As Oregon continues to contend with the pandemic, health care workforce shortages, and the impending loss of Oregon Health Plan coverage for hundreds of thousands of people, the state’s next governor will have no shortage of health care crises to tackle.
The Lund Report reached out to top contenders in the 2022 gubernatorial race to see how they’d address the state’s most pressing problems related to health care. Here’s how Betsy Johnson, a former Democrat who is running unaffiliated, replied to our questions:
What specific policy would you pursue to improve health care for Oregonians?
I believe strongly that health care is a place where government needs to show-up for people when they really need it.
As a State Senator, I have supported funding to expand health care services to Oregonians in need. As an independent governor, I will lead on health care with the best ideas from both parties. Democrats are right that government health care programs should be accessible and affordable for low-income Oregonians. Republicans are also right that we must protect the role of the private sector in delivering care to ensure innovation, efficiency, and the unique relationship between providers and patients. I believe providing health care to those in need should be a collaborative partnership between government and the private sector. I do not support a government take-over of the health care system — from insurance to doctors or hospitals.
Due to a serious automobile accident, after which I spent six months in a wheelchair, I have been a consumer of health care more than I would prefer. However, I don’t consider myself a health care policy expert. As governor, I will surround myself with diverse, smart health care minds from both the public and private sectors. People with practical health care experience as well as policy experts.
The pandemic strained our health care system and it remains fragile. As we emerge from this unprecedented crisis, we should consider many policies at the same time. My guiding principles in health care policy will be access, affordability, quality, innovation and transparency. My first goal will be greater emphasis on policies and incentives to keep people healthy and out of expensive emergency rooms. Programs that include mental health treatment, chronic disease management and better nutrition, for example, are more affordable than hospital care. We also need to encourage more young people to choose health care as a career. Our health care system cannot survive without a qualified, sustainable workforce, and that workforce has withered away over the last two years. We can help this dire workforce shortage by offering tuition assistance and better vocational training and expanding the role of advanced practice medical professionals.
Oregon is simultaneously in the midst of addiction and behavioral health system crises. What is your plan for ensuring Oregonians have access to treatment when they need it?
Sadly, Oregon has become good at legalizing drugs and bad at graduating kids from high school. We rank first for addiction and near the bottom in mental health services. The pandemic made things even worse. Right now, Oregon is a perfect storm for individuals with addiction and behavioral health problems and for communities in every corner of Oregon trying to manage the negative consequences and relationship between drugs, mental health, homelessness and public safety. As governor, I will look beyond ideology and partisan divides and take the best ideas from both parties. Democrats are right that we need compassion, services and housing. But Republicans are right that we should expect personal responsibility, accountability and no more tent cities. Using our streets as waiting rooms for services or long-term housing is dangerous and inhumane. Compassion without consequences is chaos. I believe the state of Oregon should declare a state of emergency to address our crisis of addiction and mental health. We need to rebuild partnerships with all of our county health departments and provide staffing and resources for both inpatient and outpatient care. We need to demand that Portland and Multnomah County provide a greater focus on short-term shelter with access to life-saving services while longer-term solutions are ramping up.
Finally, the situation with Ballot Measure 110 is unacceptable. People are literally dying while state government fails to show up. I opposed BM 110 and remain very concerned that the effective legalization of hard drugs is a big mistake for our state. But, given the current law, Oregonians need the treatment and recovery programs they were promised — it’s life and death. As governor, I will not deflect this responsibility as Gov. Kate Brown is doing. But that’s 10 months from now. I believe Gov. Brown should immediately convene agency leaders, legislative leaders, addiction recovery leaders and law enforcement leaders to hammer out an emergency plan to stand up services and distribute funds within 60-90 days. Voters took a risk in approving this law, now government is proving itself incapable of implementing it.
What does Oregon need to do to rebuild its public health system — and strengthen it — to address disparities and improve equity?
First, let’s be clear. No one should be denied access to quality health care based on race or income. Unfortunately, our problems with access and affordability have been exacerbated by the political, government and health care leaders who squandered public trust and credibility during the pandemic. Ever-changing rules, excessive mandates, and policies appeared to be based as much on political science as actual science.
If we’re going to make real progress, we need the state to be a more effective partner with private health care systems. The state needs to be more consistent, reliable and accountable. We need to have the courage to collect the necessary data and evaluate outcomes from an equitable perspective. Specifically, we need stronger leadership from the Oregon Health Authority to coordinate these efforts, while still allowing local, regional programs to be flexible and creative to serve their own communities. Right now, at best we are inadequately responsive to equity concerns. We need to build an actual plan and drive it by bringing public and private health systems together to execute a common vision. This is why we need an independent governor who can make that happen.
About 300,000 people must exit the Oregon Health Plan over the coming year because their incomes exceed the threshold, and Oregon is in the early stages of developing a bridge plan to cover a fraction of them — the working poor who make up to twice the poverty level. Do you agree with those who say Oregon needs a more ambitious “public option” plan covering people with incomes four times the poverty level?
We must not let the ravages of inflation and economic circumstances penalize people who need health care and cannot afford it from receiving it. If we allow people to fall through the cracks, the state will only be paying more for other community services to address their future needs. Government needs to show up when people really need it. We need to renew our federal waiver to be able to use federal funds to support creative programs to serve those in poverty. Former Gov. John Kitzhaber, M.D. is leading an independent task force to propose legislation for 2023 for specific solutions. I welcome partnering with public and private health care leaders to shore up our services for low-income residents. If we can stabilize the health care of those receiving assistance, we create a bridge for people to achieve better, safer and happier lives. We also need to require the accountability of people using public programs to be responsible and see this support as a moment in time and not a permanent state.
Oregon’s public health response to the pandemic has been criticized from different perspectives. What is your take on what worked well and what did not?
Front-line health care workers in every corner of Oregon went to heroic levels to keep us healthy and safe during the pandemic. I am grateful. The proactive and early pandemic actions to slow the spread of COVID led to fewer deaths and less serious illness than many other states.
That does not mean, however, that every policy and decision was necessary to achieve these results. Closing schools was Oregon’s biggest mistake, especially after the first school year. Our kids lost two years of learning and suffered serious long-term mental and emotional impacts. Putting teachers ahead of seniors in the vaccination line — and then not requiring schools to re-open — was cruel, unfair and damaged public trust. Mandated business closures were unnecessary and lasted way too long. Mask mandates lasted too long. Specialty clinics and out-patient surgery centers should have remained open to provide routine care.
Mostly, it was the unwillingness of state political leaders, especially Gov. Brown, to recognize and balance the economic, education and health care needs of the state and instead to simply prescribe severe lockdowns as the only solution. I believe a central cause of this know-it-all attitude and one-size-fits-all policy approach was the nearly unrestricted executive authority given (and used) by the governor and the decision by the Legislature to remain isolated and apart from the people they represent for too long by working remotely.
View responses from other leading gubernatorial candidates in Oregon’s 2022 election here.