Single-Payer Healthcare May Go Before Voters in 2016

A previous ballot measure to create a single-payer system failed in 2002, but activists say they'd try to head that off with a better education campaign

June 20, 2013 – Supporters of a single-payer healthcare system may decide to put the issue before voters in 2016, depending on what members of the statewide coalition who were behind this year's failed single-payer bill in the Oregon Legislature decide at next week's annual meeting.

Peter Shapiro, who serves as organizational development co-chair for Health Care for All Oregon – which will bring members from all over the state to Eugene to discuss the successes and failures of this legislative session, as well as to plan for the future – intends to go over a “fairly detailed political agenda” including some brainstorming about how to proceed in the coming year and beyond.

The group is likely to lobby for another single-payer bill next session, like the one introduced by Rep. Michael Dembrow (D-Portland) this year. That bill failed to make it out of committee due to an impasse over the state budget, which activists said was not surprising.

Earlier this week, a bill that would require the Oregon Health Authority to contract with a third party to study the best way to finance healthcare in the state passed out of the Ways and Means Committee. Health Care for All Oregon wasn't as active in lobbying for the bill, but activists hope it will help their cause.

“It's a bipartisan bill, and not just a single payer thing,” because it would require investigation of other systems as well,” Shapiro said.

Still, organizers have been enthusiastic about the bill, because it has the potential to be budget-neutral – the Oregon Health Authority may be able to procure private foundation funding rather than tax dollars to conduct the research – and the bill has had broad support so far.

As for the continued push for single-payer, Shapiro said he has mixed feelings about the possibility of a ballot initiative campaign, though that's likely to come up in next week's discussion.

A previous ballot measure – Measure 23 – went before Oregon voters in 2002 and failed, an outcome Shapiro attributed to a “flood of insurance money coming from around the country” which funded an advertising campaign that caused the measure's majority support to tank to 23 percent.

“We want to be sure, before we go to the voters, that people know what kind of arguments to expect,” Shapiro said.

Still, Shapiro has mixed feelings about the idea of a ballot initiative.

“The problem I have with the initiative campaign, aside from the fact that they're expensive and time consuming, is that once it's passed, it's written in stone” and can't be amended, he said.

Bill Whitaker, Health Care for All Oregon's board treasurer, who's organized a chapter of the organization in La Grande that has 60 people on its roster -- 20 to 25 of whom regularly participate in meetings or other activities -- said he hopes the study bill passes because he believes it will show – as similar studies have in other states – that a single-payer system is “more fiscally conservative” than other ways of paying for healthcare.

“What we've found is that when we ask people if they think that everyone should have access to affordable healthcare, we find most people – regardless of their political persuasion – think that makes sense,” Whitaker said of his efforts to organize a chapter in Union County, where the majority of voters with a party affiliation are registered as Republican. “I think what ultimately will happen is that Republicans are going to realize that the only fiscally responsible way we can provide universal coverage is to go to a universal payer system,” he added.

“Some of the Republican criticisms of the Affordable Care Act are correct. It's expensive,” Shapiro said, and will still leave nearly 300,000 Oregonians uninsured once it’s fully implemented. Shapiro argued that neither the Affordable Care Act nor the state's healthcare transformation efforts will adequately address the needs of certain workers, including undocumented immigrants, as well as some workers in the building trades.

“A lot of union health plans could be seriously undermined by the exchanges,” Shapiro said, such as the Taft-Hartley plans offered to union construction workers. “Apart from the practical matter of their ending up in the emergency room which costs more, it's fundamentally immoral.”

Image for this story by HCAO (CC BY-NC-ND 2.0) via Flickr.

Christen McCurdy can be reached at [email protected].

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