Oregon to Look at Single-Payer Bill Next Session
The bill would ultimately work in conjunction with the state’s ongoing efforts to form a health insurance exchange and possibly a public option, supporters say.
State Rep. Michael Dembrow, a first-term Democrat from northeast Portland, is interested in sponsoring a state-based single-payer bill, but first wants to give advocates a chance to reach consensus.
Groups involved in the effort include Portland Jobs with Justice, Physicians for a National Health Program with chapters in Corvallis and Portland, Health Care For All Oregon and the League of Women Voters.
“It’s all very preliminary,” Dembrow said. “There are many of us who feel that ultimately the best way to pay for healthcare is through a single-payer program – not deliver it, but pay for it. It’s something that needs to remain in the conversation.”
States including Vermont, Minnesota, Pennsylvania and California – where a Democratic-controlled legislature twice passed single-payer bills that were vetoed by Gov. Arnold Schwarzenegger – are also working on single-payer legislation this year.
A recent letter from U.S. Sen. Ron Wyden (D-Oregon) to Democratic and Republican leaders in the Oregon Legislature gave encouragement to the idea of seeking federal waivers so states can pursue innovative ideas that go further than the federal law. The letter did not, however, offer any specific concepts.
“I write to lend my support to your efforts to develop an Oregon-specific plan for our state to do health reform its own way,” the letter states. “I believe in the concept of ‘state choice,’ and that every state has the right to provide healthcare to its own residents in its own way, as long as the goal is to provide all citizens with quality, comprehensive coverage.”
Wyden said he authored section 1331 of the Patient Protection and Affordable Care Act to give states the ability to continue working toward cost-effective healthcare while retaining access to federal funding.
“We don’t see ourselves as acting in contradiction to anything people are doing in Salem,” said Peter Shapiro, an organizer with Portland Jobs with Justice. “We just see it as part of the mix.”
While the details of the proposed bill haven’t been ironed out, the tenets are strong. There would be a dedicated tax based on ability to pay, universal access, and a shared risk pool to increase purchasing power and reduce administrative costs.
“The basic principle is equity,” Shapiro said. “Everybody should have the same access to treatment regardless of how much risk they are or how much money they have in the bank.”
The group will soon begin working with a consultant on the costs of such a plan and the barriers, including ERISA that governs employee benefits, that could be overcome with federal waivers.
The Oregon State Public Interest Research Group is also pushing state healthcare leaders to do more with what’s already allowed in the federal law passed earlier this year. OSPIRG’s efforts, however, have focused on strengthening the health insurance exchange and creating a strong state-based public health insurance option, not a single-payer plan.
Laura Etherton, OSPIRG’s healthcare lobbyist, is pleased Oregon is among the first states to get out of the blocks to establish an exchange where individuals and small groups can purchase insurance that’s highly regulated and possibly subsidized. But, thus far, the draft plan which was released on Aug 14 falls short, Etherton said.
“Just an exchange by itself is not going to solve all the problems in healthcare,” she said. “But it’s a great tool to help us drive solutions.”
Etherton said the draft plan doesn’t allow the exchange to negotiate premiums on behalf of its members. It could include small businesses with more than 50 employees earlier. It needs stronger public accountability. And it lacks adequate protections to prevent the insurance industry from undermining the exchange’s stability, she said.
According to OSPIRG, the exchange as currently drafted would “let insurers cherry-pick only the healthiest people, and enroll them in plans only available outside the exchange. This would leave older, relatively less-healthy people inside the exchange.”
“The details matter,” Etherton wrote in comments to the draft plan on OSPIRG’s website. “Done right, the exchange will pool the buying power of hundreds of thousands of Oregonians, so all of us can get a better deal on healthcare. But done wrong, the exchange will just be a nifty website with the same expensive plans and spotty coverage.”
Single-payer advocates hope the state goes a whole lot further.
“There are a lot of people who want to see the conversation about single payer still happen,” Dembrow said. “I hope the federal plan will work. I’d like to see the state really seize the moment.”
To Learn More
Health insurance exchange draft plan.
