As In Vitro Fertilization Methods Improve, Abortion Rates Drop

Mardi Palan is a 30-year-old hair dresser from Portland. She has a partner and a one-year-old son. She hopes to carry twins for a gay couple from Israel.

If successful, she’ll get about $30,000 — money she hopes to use to buy a home.

In August, she had two embryos transferred and just found out via a blood test, that she’s pregnant. Does she feel different?

“Not really. I mean, like there were a couple of songs on the radio that I started crying to and that’s like how I knew," said Palan. "I was like, 'Oh yeah. Something's up.'"

As part of her contract with the intended parents, Palan has agreed to what people in the industry call "selective reduction" — that is, if an embryo develops a serious medical problem, or if it divides and she ends up carrying triplets.

"They have the right to abort the child if they don't want to go with it," she said. "They do a lot of testing when I'm carrying the baby to see if it has Down syndrome or things like that ... but I talked to them and they said if it was disabled they'd still have it."

In some countries like India or Nepal, it’s not unusual for three, four or more embryos to be transferred at a time — and to improve the odds, some companies will transfer that many eggs into multiple surrogates.

That can lead to a lot of "selective reduction" terminations.

But Palan is working with Oregon Reproductive Medicine in Portland.

Dr. Brandon Bankowski, who’s a partner at ORM, said the company focuses on reducing its rate of "selective reduction" by improving the science.

"Our goal is to get to the point where we transfer one embryo and we have one baby," said Bankowski. "The only options that we offer to our patients now are transferring one or two embryos. We would never transfer more than that."

On average, ORM transfers 1.7 embryos. Ten years ago, that average stood at about three embryos.  Still, said Bankowski, they do perform "selective reductions."

"This used to be something that we would talk about much more commonly," he said. "But because we only transfer one or two, it’s an incredibly rare thing for us to have to talk about. It’s essentially a needle procedure where you terminate one of the pregnancies. You can lose the entire pregnancy by doing that.”

Terminations are carried out well within legal time limits for abortion.

So, what is ORM’s success rate?

For women who use donated eggs, about 70 percent of transfers result in live births  — that’s according to the Society for Assisted Reproductive Technology (SART).

The national success rate is 56 percent.

SART is the in vitro fertilization industry's trade group and governing body. It audits success rates and makes them publicly available.

Bankowski said ORM has a high success rate for several reasons. It does an extensive medical check of egg donors, turning away 93 percent of applicants.

It also freezes and thaws eggs in a very specific way.

“That is sort of the secret sauce of the embryologist," he said. "Sometimes they’re keeping an embryo in a bath for five seconds longer.”

And the lab where eggs are collected? It’s essentially a clean room.

“It’s not just, 'Oh, well. Here’s a room and we’ll put in a little filter and here’s some incubators.' It was designed as this special box within a box after we consulted with the clean-room engineers at Intel,” said Bankowski.

People who go into the lab are asked not to wear perfume, because the volatile organic compounds they contain may harm developing eggs. Even new machines are left to air-out before being installed.

But Bankowski said their latest scientific improvement involves taking a tiny slice off the outside of a developing embryo and putting it on a microchip.

That chip contains a series of sensors that can tell whether or not a certain gene is corrupted.

“Four or five years ago, if we were to test an embryo, we would attach about 10 genetic probes to it," he said. "Now we attach about 500,000.”

Craig Reisser, a former banker who lives in London, chose to use Oregon Reproductive Medicine after putting together a spreadsheet comparing clinics across the world on their success rates and costs.

“We felt that where we had the best chance of success the first time round, was also the most financially cost effective place to go,” Reisser said.

Meanwhile, Palan is enthusiastic about the next nine months.  She’ll find out in about six weeks — via ultrasound — whether she’s carrying twins.

She gets an extra $5,000 for twins.

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Lobbying spending is up. Where does the money go?

The money companies and organizations spent on lobbying in Oregon jumped by more than 50 percent compared with this time last year. Since 2010, lobbying spending has increased by more than 94 percent.

