On August 5th, I attended the all-day meeting of the Oregon Health Fund Board (OHFB). At this meeting, the Board heard the third version of Executive Director Barney Speight's "straw person" plan. This version was noteworthy because of added elements missing from the first two versions, and better explanations of the original elements.
I'd like to begin by addressing the communication piece. As many people know, I have been following the work of the OHFB and its various committees since last fall. One thing I have observed is that people who work in the field of health care policy and with health care insurance are so immersed in the culture of their field that they don't recognize they are talking in dialect. I can't tell you how many times I have been engaged in conversation with someone with a health care policy background and have to stop him or her to ask, "Now what exactly does that term mean?" A few examples: "adverse selection," "guaranteed issue," "community rating," and "medical loss ratio." It never seems to occur to someone who is working in the field, and familiar not only with terms but also with myriad federal and state rules and regulations, that the rest of us don't know what they are talking about!
I'm left wondering if the first two versions of Barney Speight's "straw person" plan included transformative elements that I missed, not being able to "see" that from a lay public perspective. I think the lesson here for the Board itself is that their final draft must be written in a narrative that the public can understand. It must show the connection to the original vision of SB 329, and it also must be clear about the elements that lead to greater system transformation.
The two elements missing from the first versions of the "straw plan" are the state-wide insurance exchange and a "publicly-owned health plan alternative." Credit for the fact that a "public health care plan" is even on the table must go to Corvallis Archimedes Movement members Betty Johnson and Mike Huntington, and the rest of the Corvallis Archimedes Movment chapter, who worked with Mid-Valley Health Care Advocates to push this idea forward. On August 1st, Betty and Mike arranged for Barney Speight and interested members of the OHFB to take part in a conference call with Jacob Hacker of UC Berkeley. Also on the conference call were several OHPR staff and Ellen Pinney of Oregon Health Action Campaign. Jacob Hacker is the author of "Health Care for America", a paper that outlines his view that offering a public health care plan alongside private plans stimulates competition that benefits health care reform.
One of the OHFB members who took part in the conference call is Tom Chamberlain, who is Oregon President of the AFL-CIO. He made numerous comments throughout Tuesday's meeting that not only championed the idea of offering a public health plan, but also emphasized the need to protect the health care consumer from the costs of health care reform. He introduced the Board to the concept of "hold harmless", i.e., if the Board decides to finance reform through a new provider tax, they also need to enact measures so that the new tax is not simply passed through to the consumer.
The Board will meet again on the 27th of August, and will be finalizing their draft proposal at that time. During the month of September, there will be a series of public meetings to introduce the Board's proposal and get public input. The public input will be worked into the Board's proposal during the month of October.