To submit your own public comments click here.
Physicians for a National Health Program.
For related coverage click here.
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PPACA requires state exchanges by 2014. What to know in 2010? Underlying complexity will sneak up on the unprepared - http://www.healthcaretownhall.com/?p=2875
Single Payer Health Care - Dead In Oregon. Dead In America.
There are 535 members of congress and 90 members of the Oregon legislature. These are the ONLY people in the United States that can bring a Single Payer health care system to America and Oregon.
Single Payer Health Care - Dead In Oregon. Dead In America. EVIDENCE
1. The president of the United States of America does not support Single Payer.
2. The current governor and the candidates for governor of Oregon do not support Single Payer.
3. Neither the U.S. House of Representatives nor the U.S. Senate has ever been allowed to vote on Single Payer legislation.
4. Not one member of the Oregon congressional delegation supports Single Payer.
5. Not one member of the 2009 Oregon legislature supported Single Payer.
6. No Republican candidate for the U.S. Congress and the Oregon legislature has or will support Single Payer.
7. The Democratic Party of Oregon failed to persuade even one Democratic candidate for congress and the Oregon legislature to support its Single Payer resolution. [The DPO was several years behind Single Payer advocate and recent Democratic candidate for the North Portland House seat Richard Ellmyer.]
8. There will not be any member of the 2011 Oregon legislature that supports Single Payer.
9. Portland, Multnomah and Lane counties voted for Single Payer resolutions but allocated no resources to lobby state and federal officials. The Portland city council and the Lane and Multnomah county commissions failed to contact one another in order to devise a unified strategy to accomplish their similar goals.
10. The AFL-CIO and American Federation of Teachers both threatened Democratic candidate for the Oregon legislature Richard Ellmyer because he publicly exposed and championed their passage of Single Payer resolutions.
11. The Oregon legislative leadership and every member of the 2007 and 2009 Oregon legislatures summarily and discourteously rejected this letter signed by elected officials representing more than a million Oregonians.
Dear House Speaker Hunt (Merkley) and Senate President Courtney Et. Al.:
The current legislative debate over health care reform in our state does not include our view that the profit oriented private health insurance industry must not be the model upon which a solution to Oregon's moral and economic health care crisis should be based and that Oregon elected officials - public employees - voters and taxpayers must have EQUAL ACCESS to the SAME LEVEL of health care NOT a perpetuation of our current multitiered health insurance CLASS system.
We request that you find a place holder bill in each chamber which would substitute in its entirety the language of the Oregon Community Health Care Bill (see attached) so that an alternative choice may be discussed and debated this session. The Oregon Community Health Care Bill is the only current fully formed piece of proposed legislation which supports our vision of health care reform. We would welcome others that also meet our requirements.
Thank you for your attention.
Sincerely,
Richard Ellmyer - Oregon Community Health Care Bill author 2004
Sam Adams - Portland City Council 2007
Jeff Cogen - Multnomah County Commissioner 2007
Edwars "Chip" Enbody - Hubbard City Council 2007
Darrell Flood - Mayor of Lafayette 2007
Bill Hall - Lincoln County Commissioner 2007
Jim Needham - Mollala City Council 2007
Michelle Ripple - Wilsonville City Council 2007
Mary Schamehorn - Mayor of Bandon 2007
Pete Sorenson - Lane County Commissioner 2007
John Frohnmayer - Former candidate for US Senate 2008
Tim Grimes - Staton City Council 2008
David P. Trott - Mayor City of Umatilla 2008
Bill Dwyer - Lane County Commissioner 2008
Dan K. Cummings - Ontario City Council President 2008
Mark Camra - Toledo City Councilor 2009
Don Porter - Mayor of Long Creek 2009
Thomas Bradley - Long Creek City Council 2009
Fred Drake - Long Creek City Council 2009
Alvin Hunt - Long Creek City Council 2009
12. The Oregon legislative leadership and members of the 2007 and 2009 Oregon legislatures made every effort to deny access to the legislative process to those Oregonians who supported Single Payer.
