Health reform starts to take shape

Remaking Oregon's health care system will be like climbing Mount Everest, Sen. Alan Bates told a crowd of about 100 people at a town hall meeting Thursday in Medford.

The Ashland Democrat said the 2007 Legislature "set up the base camp" when it passed SB 329, the Healthy Oregon Act, which outlined the scope of reform. The next challenge will be to work out the details of a plan that would provide affordable, comprehensive care for all Oregonians to give to the 2009 Legislature.

"It'll be tough," said Bates, the co-author of SB 329 with Sen. Ben Westlund,D-Bend, "but I think it's do-able. Now we have 18 months to do it."

Bates joined Rep. Sal Equivel, R-Medford, and health-care advocates at Medford's First United Methodist Church to talk to people about how Oregon will attempt to restructure health care over the next 18 months.

Ellen Pinney, of the Salem-based Oregon Health Action Campaign, noted that Southern Oregon will play a key role in the deliberations because Bill Thorndike of Medford will chair the seven-member Health Fund Board, the committee that will oversee the entire process.

Thorndike, whose appointment was announced this week, did not attend the meeting. He said Wednesday he was looking forward to "collecting the best ideas over the next year and a half and then handing them off to the Legislature with a blueprint they can work with."

Thorndike and Gov. Ted Kulongoski's other appointments to the board are expected to be confirmed by the Senate in the fall. Meanwhile, state agencies will begin collecting data for five subcommittees of the Health Fund Board that will define the plan's eligibility, benefits, funding arrangements, and delivery system as well as how the new system will coexist with the federal Medicare and Medicaid programs.

The Healthy Oregon Act created an Oregon Health Fund that allows employers and individuals to pool their health-care dollars. Members will have an Oregon Health Card which will entitle them to basic benefits. Employers can purchase additional benefits.

Pinney said ordinary citizens need to be involved in the process to help define what the basic benefit package will include.

"Work for a plan that will work for you and your family," she said.

State agencies will make their reports to the subcommittees by early 2008, and a draft of the plan is scheduled to arrive at the governor's office by Oct. 1.

Bates said the plan would then be drafted into as many as seven or eight bills for the 2009 Legislature to consider.

He said whatever proposal emerges will almost certainly encounter "huge resistance" because it will change the way doctors, hospitals and insurance companies currently do their work.

While the proposals are still months from being written, Bates cited several examples of the kinds of changes that could be in store. Hospitals may be made to justify their expansion plans before they're allowed to build, and communities may have to learn to work more efficiently with fewer pieces of expensive medical technology. He said the Legislature also might consider a payroll tax as part of the funding arrangements.

Health insurance could even become mandatory for all Oregonians, he said. "We may be saying you have to have health insurance in Oregon, just like you have to have a license to drive a car."

Reach reporter Bill Kettler at 776-4492 or

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