We Oregonians are known for blazing our own trail. Did you know that in 1907 Oregon was the first state to elect a US Senator by a direct vote of the people? Prior to that, only state legislators could elect our Senators. We value the process of public input and make our voices heard. Read on to learn about an important opportunity to participate in this public process.
Governor Kitzhaber speaks to Federal Laws Committee On March 25th Governor John Kitzhaber made a presentation to the Federal Laws Committee, a committee of the Oregon Health Fund Board. He was invited to present a different frame of reference, one that broadens the scope within which the Committee could make recommendations to the full Oregon Health Fund Board when the committee completes its work in the next month or so.
The governor’s presentation described the evolution of our current delivery system, which began as an acute care, infectious disease model. Today the major costs in the system are driven by people with chronic conditions yet we are still using an acute care model – waiting until people are sick to treat them rather than intervening to try to keep people healthy.
In his talk Governor Kitzhaber used a metaphor from Don Berwick, founder and CEO of the Institute for Healthcare Improvement. Kitzhaber said, “Every car has a maximum speed. You can take your car – your new Corvette, your old 1985 Honda Accord, your Prius, your Dodge Ram pick-up, or whatever vehicle you own – out to the Bonneville Salt Flats and put the pedal to the floor. And each car will eventually reach its maximum speed. If you want it to go faster, what do you do? Do you yell at it? File an incident report? Provide an incentive? No. You either modify the car or you get a different car. The maximum speed is a function built into the car itself.”
“By the same token the inefficiencies and poor performance of the U.S. health care system are also built into it,” he continued, “they are a function of the system itself and cannot be changed by simply changing the way we pay for it. Which means that the debate as currently framed is simply not going to resolve the growing crisis in our health care system.”
The language in the preamble to the Healthy Oregon Act, passed during the 2007 Oregon Legislative Session, recognized that changes are needed at the federal level to alleviate the coming crisis, yet it is unclear whether any committee – or the Oregon Health Fund Board itself – will recommend that Oregon challenge the underlying structure of the US health care system. If we don’t, who will?
Community Meetings this Spring Archimedes Movement members were involved in supporting the Healthy Oregon Act and worked to get it passed. One of our jobs is to push the Board and its Committees to go as far as they can towards sustainable change to the health system. They won’t do that without strong public input.
The Board plans to hold public hearings in the fall to get feedback on their proposal, but thanks to the Northwest Health Foundation, a series of community meetings are being held around the state starting on May 1st so that you can give input prior to the draft plan being developed. Please check the schedule of meetings listed below and try to attend one that’s closest to you.
Forward the meeting information to others you know. It’s important that the Health Fund Board hear voices from all corners of the state and from all walks of life. I plan to be at as many meetings as I can because I want to hear firsthand what Oregonians are saying they want in a new health care system.
But our primary job – and it’s the reason we created the Archimedes Movement – is to continue increasing the demand for fundamental and sustainable change to the US health care system. In order to accomplish this we must continue our work to reframe the debate – to change it from a question about how we find more money to add people into the current system, to challenging the underlying structure and premises of the current system.
We want the Oregon Health Fund Board to succeed in its work, but we must also remember that our charge goes beyond theirs. They are trying to make change within the current system; we have acknowledged that the current system is the problem and must be fundamentally transformed in order for us to create a sustainable system that results in improved population health.
I started this message by saying how proud Oregonians are about our history of public input in matters that affect us all. We still value that tradition today. Participate in one of the upcoming community meetings (see below). Urge the Board to be bold in their recommendations so that we are not back in the same place five years from now, asking the same questions again.
We are not powerless; to create forward momentum, Oregonians must understand the nature of the problems we face and the trade-offs necessary to create a new and sustainable system.
I’ll be attending these meetings. Please come up and introduce yourself; I’d love to meet you.
Thanks for your support,
Liz
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