percent.
The Oregon Community Health Care Bill is not a Republican nor Democrat bill. It is neither urban, nor suburban, nor rural. Unlike all the other so-called health care bills submitted this session which are all merely partisan tinkering around the edges, the Oregon Community Health Care Bill provides a solution which directly addresses the need to provide affordable health care to all Oregonians.
For the record, this letter is a personal appeal to each and every one of you to introduce the Oregon Community Health Care Bill* before February 27th. And for those of you serving in the senate an additional commitment to bring it up in committee for discussion and eventually a floor vote.
Senator Carter, Representative Hansen:
You are my representatives in the Oregon legislature. It is not clear to me why neither of you have submitted legislation written by me entitled, Oregon Community Health Care Bill*. If you were afraid of taking personal responsibility for legislation that could bring affordable health care to all Oregonians then you could have easily avoided that "onerous liability" by submitting a "personal" or "constituent" bill by adding "this bill submitted at the request of Richard Ellmyer."
Questions you need to ask everyone you engage in conversation or debate on the matter of making health care affordable to all Oregonians are these:
Do you have health insurance?
Do I pay for a part of your health insurance with my property or income taxes?
Am I excluded from your insurance pool of participants?
Do you believe that every Oregonian should have the right to affordable health care?
If yes, then what have you done to support the Oregon Community Health Care Bill*?
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.
In the last twelve years neither Democrat Bill Clinton nor Republican George W. Bush has succeeded in bringing affordable health care to every American. It is time to come to grips with this reality. The entrenched power brokers in Washington D.C. will never allow meaningful health care reform in America. If we, as Oregonians, want affordable health care for ALL of us then WE MUST DO IT OURSELVES. We share our beaches, our mountains and our forests. We share a common purpose in maintaining our glorious Oregon environment. We must now share our concern for the health of our fellow Oregonians.