13. Not one union that passed a Single Payer resolution endorsed and supported any candidate for federal or state legislative office that campaigned in support of Single Payer.
AFL-CIO
AFSCME District Council 75
Amalgamated Transit Union Local 757
American Federation of Government Employees Local 2157
American Federation of Teachers Local 5017
International Alliance of Theatrical Stage Employees
Oregon Education Association
Oregon Federation of Nurses & Health Professionals
Oregon Nurses Association
Oregon Teamsters Local 206
Painters Local 10
State Council of Machinists (IAM)
14. The business community of Oregon represented by Associated Oregon Industries, the Portland Business Alliance and Chambers of Commerce throughout Oregon did not support Single Payer.
15. A resolution of support for Single Payer means the removal of the for-profit health insurance industry as the foundation for delivery of health care to Oregonians. It means the repeal of the recently passed federal health insurance bill and the Billion dollar health care bill passed by the Oregon legislature in 2007. A resolution of support for Single Payer means political confrontation of the highest order. No elected official nor candidate for elected office in Oregon, including those running for governor, has the demonstrated courage for such a battle, except the former candidate for the North Portland House seat, Richard Ellmyer.
16. Bill Moyers, America's most courageous journalist and the American most responsible for giving voice to the Single Payer arguments, has ended his inspiring and edifying program, Bill Moyer's Journal.
17. The corporate ownership of every media company in Oregon opposes Single Payer.
Conclusions
A. There is no chance nor hope that a Single Payer health care system of any kind will be voted upon much less passed by the U.S. Congress or the Oregon legislature in the foreseeable future.
B. The for-profit health insurance and pharmaceutical industries will continue their legal and rightful corporate obligation to maximize shareholder profits by charging whatever the market will bear.
C. The for-profit health insurance and pharmaceutical industries will continue to use their legions of lawyers, lobbyists and legislators under their control to seek out every loophole and stop any legislation that would impede profit making opportunities.
D. The congress of the United States of America and the Oregon legislature will not, indeed, they cannot stand up to the superior forces of the for-profit health insurance and pharmaceutical industries.
E. Unless and until every elected official, every public employee - including military personnel, and every American citizen are all covered by the same health care plan, we Americans and Oregonians will continue to have an unjust and unfair health care class system which will erode our democratic values, competitiveness and prosperity.
If there are any members of Oregon's congressional delegation, Oregon's legislature, leaders of public jurisdictions, unions, business groups or media corporations that would challenge the veracity and relevance of my evidence and the reasoned logic of my conclusions please contact me to discuss a public conversation/debate.
Good luck and good health.
Richard Ellmyer
Oregonian by choice - 39 years
American by birth - 64 years
This post is too long to respond to all the inaccuracies in it, but for the record: Jeff Merkley was prepared to vote for Bernie Sanders's single payer bill and would have done so had Republican parliamentary maneuvers not prevented it from coming to the floor. Michael Dembrow is involved in drafting a single payer bill which he plans to introduce in for the 2011 legislative session in Salem. Chip Shields is committed to sponsoring a companion bill in the state Senate. Jobs with Justice has talked to at least a dozen state legislators who are open to co-sponsoring such a bill.
Single payer will have to happen, sooner or later, because we will not be able to resolve our health care crisis without it. Less ambitious reforms may provide a some measure of relief, but the burdens on state budgets and the economy generally will keep growing as long as the administrative costs of maintaining a private insurance system continue to eat up 30 percent of our health care dollars. More and more people are coming to understand this, and some of them are politicians.
Dear Mr. Richard Ellmyer,
Your points are well made and demonstrate that it won't be easy. But single payer is the right thing to do, so we must work hard and not despair. Back in the 1960's you could have easily assumed that South African apartheid and the lack of civil rights presented insurmountable problems because of entrenched special interests. But on June 6, 1966, at the University of Capetown, Robert F. Kennedy in the Day of Affirmation Address, explains why me must continue and not give up.
"We must do it for the single and fundamental reason that it is the right thing to do."
Randal S. Davis
Portland, Oregon
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