But some lobbyists say despite the spending and public opinion of their profession, it’s more innocent than it seems. And, both sides of nearly every issue have representatives lobbying politicians.

“Everybody has representation in Salem for almost any conceivable interest or business,” said Paul Cosgrove, a lobbyist and head of government relations at Lindsay Hart, a Portland law firm.

Quarterly data from the Oregon Government Ethics Commission shows $20.8 million has been spent on lobbying activities so far in 2015. Half way through 2014, $13.7 million had been spent, but $26.8 million was spent by the end of 2014.

Lobbyists and the organizations they represent are required to register with the Oregon Government Ethics Commission. The commission collects the total amount spent by lobbyists and their clients, although the state “does not require any detail as to what that total contains” according to Government Ethics Commission program manager Virginia Lutz.

“I don’t think anybody would call it itemized,” said Gary Conkling, lobbyist and co-founder of CFM Communications, a strategic communications firm.

Brian Doherty, a lobbyist who represents the Western States Petroleum Association, BP America, Obsidian Renewables and Amazon, said lobbying money is spent on a litany of day-to-day government relations activities. Doherty’s clients have spent more than $330,000 on lobbying so far in 2015.

Most of the expenditure is payroll, Doherty said. But it also goes towards researching legislation, finding experts to testify on those bills and media campaigns that help shape public opinion about a client’s interests.

“Think of it as billable time,” Conkling said. He said other than payroll, most of a client’s expenses are on daily administrative needs like parking or printing at the Capitol. But it wasn’t always that way.

“It’s not so much that you’re hanging out in the bars with legislators, but back in the day when I started that was pretty typical.”

Conkling said that now lobbyists are tied into technology and servicing their clients almost 24 hours a day. When the legislature is in session, they’re spread thin.

Much of a lobbyist’s time is spent figuring out which bills will have the biggest effect — positive or negative — on their client and discerning where votes stand on those bills. Lobbyists then speak with coalition groups, committees, legislators and their aids to voice their position on a bill’s language (and sometimes attempt to change it to reflect the client’s interest) or to rally a group to look at voting one way or another.

According to Doherty, lobbying is about communication, not favors or hand outs.

“I can’t remember the last time I bought a legislator anything,” he said. “There’s no Blazers tickets or big treats.”

Doherty has no reported personal spending this year, according to expenditure reports from the Oregon Governmental Ethics Commission.

Conkling said the rules have changed for the better since he began working as a lobbyist.

“Many years ago I actually had personal Blazers tickets, and when legislators were able to accept invitations to dinner and a game I did take them,” Conkling said. “But the legislature changed those rules, and as a general rule we don’t entertain legislators at all.” He also does not have any personal lobbying spending reported this year.

Now, when a legislator meets with a lobbyist for a meal, they pay separately.

“It seems awkward. It’s like a bad date, but those are the rules,” Conkling said.

Although the legislature has reformed what lobbyists can spend on, total spending is still up. One theory as to why is that this year’s longer legislative session may have meant more spending just because of payroll.

“The length of the session compared to short sessions obviously makes a difference just in terms of bills considered,” Cosgrove said.

The data show longer sessions tend to coincide with more spending. In 2013, a long session, $20.1 million had been spent by the end of quarter two and $33.9 million by the end of the year.

On the other hand, Doherty said, regardless of its length, this legislative session was especially contentious and the “seriousness of the issues” may have prompted increased spending. “We’re spending more now because we’re getting into business issues,” he said.

“I would attribute the rise in overall cost to the number of the players, the intensity of working out some of these issues and for that matter the complexity of the issues themselves,” Conkling said. “I would look to those things more than the length of the session.”

Cosgrove agreed, and said because there’s more lobbyists in Salem, spending will naturally rise.

Conkling also said as time has gone on and there are more lobbyists, one thing has been central to his work: integrity.

“I can tell you when I first started, things were a little more slippery than they are today,” Conkling said.

“If a lobbyist is found to have misspoken, let alone lied, and I distinguish that one might be accidental and the other intentional, they’ve lost all their credibility,” Cosgrove said, adding that most ethics complaints at the Capitol are filed by lobbyists, not politicians.

