Healthcare Transformation Bill Moves Forward

Weeks of behind-the-door negotiations end
The Lund Report

June 22, 2011— The healthcare transformation bill that will completely overhaul the Oregon Health Plan is moving forward, after weeks of intense behind-the-scenes political negotiations, as well as rumors among lobbyists, advocates, providers and others regarding what would happen to the bill.

This evening, the Joint Ways and Means Capital Construction Committee voted unanimously to move House Bill 3650 to the full Joint Ways and  Means Committee, recommending that the committee approve the bill. That will allow it to move toward House and Senate floor votes.
The committee, which met for a total of 25 minutes to consider eight bills, passed the transformation bill without discussion.
Within seconds of the vote, Governor John Kitzhaber released a press statement lauding the vote. “The Legislature’s action today is critical to ensuring that Oregonians get better healthcare at a lower cost,” the paragraph-long press statement read. “The bipartisan leadership that has brought us to this point demonstrates just how effective we can be at addressing the real issues facing our state when Democrats and Republicans come together.”
The Capital Construction Committee is a seemingly innocuous committee, but it's made up solely of legislative leadership, including the House’s two co-chairs, Rep. Arnie Roblan (D-Coos Bay) and Rep. Bruce Hanna (R-Roseburg) and Senate President Peter Courtney (D-Salem).
When a bill is sent to that committee, it's usually a signal that the bill is politically controversial. Negotiations typically take place behind closed doors, and everything is agreed to prior to the bill coming before the committee, which passes it out without discussion.
The committee adopted amendments to the transformation bill that will give an additional $1.1 million in general fund dollars to the Oregon Health Authority to conduct a study related to defensive medicine and medical malpractice.
Those two issues became key sticking points during the Joint Committee on Healthcare Transformation’s May 4 meeting. Sen. Frank Morse (R-Albany) said that the bill would not get any Republican votes unless it dealt with tort reform. 
“If you want to save this bill, there's a way to do it and address medical malpractice,” he said at the meeting.
Sources told The Lund Report that collective bargaining for home health workers, tort reform and how the coordinated care organizations  created by the bill would be governed became the final three sticking points in the final weeks of negotiations.
The money will also be used for the Home Health Care Commission to develop a training and certification program for home health workers, who are expected to play a more significant role in the newly revamped Oregon Health Plan.
The transformation legislation will consolidate 40 managed care organizations that currently administer the Oregon Health Plan into regional organizations, called “coordinated care organizations.” Those organizations will coordinate physical, mental and dental healthcare for Oregon Health Plan clients and the dually eligible (those receiving both Medicaid and Medicare services). 
Those efforts are estimated to save roughly $700 million in total funds –$240 million in general fund dollars – during the second year of the biennium.   
The newest version of the bill, and the amendments discussed at tonight’s meeting, were not immediately available. The Lund Report will continue with follow-up coverage as soon as more information becomes available.


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Senator Morse's adamant insistence on the reform of medical malpractice should be addressed to the insurance industry. Medical malpractice as a total cost of medical care in this country is .5% or less. It would seem to me that looking at issues such as insisting on justification for medical insurance rate increases portend to save a significantly greater amount of money than any medical malpractice reform could ever achieve. It seems to me that the Republicans trot out this old, tired warhorse whenever they want to muddy the waters rather than add clarity to the discussion.

Tort reform is a real and needed element of our healthcare. The biggest impact that the lack of reform has is on whether providers will continue to see certain population pools that tend to be more risky and more prone to seek legal settlement. When you are going to require a provider to see all risk pools of patients then you have to provide some modicum of protection from that pool. The fact that there is NO recourse for filing frivolous law suits is the problem. The defendant does not have to lose the suit to lose s they are still out the legal billing, time out of clinic, possible damage in the public eye, etc. Court damages awarded to the defendant and public printed apology requirement would save a bundle as lawyers will not take the risk on these "let's just see what we can get" lawsuits.

Tort reform? Really? Think again--our rights are being "spun" out from under us. See the new documentary "Hot Coffee" and get a reality check:

As much as I like the idea of healthcare transformation, I hold no hope for any net improvement coming out of Washington. There are entire industries there thriving with the sole purpose of taking healthcare money from consumers' (and taxpayers') pockets. Of course, I just watched "Hot Coffee," last night, so I'm feeling a little more hopeless than usual today.