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Oregon to vote on single-payer health care system
American Medical News ^ | 10/28/02 | Markian Hawryluk, AMNews staff

Posted on 10/31/2002 9:10:10 AM PST by RJCogburn

Washington -- Oregonians will go to the polls Nov. 5 to decide whether to be guinea pigs in the nation's first universal health care program.

The proposal, ballot measure 23, would cobble together funding streams -- including personal and employer taxes, federal health programs and the state workers' compensation system -- to create a single-payer system that would provide health care to every person in the state.

The initiative would create a health plan covering 100% of medically necessary health care costs with no deductibles or cost sharing. Prescription drugs, preventive care, mental health services, long-term care, dental and vision care, and many alternative therapies would be covered.

A 15-member administrative board would oversee the plan and negotiate payment rates for physicians and other practitioners. Administrative costs would be capped at 5%.

Less than month before the vote, a Portland Tribune poll showed support for the measure trailing opposition by 36% to 39%, with 25% of voters still undecided.

Critics of the measure do not believe the plan can keep costs in line with its revenues. The Oregon Medical Assn. opposes the proposal.

"There are just no limits," said OMA spokesman Jim Kronenberg. "There would be no apparent control of utilization, no control of services, the patient could go to any sort of practitioner for any kind of problem without any real direction."

The plan would cover any services deemed necessary by a certified, licensed or registered practitioner. But in Oregon that includes a broad range of professions, Kronenberg said. "Oregon has reputation for licensing anybody who can breathe and says that they're a health care practitioner," he added.

Financial drain or cost saving? A study commissioned by the American Assn. of Health Plans estimated that the measure would cost at least $3.5 billion more in 2005, the first year of the plan, than it is expected to collect in taxes. The remainder would have to be covered through government health care program and workers' compensation funds.

Associated Oregonian Industries, a group of more than 20,000 companies, said the proposal's "sky's-the-limit coverage would mean skyrocketing costs" that would cripple businesses and cost Oregon jobs.

The measure would increase personal taxes by 8% and employer payroll taxes by as much as 11.5%. Small businesses, particularly those that can't afford to pay health care benefits now, would be hit hard by the plan's high payroll tax, said Lisa Trussell, AOI's legislative director.

But supporters believe the increased taxes will be offset by the cost savings that could come from moving to a single-payer system that doesn't have to pay for marketing, shareholder profits or CEO bonuses.

"Our view certainly is that many employers are already paying a good deal more [for health benefits] than the maximum payroll rate that we've proposed at 11.5%, and they would be freed of a lot of the administrative headaches," said Mark Lindgren, the president of Health Care for All Oregon, which is leading the ballot initiative. At the same time, the proposal would extend benefits to more than 400,000 currently uninsured Oregonians, who often gain access to care in less than efficient ways.

The proposal also hinges on the federal government allowing Oregon to use the Medicare and Medicaid funds now spent in the state. While the plan's authors haven't contacted the Centers for Medicare & Medicaid Services about it, Lindgren said, the Bush administration has signaled its support for innovative approaches to expanding coverage in the past.

Low Medicaid payment rates have made it difficult to get physicians on board with Measure 23, Lindgren said. But he believes the board that will negotiate physician rates will ensure that those rates are sufficient to retain the state's doctors. "It's just not in the interest of the board to drive people from the state," he said.

Oregon has a history of adopting innovative and controversial health proposals. Its citizens voted to legalize physician-assisted suicide in 1996 and the medical use of marijuana in 1998 through ballot initiatives.

Lindgren said the strength of the insurance and pharmaceutical lobbies makes it unlikely for a universal health plan to be approved through legislation.

The ballot campaign is being outspent 20-1 by insurers opposed to the plan. The Health Insurance Assn. of America has contributed several thousand dollars to the opposition and has encouraged its members, even those that don't operate in Oregon, to help finance the drive against it.

HIAA was a key player in defeating the Clinton health care proposal in 1994. But proponents for a national health care program believe the political landscape may have changed substantially since then. They hope a good showing in Oregon, even if the measure doesn't pass, could provide the momentum to pursue additional efforts on the state and federal levels.

"The problem of health care in this country and the way our system works -- or doesn't work -- has gotten worse," said Rachel DeGolia, operations director for Universal Health Care Action Network in Cleveland. "We think that the time is right to revisit this issue, and we hope it will be a major issue in the 2004 elections."

DeGolia said the grassroots campaign in Oregon also would help to educate the public on health care issues. "It's not something that lends itself easily to 30-second sound bites. It really is a long process to educate folks, and a ballot campaign like this does provide an opportunity."

DeGolia would like to see Congress pass some legislation that would provide waivers or incentives for states to try innovative approaches, such as the Oregon measure.

Sens. Ron Wyden (D, Ore.) and Orrin Hatch (R, Utah) recently introduced legislation that would establish a national discussion on health care reform, including a citizens' working group that would submit recommendations to Congress. In the mean time, all eyes will be on Oregon in early November.

"I have to say I'm kind of pleased we're this close," Lindgren said. "I think we're achieving a lot of goals right now."


TOPICS: Business/Economy; Culture/Society; News/Current Events
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1 posted on 10/31/2002 9:10:10 AM PST by RJCogburn
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To: RJCogburn
I sure hope this passes. I feel a cold coming on and although I live in California, I can move.
2 posted on 10/31/2002 9:12:45 AM PST by Drango
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To: Drango
It might be a good thing, in reality,if it passes. One would think that it would be so expensive, so unwieldy, so unsatisfactory, that it would demonstrate what a bad idea it is.