“The thing is, the public doesn’t have a very high opinion of lobbying regardless of what the reality is, and we care enough about what we do that if someone steps over the line they’re taught that won’t work and that’s not acceptable.”

To him, the whole point of lobbying is to develop a sense of trust when it comes to information. Lobbyists are essential when it comes to informing legislators on the hundreds of bills they vote on — without that, he said the system simply wouldn’t work.

“More often than not, they’d be making decisions in a vacuum,” Cosgrove said.

Conkling said the Oregon lobby has respect for the state’s political institutions and that even divisive political disagreements have generally been handled with tact.

“We fight hard, but everything tended to fight fair,” he said.

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SEIU home-care workers agree to ‘historic’ contract

The Service Employees Union International Local 503, which represents 24,000 Oregon home-care workers, announced a tentative contract agreement with the state on Thursday. They called it historic.

The contract paves the way for a $15-an-hour wage for home-care workers by 2017, among other provisions.

“Our workers, personal support and home care, really need to have a living wage,” said Eileen Ordway, a home-care worker and member of the SEIU’s bargaining team.

“Without a living wage, we have to rely on public assistance programs to make ends meet. So, we’re like any other worker,” Ordway said. “We want to be able to sustain ourselves and our families.”

The $15 an hour wage will be reached through incremental pay increases.

Starting Jan. 1, wages will increase from $13.75 an hour to $14 an hour. On Feb. 1, 2017, wages will increase to $14.50 an hour.

Also in 2017 a training certification takes effect that could boost pay 50 cent per hour, meaning home-care workers can earn $15 an hour.

“The contract we won last night was awesome and it’ll go all over the nation,” said Phyllis Wills, a member of the SEIU 503 collective bargaining team. The team met with state negotiators into early morning hours for several weeks to reach an agreement on the contract.

The agreement also secures paid time off and implementation of new state retirement options.

“This is history for us. We’ve never had retirement security,” said Alice Redding, a home-care worker and bargaining team member. “And people who have been working for years, they just have Social Security. So this is a big plus for those that are still working and are younger.”

SEIU 503 bargaining team members hope this contract will become a model for home-care workers around the nation.

“It’s amazing. I was in tears when I was at the Capitol,” Redding said.

Home-care workers represented by SEIU Local 503 will have the chance to vote on the contract’s ratification soon.

‘A fight on their hands’

SEIU Local 503 was met with a class action suit earlier this month from the Freedom Foundation, a nonprofit think tank based in Washington state. The Freedom Foundation advocates against required union membership. They recently opened an office in Salem.

Ordway said the value of union membership isn’t in the dues, it’s the ability to influence the industry through one voice. “When we’re individuals we don’t have the kind of power that we do when we combine our voices.”

She said workers from states where litigation similar to the Freedom Foundation’s has succeeded described their labor system as “in shambles,” saying worker’s weren’t able to live on their wages and they lost their benefits.

The suit, filed in federal court, is pending.

“They’re going to have a fight on their hands,” Wills said.

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Study: Working On Children Rattles EMS Staff

Emergency medical staff sometimes get rattled and make mistakes when dealing with children, according to a new study out of Oregon Health & Science University.

OHSU Dr. Jeanne-Marie Guise interviewed more than 750 emergency workers across the nation. Those are the workers who help out after a car accident or similar emergency.

She asked them when were they most likely to make mistakes.

“The EMS workers identified that airway management, their own personal heightened anxiety when caring for children, interference with the family members. That those are the factors that they were listing as commonly contributing to patient safety events,” she said.A ‘patient safety event’ is essentially a mistake that may cause a patient harm.

Guise said medical equipment that isn’t properly sized for children can also be a problem.

She said more training that simulates pediatric emergencies could help improve care.

Her report is published in the latest issue of The Journal of Pediatrics.

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Study: First responders lack pediatric experience

The lack of exposure to pediatric emergency events compounded with not enough training for first responders leaves children in medical crises vulnerable to errors and safety gaps, a new study by an Oregon Health & Science University professor found.

