Dembrow Intends to Keep Single Payer Movement Alive Next Session

The Portland legislator is convinced that a single payer health system is the most affordable and comprehensive option
The Lund Report

October 18, 2012 -- Despite the emphasis on healthcare transformation, evident by the $1.9 billion in federal funds that Governor John Kitzhaber garnered to implement coordinated care organizations, the single payer movement isn’t dead in Oregon.

Its champion, Rep. Michael Dembrow (D-Portland) plans to re-introduce the same legislation again next February. In 2011, it received a hearing in the House but stalled there (House Bill 3510).

This time around, Dembrow has his eyes set on having public hearings in both the House and Senate healthcare committees.

“I don’t see transformation and single payer as being mutually exclusive, but complimentary,” Dembrow said. “The principles of coordinating care are very much the same with the single payer philosophy – focusing on focusing on prevention and primary care including oral health and mental health as well as physical health.”

But Dembrow faces an uphill battle with his legislative colleagues, among them Rep., Tina Kotek (D-Portland) who said she applauded the conversation in 2011 but wants to let the dust settle on health reform before jumping on board.

“With the Affordable Care Act and the coordinated care organizations, we need to see how they work first. If they don’t work we’ll have to move to single payer because it’s an economic issue. People need access to healthcare, and my hope is that restructuring the Oregon Health Plan we can eventually impact and transform the entire private system. Let’s go there first.”

Rep. Bruce Hanna (R-Roseburg) said he’s never seen evidence showing that single payer is the best alternative. “Single payer takes away the competitive nature of providing healthcare. Anytime you eliminate competition, you increase costs, not decrease them.”

Nevertheless, Dembrow plowing ahead and insists that people have serious questions about the impact of the Affordable Care Act.

“It’s a move in the right direction but will still leave people without affordable coverage. Single payer is where we need to wind up as a country because it’s going be most affordable option. In principle, it will extend Medicare to all Oregonians and lead to lower administrative costs, less paperwork and be more comprehensive.”

Thousands of Oregonians favor a single payer system, he believes. “They’re calling for us to move in this direction, and this legislation will create a focus for their organizing to keep this movement going.”

Next session, Dembrow’s also contemplating legislation that would call for a constitutional amendment saying healthcare is a fundamental right, an issue championed in the past by Rep. Mitch Greenlick (D-Portland). If successful, it would appear on the November 2014 ballot.

A rally being planned for the opening day of the session next February could draw support for such an amendment.

“If we do go forward with the constitutional referral, it’ll be kicked off then, but we’ll only go forward if I feel like there’s real potential for a statewide organization,” he said. “I don’t want to put this measure on the ballot unless I feel that proponents are willing to organize at the grassroots level to get it through.”

Dembrow realized the need for a single payer system after the birth of his first child, who needed surgery when he was two weeks old. Both he and his wife were graduate students at the time, and the medical bill completely wiped out their savings. Four years later, his daughter was born in France, and Dembrow encountered the single payer system firsthand. “All of our contributions came directly out of our paycheck; we had an excellent level of care without any kind of hardship or worry.”

Later, as president of the faculty union at Portland Community College, he saw the struggles that teachers faced who worked part-time and didn’t have access to healthcare. That led Dembrow to create a fund allowing these educators to be reimbursed for their insurance bills.

During his first stint in the legislature in 2009, he succeeded in passing legislation that allowed part-time faculty to combine their employment from multiple public colleges or universities and become eligible to purchase benefits from the Oregon Educators Benefit Board.

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Comments

People who favor single payer plans often assume that people who oppose it think that we don't have a problem. We have a huge problem, which is primarily hidden price-fixing and complete lack of competition, resulting in escalating costs. In favor of single payer is the idea that one does not need to worry about the cost, or save up for things. In favor of it is the idea that you will get what you need, and probably you would, most of the time. The problems include that when you don't worry about the cost, people make too many visits for things they don't really need, and resources are not optimally allocated. Costs really can't come down, and all efforts to decrease costs involve more bureaucracy. The only way to control costs is always some form of rationing. Eventually, single payer harms the economy, and must be reined in. That leads to the biggest problem, which is that sometimes you will NOT get what you need, and that you no longer have the freedom to seek out what is best for you. Single payer is the opposite of freedom, but a lot of people do not seem to value freedom. I know that I do. And, I will not practice medicine under a single payer plan, and any doctor that took their oath seriously, to do their best for each individual, cannot in all honesty practice under single payer. The "new ethic", advocated by many in medical academia, is to "balance the needs of the individual with the needs of society". I would not see a doctor who feels that way, as I would not trust such a doctor. There is an alternative. Allow competition. Competition and true choice have become almost illegal in health care. Wherever there is competition, prices come down and quality often improves. Then, the number of people who need safety nets would drastically decrease. We do not have to have rationing; we can have a flourishing health care system, with an abundance of choices. It is truly possible! We are in the information age. Empowered patients can transform health care; that is, if they are allowed.

Kathleen, I couldn't disagree with you more. Single-payer advocates are very concerned about costs. The private insurance industry ("the free market") has failed. They provide a bad product, where the premiums far exceed inflation and whose only real interest is their fiduciary responsibility to their investors. Saving and redirecting the redundant overhead costs and the profit of the private insurance industry would more than pay for the total annual cost of Universal healthcare in the US. Single-payer advocates want a public insurance system with private delivery...... Private delivery! We have major healthcare rationing now. If you have money, a great job or are in the safety net... you get care. If you are the working poor, you don't get care. Don't be reassured by having insurance though (bad product). Most people who go bankrupt do so because of healthcare costs. Most of these people had health insurance when they got sick or injured. There is significantly less choice with our current system then there would be with a Single-payer system. Healthcare providers would compete on quality and accessibility. People would have the ability to choose and physician they wanted.