Sen. Michael Dembrow’s bill to study healthcare financing in Oregon died last Friday, but it rose again on Sine Die Monday, as Sen. Alan Bates, D-Ashland, reaffirmed his support in a 16-14 vote on the final day of the 2015 legislative session.
Near the start of the Monday morning Senate floor session, Bates said he was changing his vote “with two broken arms,” and while he’d offer his begrudging support, he highlighted the single-payer aspect of the study and described it as a lost cause.
“I think we’re going to spend $300,000 in this state on something that’s not going to happen,” said Bates, an osteopathic family physician. “I don’t want to spend money on this [study] ever again. Our present healthcare system is barely sustainable and I don’t want to put any more load on it.”
Bates had been a sponsor of House Bill 2828, but in a moment of fatigue and frustration on Friday, his nay vote sank the bill, as its supporters looked on, stunned. His opposition led a Republican supporter, Sen. Jackie Winters of Salem, to switch her vote, and Democratic Sens. Mark Hass of Beaverton and Chuck Riley of Hillsboro also voted it down.
The senator from Ashland was clearly frustrated that Senate President Peter Courtney, D-Salem, had kept the Senate in session at 6 p.m. on a holiday, while Bates had to drive five hours back to Southern Oregon. He complained aloud on the floor about having to make the long return trip, pleading with Courtney to not require an early-morning session Monday.
Bates is equally passionate about shaping public policy and practicing medicine. Since February, he has kept a grueling weekly schedule of four days of lawmaking in Salem, followed by three days at his clinic in Jackson County.
Dembrow never regained the support of Hass or Winters, both of whom supported an unfunded study in 2013, along with Sen. Betsy Johnson, D-Scappoose and three other Republicans, including Sen. Jeff Kruse of Roseburg. All Democrats and one Republican -- Rep. Andy Olson of Albany -- supported HB 2828 in an earlier House vote.
Now that the study looked to actually be going forward, Johnson suddenly had concerns that it might be tainted by a small amount of private funding from the Northwest Health Foundation that will supplement state resources.
House Bill 2828 authorizes $300,000 for the Oregon Health Authority to oversee a comprehensive study of healthcare financing in Oregon, one that will look at a number of possible situations, including single payer, a public option on the insurance exchange, and a full rollout of the Affordable Care Act, possibly with a Basic Health Plan for working-class residents.
Dembrow highlighted the support of Oregon Health & Science University President Dr. Joe Robertson, the Oregon Public Health Association and the Oregon Medical Association. Aside from examining the expansion of a Medicare-like system -- the single-payer option -- Dembrow hinted that HB 2828 could give the state insights into less revolutionary reform efforts.
“The results of this study could strengthen the existing CCO system,” he said, referring to the coordinated care organizations that manage the Oregon Health Plan for low-income residents.
Single-payer advocates have also said they will use the results of the study to serve as the backbone for a ballot measure charging the Oregon Legislature with implementing a universal healthcare system. Measure 91, legalizing recreational marijuana sales, was approved by the voters but carried out by the Legislature, and had a similar implementation structure.
Although Dr. John Kitzhaber, the former Oregon governor, has always taken an ambivalent stance towards single payer, Kruse tied Kitzhaber to HB 2828 like an albatross, now that he no longer supports the study: “Our former governor, who resigned in disgrace, was always a supporter of single payer. … Friends, a move to have the government take control of healthcare is one of the worst things we can do for our citizens.”
Another Republican, Sen. Brian Boquist of McMinnville, was more judicious. He said he did not actually oppose the study, he just thought the Oregon Health Authority was wasting well more than $300,000 in its existing $19.5 billion budget through duplicative programming. “We just need to tell them to go study it,” he said.