Errors in pediatric medical transport result in significant injury or death in 4 percent to 17 percent of hospital admissions, according to the study.

Dr. Jeanne-Marie Guise, a professor of obstetrics and gynecology and emergency medicine, said while a lot of attention has been paid to hospital patient safety, not much is known about out-of-hospital care settings.

In the hospital, situations that are both rare and life-threatening tend to be worst environment in terms of patient safety, Guise said. Applying that concept to the work of emergency responders, the perfect storm is pediatric cases, she said.

Outside of the hospital, emergency responders likely have experience with car crashes and adult cardiac arrest, but only 13 percent of emergency medical service transports involve children, she said. And only 1 percent require life support during transport.

The study, published Tuesday in The Journal of Pediatrics, attempted find a consensus from a national sample of 753 emergency physicians and EMS professionals’ perceptions of the factors that could lead to errors in out-of-hospital care.

Limited clinical proficiency, airway management, anxiety emerged as some of the top factors that could lead to errors and safety problems.

“It’s particularly challenging because the equipment hasn’t been designed for children,” Guise said of airway management. “There are things like intubation where they are sized for children but require sophisticated skills.”

One of the surprising results was how commonly emergency responders reported that family and bystanders could make their jobs more difficult, Guise said.

“The things parents and bystanders could do are to designate one person to communicate with the first responders,” she said. “And if possible have the others stay back and keep as calm as possible.”

Medication and communication errors are frequently cited in patient safety issues in hospitals, Guise said, but those weren’t as high priority in the out-of-hospital setting.

Responding to children with chronic conditions and home equipment is more challenging, the study found.

The next step in Guise’s research will be collecting narratives of scenarios that emergency responders encounter when working with children and finding ways to use them for training.

Other ideas to improve pediatric emergency services include skill sessions, allowing out-of-hospital providers to shadow providers in clinical settings and simulations. Also, regionalizing pediatric care so that a group of responders could be dedicated to responding to children’s emergencies could work in certain areas, she said.

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Food safety concerns at David Douglas High School lead to whistleblower lawsuit

An ailing head cook has led to a whistleblower lawsuit against David Douglas School District, according to documents filed Wednesday, Aug. 12, in Multnomah County Circuit Court.

The lawsuit brings up concerns of food safety at David Douglas High School, where approximately 3,000 kids attend school.

Two food service workers and a special education assistant filed the suit against the small east Portland school district alleging that officials did nothing when they brought up concerns about Head Cook Kim Fragall’s increasingly erratic behavior, which they linked to her worsening health. The workers — second cook Deborah Rowley, cook’s helper Julie Passantino-Symonds and Special Education Instructional Assistant Trisha Williams — further allege that Fragall retaliated against them for bringing up their concerns with management. When they told administrators of the retaliation, including Superintendent Don Grotting, “there was no further response from DDSD,” reads the complaint.

The plaintiffs, represented by Portland attorney Mark Morrell, are asking the court for $250,000 each in non-economic damages, plus attorney’s fees.

The plaintiffs say the retaliation started after an April 2012 meeting of kitchen staff in which they told district nutritionist Jody Taylor and an unidentified union representative about their concerns of Fragall’s worsening condition and its effects on food safety. They say the head cook frequently complained of pain, would take long breaks, and would not work full days “obviously exhausted and in pain,” the suit reads. The complaint alleges Fragall’s mental state was such that she would forget how long food had been cooking and at what temperature; forget to order ingredients or order too much; fail to notice health and sanitation violations in food preparation and storage; and make uncharacteristically demeaning comments to staff.

The issues appear to have come to a head for the plaintiffs during the spring when “rumors were” that they would be permanently reassigned to North kitchen from their post at South kitchen.

Finally, the lawsuit claims that staff “have noticed a marked reduction in the number of students eating at the cafeteria. Many students have simply refused to eat the food served at South.”

A David Douglas spokesman did not immediately return a request for comment on the allegations.

[email protected]

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Youths file federal climate change lawsuit in Eugene

A group of 21 youths — several of them from Eugene — today filed a lawsuit against the federal government, claiming that it is violating their constitutional rights by promoting the development and use of fossil fuels.

