Let's get on the bus

Submitted by Mallen Kear on Thu, 09/04/2008 - 7:48am.

Attention! The Oregon Health Fund Board (OHFB) bus is pulling into the station.

Should we climb on board?

It’s not the bus we were expecting. It’s not the express bus we were hoping for – the bus with seats for everyone and a direct route to where we want to go.

In fact, it’s quite a local bus. Slow. Lots of stops along the way. A major stop two years down the road to pick up extra passengers and to pull out maps to check the route.

Should we get on the bus?

I say “yes, let’s take this bus.” It’s the only bus pulling into the station in the foreseeable future. It’s going in the direction we want to go. Sure it’s slow, but at least it is moving toward the place we want to be.

On Wednesday, August 27th, the Oregon Health Fund Board met for five hours in a working meeting, making changes to the draft of their health care reform proposal. The revised draft proposal is now available (PDF). This revised draft proposal is the document that we will be invited to make comments on in the September public meetings.

It has taken me a lot of thought to decide that I want the Archimedes Movement to support the OHFB proposal. I hesitated for a long time. I could not find the comprehensive vision contained in SB 329 within the draft. I could not find the innovative work of the OHFB committees within the draft.

But once I changed my mindset from “health care consumer” to Oregonian (taxpayer), I could see the reasoning behind the plan’s approach. Archimedes said “Give me a place to stand and a lever long enough and I will move the world.” The OHFB plan starts with the leverage that the state already has, as a major health care purchaser, to begin the process of health care reform.

As Oregonians, don’t we want the state to be smart about how it uses its public health care dollars? Don’t we want the state to set mandatory health data collecting guidelines? Don’t we want the state to establish public health initiatives regarding smoking, obesity, and the POLST registry? Don’t we want to add more children and adults to OHP? Don’t we want the state to develop community health collaboratives that model the integrated health home?

When you read the draft of the OHFB proposal, try to see it from the point of view that I’ve so recently adopted. As Oregonians, don’t we want our state to make these changes?

Will these changes be significant in the overall landscape of health care reform?

As a matter of fact, the state does have quite a big lever to wield. In some of our counties, perhaps as much as 50% of the population is directly connected to the state’s role in health care purchasing through OHP, FHIAP, PEBB, and OEBB. So yes, I’m now convinced that these changes can be significant.

Are they enough? Absolutely not. That is the reason we are committed Archimedes members.

The OHFB bus is now pulling into the station. As Archimedes, let’s climb on board.

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I'm in!

Submitted by Roger Warren 2 on Fri, 09/05/2008 - 10:01am.

At some level, I think most of the Archimedes members knew this would be a series of baby steps. This is the first one...of many, I hope!

Draft Proposal

Submitted by Catalyst1 on Sat, 09/06/2008 - 8:10pm.

Catalyst1 I read all 78 pages of it too. It does not represent ANY substantial change in the status quo. It is a plan for keeping what is important to the powerful people in the business of healthcare status quo, masquerading as a plan for change. The plan rivals the current system in its complexity and obvious dysfunctionality, but it does manage to pander to the insurance industry and keep the power with physicians and pharmaceutical companies. If we want to see real change, the following features of a new system will be present: 1) No insurance companies. Payment will be administrated by a single entity with no conflicting financial interests. Insurance currently accounts for 30% of every health care dollar spent. It stands to reason that if we get rid of insurance, we can have 30% more health care available for people without spending any additional dollars. 2) We re-think the concept of healing. The current system is really good at generating money and really poor at producing genuine health. In most health clinics and hospitals, the name of the game is to "process" the patients as quickly as possible. Expediency dictates that most of the time, the "cure" that is offered is a prescription or surgery, instead of something that would be more efficacious, such as a consult with a dietician, or referral to mental health services. M.D.'s don't make money when the patient gets well by addressing the problem this way. 3) A new system will reward providers who produce genuine, measurable HEALTH, rather than such things as "lower utilization," or the shortest amount of time spent in actual contact with the patient. As Dr. Kitzhaber said, "we need to change the incentives." All the electronic information systems in the world will not compensate for the absolute lack of morality, lack of genuine desire to produce health in patients, and the rampant greed that permeates the current health care "system." Unless this is addressed publicly, and ACKNOWLEDGED by the parties involved, the dysfunctionality in the current system will prevail despite the grandiose plan in the Draft Proposal. The ONLY aspect of the Draft Proposal that I find hopeful is the press to make charges for services transparent. Of course, what is left out is the mandate to make all costs of health insurance transparent and public. So, no, I am not "getting on the bus." I am going to shout, write, and tell others until my voice is heard, that the "emperor is naked ." I am going to challenge the members of the board publicly on the weak thinking that is behind this draft proposal. I am going to challenge them to get a spine and some intestinal fortitude and "just say no" to insurance companies.

Draft Proposal

Submitted by havefreedom on Tue, 09/09/2008 - 10:47pm.

I want to agree with Catalyst 1 .

I will not duplicate her statements but only say from experience that if we get on the wrong bus, even if it is the only bus in the station, a slow one at that, we will arrive at some unknown destination far from where we want to be.

Lurelle Robbins BS Ag Econ EMT-P

This is the wrong Bus!

Submitted by Carolann Hennen on Mon, 09/15/2008 - 3:03pm.

Don't get on this bus just because it's the only one at the station. This plan is just some more of the same old politics-as-usual. It won't help with the real problem. We need universal health care like almost all of the other industrialized nations have. Any reform we have needs to be national, it needs to address all of the issues and it needs to stop the health care dollars from simply lining the pockets of insurance companies. We support the Wyden Plan. Carolann Hennen Southern Oregon Health Care Reform Movement carolann@mind.net

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About Mallen
Before retiring in 2005, Mallen Kear was a staff RN on the medical floor at Providence St.Vincent Hospital in Portland. While there, she was dismayed at the number of severely ill patients who had no health care coverage and who were brought to the medical floor directly from the hospital ER.

After learning about the Archimedes Movement, Mallen became a supporter in early 2006, and started the Eastside Portland chapter in June of that year. When the Healthy Oregon Act was passed in 2007, Mallen followed its progress. She applied and became a member of the OHFB Federal Laws Committee, and attended many of the other committee meetings as well as meetings of the full Oregon Health Fund Board. She has been writing blogs about her observations for the Eastside Portland chapter since January of this year.