Maybe not.
3 posted on 10/31/2002 9:15:37 AM PST by RJCogburn
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To: RJCogburn
The measure would increase personal taxes by 8% and employer payroll taxes by as much as 11.5%.

What utter Barbra Streisand. The increase in taxes will be sh*tload more than that when it's all said and done.

Small businesses, particularly those that can't afford to pay health care benefits now, would be hit hard by the plan's high payroll tax,

And as a result, THEY WILL LEAVE THE STATE, thus leaving their "health tax" burden for the remaining people to pick up. THEY WILL LEAVE and jobs will evaporate, further reducing tax revenues to the state. Are people so stupid they can't see this? Are we really a nation of toddlers who can only think in the BUT I WANT IT mode????

4 posted on 10/31/2002 9:17:25 AM PST by Lizavetta
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To: RJCogburn
I gotta hang nail too...
5 posted on 10/31/2002 9:17:39 AM PST by Drango
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To: Drango
"I sure hope this passes"

It won't.

6 posted on 10/31/2002 9:19:50 AM PST by Crispy
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To: RJCogburn
The measure would increase personal taxes by 8% and employer payroll taxes by as much as 11.5%.

Already voted "NO" on this.

The Oregonian is reporting that this would be a financial disaster for Oregon.

7 posted on 10/31/2002 9:21:30 AM PST by Salvation
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To: RJCogburn
Brilliant. If they wanted to control health care costs, they'd make it a felony to offer health insurance as part of an employer plan, eliminate tax deductions for the provision of health insurance, prohibit health plans from providing prescription benefits, and mandate no deductibles less than $10,000 per family.

Health premiums would go down to about $70/month for a family plan, docs would buy slightly smaller homes and the large specialty mills would break up (giving the docs more free time), and folks would start monitoring room charges.

8 posted on 10/31/2002 9:22:24 AM PST by Chancellor Palpatine
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IN 5 DAYS, THEY'LL BE VOTING DEMOCRAT

WHAT ARE YOU DOING TODAY TO HELP TAKE BACK THE SENATE?

TakeBackCongress.org

A resource for conservatives who want a Republican majority in the Senate

9 posted on 10/31/2002 9:22:59 AM PST by ffrancone
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To: Drango
A cold and a hangnail...that will require two separate visits to the doctor.
10 posted on 10/31/2002 9:23:11 AM PST by RJCogburn
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To: Lizavetta
You hit the nail on the head. People will be flooding the hospitals for paper cuts, bruises, black eyes, and sprains.

This is simply Hillarycare on the state level.

11 posted on 10/31/2002 9:25:50 AM PST by ServesURight
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To: Crispy
What was that bumper sticker again?

IF YOU THINK HEALTHCARE
IS EXPENSIVE NOW,
JUST WAIT 'TIL IT'S FREE.

12 posted on 10/31/2002 9:26:24 AM PST by smokinleroy
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To: Drango

Not many people are aware that about half of the population in the state of Oregon are conservatives. The large population centers of Portland and Eugene have been taken over by liberals - the largest influx from California.

Rather than leave Oregon to the wolves, I would hope good people elsewhere will continue to support those who are fighting the good fight in Oregon. It is still not too late to wrench the state back from the hands of the socialists. Votes are often very close.

Besides, the liberals who are invading Oregon to try to get programs such as this passed are doing so as just their opening act. If they succeed in Oregon - they will be coming your way. Do not be lulled into thinking your state is immune. They are patient, they are devious - and they cheat.

Fight - in every state - and never stop fighting.
13 posted on 10/31/2002 9:31:38 AM PST by Route66
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To: Lizavetta
Our property taxes are a killer as it is. We have private ins. and I would like to keep it that way as my son is severly disabled and most Drs. here will not see him. They claim that their liability ins. does not cover them to treat my son. I would hate to see what would happen with a social Med. plan.

We are both voting NO on 23!
14 posted on 10/31/2002 9:39:18 AM PST by oceanperch
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To: RJCogburn
I hope it passes. Oregon deserves it. Then they can secede and join Canada.
15 posted on 10/31/2002 9:39:55 AM PST by leadhead
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To: Chancellor Palpatine
"If they wanted to control health care costs, they'd make it a felony to offer health insurance as part of an employer plan, eliminate tax deductions for the provision of health insurance, prohibit health plans from providing prescription benefits, and mandate no deductibles less than $10,000 per family."

Absolutely brilliant!

However, I happen to think that most of this benefit would easily be achieved without harming any liberties by simply making employer-provided medical insurance benefits taxable as income.
16 posted on 10/31/2002 9:47:51 AM PST by Atlas Sneezed
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To: Route66
The large population centers of Portland and Eugene have been taken over by liberals - the largest influx from California.

Don't forget the transient left-wing element in those areas...college students that vote while they're in school and then leave to find jobs.

17 posted on 10/31/2002 10:14:59 AM PST by gundog
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To: leadhead
Oregon deserves it.

This from Maryland? Oregon can be a political basket case at times, but I'd take Kitzhaber over Glendingdong any day of the year. :)

18 posted on 10/31/2002 10:19:52 AM PST by gundog
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To: gundog
"I hope it passes. Oregon deserves it. Then they can secede and join Canada."

You deserve to be bitch slapped.

19 posted on 10/31/2002 12:33:04 PM PST by Crispy
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To: Crispy
What's yer beef with me? Or is ya mad at leadhead?

I'm a firm believer that people genereally deserve whatever their elected officials foist on them, but saying that Oregon deserves HillaryCare is akin to saying that Maryland deserves a serial sniper for passing all of those stupid gun control measurtes.

20 posted on 11/01/2002 9:21:01 AM PST by gundog
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