The plaintiffs are seeking a court order requiring President Obama to immediately implement a national plan to decrease atmospheric concentrations of carbon dioxide to a safe level.

The 96-page suit was filed in U.S. District Court in Eugene. The plaintiffs are between the ages of 8 and 19 years old, and include Kelsey Juliana, a Eugene native and plaintiff in a high-profile climate change lawsuit filed in Lane County Circuit Court against the state of Oregon.

The suit filed today alleges that the federal government has known for more than 50 years that carbon dioxide pollution from burning fossil fuels is causing global warming, but has continued to allow and promote the development and use of fossil fuels.

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Agent Orange likely culprit in man's health saga

Forest Grove veteran blames chemical defoliant used in Vietnam War

War has many casualties, and the Vietnam War was no exception. But many years beyond the fighting in Southeast Asia, a chemical defoliant used by the U.S. military to clear jungles for warfare is killing veterans from the inside out.

And as a 63-year-old Forest Grove man will tell you, the government has few answers for the questions of those allegedly exposed to Agent Orange.

In 1997, Louis Lines was a relatively fit, happily married father in his 16th year working for Southern Pacific Railroad. Five years later, he was 100 pounds heavier and suffering from Crohn’s disease and an enlarged heart. Lines was also preparing for a bout of chemotherapy to combat hairy cell leukemia.

“I’m a firm believer in karma. From high school, to the U.S. Army, through the railroad, I’ve never been in trouble for anything in my life. So I’m lying there in the hospital thinking to myself, ‘what in the heck did I do to deserve this?’”

To understand where he was, it’s important to learn how he got there.

Lines was born in Hillsboro on June 17, 1952. He grew up in Forest Grove and graduated from Forest Grove High School in 1971. At a time when many were either going to or returning from Vietnam, Lines was drafted into the army, sent to Fort Lewis military facility in Washington state and became part of the 3rd Armored Calvary.

From there he went to train at an army base in White Sands, N.M., where — thousands of miles removed from the horrors of the Vietnam War — he was exposed to a chemical he believes has led to a personal war with a variety of health problems five decades later.

Chemical moved through air, water

Agent Orange is one of many herbicides known to have been used in Vietnam. In November 1961, President John F. Kennedy authorized the start of Operation Ranch Hand — the code name for the U.S. Air Force’s herbicide program there — and subsequently kick-started a program whose effects continue to be felt by soldiers who were in the field, troops that remained stateside and even the children of both groups.

Paul Sutton, a Vietnam veteran, past chairman of the Veterans Administration’s National Agent Orange Committee and a nationally recognized expert in the subject, has advocated for veterans and their families since 1977. Based on his research and studies, and contrary to the limited knowledge of exposure by most soldiers in the war itself, “anyone who spent 30 days minimum on the ground in Vietnam was exposed to Agent Orange.”

“As soldiers we didn’t know,” Sutton said. “Guys assumed that if they weren’t around during the application they were fine, but what we’ve learned since is that the chemical moved through the air and water, and also lived well beyond the terrain where it was applied.”

Sutton tells stories of soldiers who spent the entirety of their service in Vietnam at a desk on a military base, but who years later suffered the effects of poisoning traced back to contaminated water dumped from planes during aborted herbicide missions. Some unwitting soldiers used Agent Orange to clean tools. And more recently, tales of woe have involved veterans who never set foot “in country.”

“It’s proving very tough for these reservists, even with a well-rounded [medical] claim, to get it through the system,” Sutton said. “Unfortunately, that’s common for any veteran trying to deal with the VA regarding these types of issues.”

Episodes of blindness

Louis Lines never stepped foot in Vietnam, but in 1997, after building and moving into his dream home in Grants Pass — 23 years after his discharge from the army and two decades into a career with the railroad — he was diagnosed with Crohn’s disease, an inflammatory bowel disease affecting the gastrointestinal tract. He spent the next five years coping with pain and discomfort, but in 2002 was forced to have his large intestine removed.

