A result-oriented business consultant and a Republican, Warren George’s presence on a new state board gave hope to some that it could succeed in designing an on-ramp to universal health care for more than 4 million Oregonians.
But five months after its launch, George is stepping down, saying the new board has put staff in the driver’s seat instead of its volunteer members.
Having formerly managed large manufacturing plants, George was seen by some observers as proof that support for universal health care could expand beyond progressive true believers and become more than a bumper sticker. Advocates hoped his background in finance and management would help steer the plan in the right direction.
His decision to step down deals a blow to prospects for a board that already had faced skepticism among business interests and the state’s Democratic governor.
“Warren is a man with real-world practical experience in business, in labor-management relations and in dealing with healthcare benefits from the employer standpoint,” Dr. Sam Metz, a physician and single-payer advocate. “It is a much-needed perspective, unique on the board.”
“It’s pretty clear it’s not going to be my way. The most constructive thing that I can do is to not be constantly at odds with them.”
George’s resignation comes as others are raising concerns that the board is not on track to answer thorny questions of how to finance universal health care, a problem that doomed similar efforts in other states. The board has a September 2026 deadline to deliver a comprehensive plan to implement a new universal health system.
The board has “done very little of the work expected of it” and will need to accelerate its pace, Metz said.
Board grew out of earlier report
The board grew out of earlier efforts to explore universal health care in Oregon. In 2022 a task force released a report that laid out a plan to create a statewide health insurance plan that would provide robust coverage without co-pays, deductibles and other costs blamed for burdening patients.
The following year lawmakers approved legislation setting up the board. The approved bill removed language requiring the board to specifically create a “single-payer system” and instead directed it to create a “universal health plan.”
Universal health care is often associated with single-payer plans, such as those in Britain or Canada where the government pays all expenses. However, it can also mean a hybrid that includes public and private insurers and may include a transition period.
Oregon has achieved near-universal health coverage through a combination of public and private insurance. But supporters of Oregon’s universal health plan effort hope to fix a health system they say leaves too many unable to access care because of high costs.
Last year, while signing the bill creating the board, Gov. Tina Kotek expressed support for universal health coverage but expressed concern that the board lacked clear direction and could be duplicative as well as more costly than anticipated.
Growing concerns
George’s resignation comes amid increasing concerns among observers of the board’s work.
“Please move on to the question of how to pay for the system immediately,” Karen Christianson, legislative chair of Mid Valley Health Care Advocates, wrote in a recent comment to the board. She continued, “This will be the first question the legislature will ask, and you must have a clear answer for them and the people of Oregon or this effort will be a failure.”
Comments from Corvallis doctors Mike Huntington and Bruce Thomson raised concerns that staff at the Oregon Health Authority, which oversees most public health care spending in the state, was having an undue influence on its work. They also wrote that board members “cannot build vital relationships and effectively share ideas” under guidance from state attorneys advising them not to communicate with each other outside of meetings to avoid running afoul of state laws such as open-meetings law.
Tom Sincic, a retired nurse practitioner and single-payer advocate, criticized the board during its public comment period in September for including a discussion about the health authority's program to control health care spending.
“This time may be better spent focusing on organizing around the work of the committees and continuing a discussion of how to identify the many revenue sources known and yet to be discovered that are being spent that makes healthcare so expensive,” he said.
“You’ve got this hill of people who all have been told, ‘It’s gonna solve everybody’s problem.’ Well, no. You’re gonna have to pay for it, right? And we can’t do everything for everybody immediately.”
Dr. Helen Bellanca, the board’s chair, denied during its September meeting that health authority staff were overstepping their role. She added that a financial plan is the board’s “highest priority.”
Bellanca told The Lund Report recently that the approved legislation did not include funding to pay board members, resulting in state employees having a large role in its work.
‘You actually have to do some unpleasant things’
Bespectacled and wearing a pink button-down shirt, George’s demeanor easily toggles between chuckling affability and intent seriousness. In between sips of lemonade at a restaurant in Wilsonville, George shared with The Lund Report his thoughts on achieving universal coverage.
George, 74, cited family considerations when informing the board of his resignation, and he told The Lund Report he wants to maximize his time with his wife after recently celebrating their 50th anniversary.
But he said he’s also leaving because the board is relying too much on its staff and is outsourcing key work to consultants when he said citizens should be driving innovation.
“This time may be better spent focusing on organizing around the work of the committees and continuing a discussion of how to identify the many revenue sources known and yet to be discovered that are being spent that makes healthcare so expensive."
“It’s pretty clear it’s not going to be my way,” George said. “The most constructive thing that I can do is to not be constantly at odds with them.”
To show how close Oregon is to having single-payer health care, George scribbled a diagram on a legal pad. On one side, he drew a label for “a social justice movement.” On the other side, he drew a label for “a rock solid business plan.” He then drew a hill and a river separating the two.
Getting from the movement to a business plan means “you actually have to do some unpleasant things,” he said.
Other states have considered single-payer plans to control costs and improve access. But questions over how to pay for state-based single -payer systems helped sink efforts in Colorado, Vermont and California.
“You’ve got this hill of people who all have been told, ‘It’s gonna solve everybody’s problem,’” he said. “Well, no. You’re gonna have to pay for it, right? And we can’t do everything for everybody immediately.”
George hoped the board would include more people from the business community, where he said there is a surprisingly strong source of quiet interest in single-payer health care.
Businesses want healthy communities and are interested in addressing the cost, complexity and injustice of the current health care system, he said. Many business leaders resent being cast as uncaring and could be persuaded to support a single-payer system that treated health care like a utility or other essential public service, he said.
George, who described himself as a “Hatfield Republican,” said that the current political landscape makes it difficult for businesses to embrace single-payer because its biggest advocates are unions, progressives and others typically opposed to commercial interests.
“One of my complaints about advocates is that by choosing their friends, they’ve chosen their enemies,” he said.
He said that a single-payer plan could be phased in gradually with a smaller price tag by covering only cancer and other expensive treatments or primary care.
George in 2019 sponsored a poll that showed broad support for a universal health plan, including in more conservative rural areas. He said his big takeaway from the poll was that “if you treat it as a non-partisan thing, you're going to get higher support.”
Bellanca, the board chair, said George will be missed on the board and that he brought an “important voice” to the discussion.
She said the board is organizing four committees to advise the board and preparing to hire a firm to prepare a financial analysis.
“We are at an exciting turning point and that is bringing on more people and this is a really big job,” she said. “We need Oregonians involved and experts from wherever they come from.”
But she said hopes George stays involved and has asked him to serve on its finance committee.
George said he is interested in staying involved.
“I really believe in a universal health system where everybody gets adequate benefits under one plan,” he said.
What do other Governance Board members say about George’s resignation?