Comprehensive Health Reform Bill Nears Passage

Advocates say the bill is too soft on insurance rate review, but there’s much to applaud

May 28, 2009 -- A comprehensive health reform package winding its way through Oregon’s Legislature promises to reduce costs while improving quality.

“We’re going to end up with a world class healthcare system in Oregon that’s focused on prevention and primary care,” Eileen Brady, owner of New Seasons, told legislators on May 28. As a result, medical professionals will be proud to work in Oregon, said Brady, who co-chaired the Oregon Health Fund Board, which recommended House Bill 2009.

Other hearings are slated during the next few days in the Ways and Means Subcommittee on Human Resources, but victory is certain, according to Senator Alan Bates (D-Ashland).
Otherwise, he said, our healthcare system is headed toward a Wall Street meltdown. “We’re going to take steps to stop that from happening,” Bates said. “Not everyone loves this bill. Some advocates want a single payer system. But we have to move forward.”
What Oregon’s doing actually dovetails federal efforts, said Tom Burns, a consultant to Rep. Mitch Greenlick (D-Portland) who wrote House Bill 2009. “It could be two to four years before we see the impact of what happens in DC. We’ll be ahead of the game.”
But advocates aren’t happy with the compromise reached with the insurance industry over rate regulation. They wanted a limit placed on administrative expenses and a harsher review process for rate increases. “The legislature wasn’t willing to stand up to the insurance industry,” said Ellen Pinney, executive director of the Oregon Health Action Campaign. (For in-depth comments from OSPIRG lobbyist Laura Etherton click here.)
This legislation focuses on patient care, access and cost management. “It gives us a platform for a path toward universal affordable health care,” Brady said.
Within the next ten years, these reform efforts could save $10 billion, according to Dr. Bruce Goldberg, director of the Department of Human Services. In a nutshell, here’s what House Bill 2009 is expected to accomplish: 
  • Consolidate the purchasing power of governmental agencies to get better rates and focus on evidence-based care. City, county and state employees, public school teachers and Medicaid recipients would comprise the pool and represent 1 million lives.
  • Make certain that Oregon has an well trained work force that supports delivery system reforms.
  • Create an all-payer all-claims data base to compare costs and quality in order to achieve transparency.
  • Encourage people to have a primary care physician who can deal with asthma, obesity and diabetes and provide incentives to physicians.
  • Move toward electronic health records by capturing federal stimulus dollars.
  • Make investments in the health care work force to meet the growing demand.
  • Develop a premium-assistance program for moderate income Oregonians.
The Oregon Health Policy Board will be created to accomplish these goals. With the exception of one physician, the other eight members must be consumers who don’t work in the healthcare field. .
“That policy board will have an amazing amount of power, and will make lots of decisions,” said Burns, who urged advocates to “pound” on the governor’s office to nominate their colleagues. “It’s already being done by people who have a lot of money invested in the system.”
By the time the 2011 legislation meets, that board must devise a plan for an insurance exchange, a public purchasing option and a way to achieve universal coverage. Guaranteed issue (no pre-existing conditions) and community rating (charging everyone the same rate) will also top their agenda. “It’s not going to be an easy road map,” Burns said.

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