While in the hospital for that operation, doctors informed Lines he had hairy cell leukemia and an enlarged heart. He underwent micro-valve surgery to repair his heart and chemotherapy to address his leukemia. Doctors estimated he likely had no more than six months to live, and told Lines his best course of action was to stay in the hospital and keep as comfortable as possible while awaiting his inevitable demise.

“They wanted me to just sit in bed and push this button until I died, but I was like, ‘no way — if I’m going to die it’s going to be in my house on the mountain.’”

He spent the next three years in a wheelchair due to complications from chemotherapy, packed on weight, suffered occasional episodes of blindness and lost his wife to divorce — a result, he said, of the strain his medical issues put on their relationship. Lines sold his house, moved to LaPine to be near family and began receiving epidural pain medication every 90 days to help him walk.

Eventually the epidurals stopped working and Lines had neuro-stimulators implanted that allowed him to walk. But even as things were looking up, he still dealt with digestive issues. Some doctors couldn’t explain it, Lines said, and others chose not to engage with his situation.

“When you walk into a doctor’s office with an insurance card and cash and they still won’t treat you because they say you’re too high-risk, that really stinks,” he said.

Those issues, along with the price of his medications, led Lines to the VA, where his initial doctor theorized he was a victim of herbicidal poisoning connected to his military training during the Vietnam era.

“He said, ‘this has to be Agent Orange poisoning,’” Lines said, “but VA doctors aren’t the same as VA lawyers, and they sent me a letter that said ‘we don’t owe you anything for anything because you can’t prove it.’”

The truth is, he can’t.

Lines spent the bulk of his time in the Army living and training in tanks in White Sands. There is no documented evidence that Agent Orange was stored or tested there, and while the tanks he worked with were used in Vietnam, he was told they were cleansed of potential Agent Orange contamination prior to their return.

While his physical condition makes a strong case, the burden of proof the government demands when it comes to Operation Ranch Hand simply isn’t there.

‘I wasn’t looking for benefits’

Jennifer Walters, a Texas resident whose husband, John, died in 2000 as a result of apparent Agent Orange poisoning, is an example of one of the many people caught in the wake of the Agent Orange tidal wave.

She spent 10 years trying to get answers from government officials.

Her husband — who in his early 50s was stricken with a kidney disease normally found in small children, a colon issue and a rare form of sarcoma — died less than a year after his initial diagnosis but was never declared a victim of herbicide poisoning in spite of overwhelming evidence.

“I wasn’t looking for benefits. I simply wanted answers and a recognition of his cause of death,” Jennifer Walters said. “It’s very difficult [for veterans and their families] to get help, and when they do, it’s with an understanding that it will only go so far.”

Paul Sutton says that’s commonplace — and suggests answers, if they come, won’t come soon. “It will be long after Vietnam veterans are gone before our government acknowledges this,” he said.

For his part, Lines says he only wants accountability from the government — and maybe a little help for veterans still struggling to cope with something beyond their control.

“I had my large intestine taken out, had a bad heart and got leukemia,” he said. “I went blind and lost the use of my legs. But they said there was no correlation between one and the other.

“I just want them to call it what it is, and maybe give me someone I can talk to about what I’ve gone through.”

Despite his health travails and his stalemate with the VA, things haven’t been all bad for Lines in recent years. Lines moved back to Forest Grove in 2010 and got remarried in 2010 to a woman he’d originally met in 1970 at the now-defunct Hudson House Cannery, which used to operate in Forest Grove.

Louis and Lynette Lines had shared a relationship until she went off to college, and he to the army, in 1971. They reunited at a small church in Gaston nearly 50 years later.

“I look back at my tough times and sometimes wonder why. But I look at meeting my wife, and the 13 years since they told me I’d be dead, and I say ‘that’s my karma,” Lines said.

He insists he’ll face the future with a smile on his face.

“That’s just who I am,” Lines said. “That’s just who I’ve always been.”

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Journalist turned activist promotes changes in health insurance coverage

A journalist turned activist says that it’s more likely that Colorado, not Oregon, will be the first to lead the United States in providing health coverage for everyone.

“We beat you to marijuana and we will beat you to universal health care,” says T.R. Reid, the one-time Washington Post reporter who is now leading a campaign to qualify a financing measure for the 2016 ballot in Colorado.

Reid spoke Saturday at Salem Hospital during a presentation sponsored by the Salem City Club. He also spoke at Linn-Benton Community College in Albany. He also made several appearances in Portland.

Reid is chairman of the Colorado Foundation for Universal Health Care, which proposes a payroll tax on employers and employees to supplement existing funds for health coverage.

Oregon lawmakers have just budgeted $300,000 for a study, which they authorized two years ago, of better ways to pay for health care.

While the national health care overhaul signed by President Barack Obama in 2010 and known as “Obamacare” has taken some steps toward putting the United States on a par with other democracies with advanced economies, Reid says it’s still far short of the ideal of universal coverage for everyone.

“We are not going to get to that destination on a national basis,” he says. “The U.S. Congress is gridlocked and cannot do anything big. The way we are going to get there is state by state.”

He mentioned Canada’s program, which started with government-paid hospital care in 1961 and evolved into universal coverage in 1984. It originated in the province of Saskatchewan after World War II.

Under the 2010 law, any state that offers universal coverage may opt out of the federal requirements. Sen. Ron Wyden, D-Ore., authored the provision as a way to encourage state experimentation.

Personal interest

Reid is the author of “The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care.” It was published in 2009, the year after the documentary “Sick Around the World,” made for PBS Frontline. He also took part in a 2012 documentary, “U.S. Health Care: The Good News.”

Reid acknowledges he is not an expert in the field.

“I’m just an ink-stained reporter who got interested in this topic,” he says.

He did so when he was the Washington Post’s bureau chief in Tokyo, where he was initially worried when he had to take his children for medical care. He need not have worried.

“It was an American standard of care; the facilities were fine,” he said. “We did not wait very long. But the really striking thing was the bills — one-20th or one-tenth what you would pay in the United States for the same treatment.”

Japan relies on private doctors and hospitals. Great Britain, where Reid was London bureau chief for the Post, has a National Health Service established in 1948 that provides most care.

As Reid investigated health care in other nations, he spotlighted his quest for relief for an ailing right shoulder he injured in the early 1970s while a seaman in the Navy.

His conclusion: “We are paying vastly more and getting much less than all the other countries like us when it comes to health care. The main answer I get in those other countries is that they see it as a moral obligation. The United States has never seen this obligation like all the other rich countries.”

According to a July 20 compilation by the World Health Organization, based on 2013 data, the United States led with 17.1 percent of its gross domestic product on health spending. Of five other advanced democracies, the range was from 9.1 percent in Great Britain to 11.7 percent in France.

On Obamacare

Reid spent most of his talk about the Patient Protection and Affordable Care Act, the official name of the 2010 congressional overhaul, in terms of expanding coverage, restraining costs and other factors.

“It is working better than before,” he said. “But it doesn’t get us to where I think we ought to be. It has expanded coverage much more broadly than what opponents say, but much less than what the White House promised.”

Although some provisions took effect earlier, the law kicked in on Jan. 1, 2014.

While the law has expanded coverage to more than 16 million people, Reid said that’s still about half the intended target of 32 million people. By 2020, an estimated 31 million will still be without coverage, counting 11 million in the nation without immigration documents, who also had been excluded from the initial target.

Some are covered through plans under health insurance exchanges, for which there are federal tax subsidies.

Others are covered through an expansion of Medicaid, the joint federal-state program of health insurance for low-income people. Oregon is among the 30 states that have some form of expansion, according to the Kaiser Family Foundation; 19 states do not, mostly in the South, Great Plains and Mountain West. Exceptions are Maine and Wisconsin. Utah is considering its options.

States will have to share costs of that expansion beginning in 2017, but Reid said it is a fallacy for critics to say that states will have to assume 100 percent. “Congress does not take away entitlements,” he said.

Health care costs, which had been rising annually by two to three times the rate of the Consumer Price Index, have moderated. While costs have still grown, Reid said they rose by just 2 percent in 2014, matching the CPI, and actually fell by just under 1 percent in the first quarter of his year.

However, drug prices are increasing much faster.

“If cost increases level off, I think we have to give some credit to Obamacare,” even if there are other factors involved, Reid said.

Reid said the 2010 law also did some good things, such as put an end to insurance company exclusions for pre-existing medical conditions and arbitrary policy cancellations known as “rescissions.”

It also put an outside limit of 20 percent for administrative costs from premium dollars, down from 30 to 35 percent. But Reid said that’s still far more than the international average of 5 percent, or the 3.8 percent paid by Medicare, the federal program of insurance for those 65 and older and for some people with disabilities.

“Those of us who have looked at other countries believe the (2010) limit is not enough,” he said.

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Silent Epidemic: A Mother's Heroin Addiction Story

Diana Cooper said probably the scariest moment during her heroin addiction was the night she was driving her four kids along the Oregon coast, headed toward Gold Beach.

“I had a lot of cocaine but I didn’t have any heroin,” Cooper, 27, said. “And so I was nodding out while I was driving. I kept doing more cocaine, thinking that would keep me awake and I just kept nodding out and I woke up hitting the guardrail on the other side where the cliff is to the ocean."

Cooper says her 8-year-old daughter still talks about the time “Mommy wrecked the green van.”

Cooper started taking prescription opioid painkillers after getting meningitis when she was 18. She had ongoing migraines and was kept on opioid drugs for the next seven years.

“After a while, I realized that I did not like to function without taking my medication," Cooper said, adding that she eventually needed the pills just to feel normal. “And you don’t even realize that’s what keeps you normal, that’s what keeps you functioning."

When she was pregnant with her fourth child, her doctors kept her on the painkillers, but on lower doses. So she supplemented her prescriptions with pills from the street.

Her son was born prematurely, with a low birth weight. But Cooper said her doctors didn’t seem concerned. At the time, she wasn’t either.

“Now, I can’t even look at his baby pictures,” Cooper said. “He didn’t look normal. He was very gray, he had dark eyes, and he was very skinny."

Cooper’s life spiraled downward. For a while she was homeless. She, her husband – also an addict – and the kids lived for several months in their van in a Wal-Mart parking lot.

Then, shortly after her youngest was born, Cooper tried heroin. She liked it … a lot.

“Your heart is racing. You get a rush. You get a lot of endorphins,” Cooper said. “You feel invincible to the point where, ‘I can do everything I need to do. Nothing’s going to hold me back, no little pain, no illness, no nothing.’ "

From then on, heroin was her drug of choice. Soon, though, Diana’s husband had had enough. He insisted they both get treatment and reluctantly, she agreed. Cooper and her family got into a residential treatment facility where they could all stay together.

She says at first, all she could think about was getting a fix. But she knew if she left, she’d lose custody of her children.

“That really says something to the pull of addiction, when you’re considering, ‘Do I stay here and get clean, or do I leave them all here and I go use?’ ” Cooper said. “You know, when you’re even contemplating that … I love my kids, and I would die for my kids. But at the time I wouldn’t give up heroin for my kids."

On her third day in treatment, Cooper met a recovering addict who told how her newborn baby had been taken from her for several days when she entered treatment.

“And she said the day they gave her her baby back, the want to use immediately was lifted. And as soon as she said that, mine was lifted. I realized I didn’t have to want to use."

Cooper and her husband have been clean for about two years now. Both are working and she’s going to school to study early childhood education. She wants to be a clinical social worker.

She still struggles with her addiction. And she said it takes day-by-day discipline to keep her dealings honest and above board.

“I have to keep myself in check about everything. I can’t lie for people. I have to be totally up front and honest about everything in my life,” Cooper said. “Or else, yes, I will go back out."

Cooper is grateful for the help and support she and her family have been given to get their lives back on track. She urges people to get educated about their addiction problem and get involved in solutions, because, she says, addiction isn’t something that happens just to other people’s families.

This story is a part of Jefferson Public Radio's series on heroin addiction in Southern Oregon, "Silent Epidemic: Addiction In Southern Oregon." Read more at

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