This morning 450 hospitalized Oregonians are waiting to be discharged, with nowhere to go, and 223 are being boarded in ERs waiting to be admitted, but with no beds available. Oregonians are dying and suffering avoidable harm from this situation, which is due both to an acute workforce shortage and to misaligned financial incentives in a payment model that is no longer financially sustainable. This crisis offers Oregon a unique opportunity to both resolve the workforce shortage and change the payment model to stabilize the system and reduce the total cost of care.
I have come to believe that the only way we are going to break through hyper partisanship and an increasingly toxic political environment is by linking a number of issues together in a way that broadens the constituency base for shared goals. By solving for multiple problems at the same time, we may be able to restore a sense of common purpose and shared identity as Oregonians. This presentation to the Oregon Board of Forestry explores this idea as it relates to wildfire, forest health and housing.
ENSURING EVERY CHILD, FAMILY AND COMMUNITY HAS AN EQUITABLE OPPORTUNITY TO SUCCEED Speech to the Oregon Alliance May 5, 2022 American novelist Wendell Berry once said: “It’s all a question of story. We are in trouble just now because we do not have a good story. We are in between stories. The old story, […]
There are over 45,000 children born each year in Oregon, and we cannot afford to lose a single one. Yet every day that passes without an effective way to ensure that each and every one of these children truly has an equitable opportunity to succeed, some will be lost. And every time that happens, we are all diminished and we lose a little bit more of the soul of our state. It is imperative that we act on this now—our children can’t wait … and neither should we.
The World Health Organization defines health as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” If we could write a prescription for America that would surely be it. And if we could fill that prescription by spending more money on the U.S. health care system, we would already be there. Yet, fifty years of evidence tells us that the promise of health care for all Americans is not the same as a healthy America. In 1968 the U.S. was spending 6.2% of its GDP on health care. Today we are spending almost 18%, yet life expectancy has declined three years in a row, driven largely by inequality and economic hardship, particularly in working class America.
The Oregon coordinated care model was implemented in 2012 through “Coordinated Care Organizations” (CCOs), which operate under a Section 1115 waiver, first granted by the Obama Administration. A coordinated care organization is a network of all types of health care providers (physical health care, addictions, and mental health care) who have agreed to work together […]
From the sky bridge at OHSU, in a neighborhood where the median annual income is $42,000 and poverty is less than 15%—you can see neighborhoods six miles away with incomes half the size and the poverty rate twice as big. Between the sky bridge and those neighborhoods, poverty and its associated health disparities increase by […]
The Oregon Health Plan (OHP) was enacted in 1989 as part of a larger effort to achieve universal coverage in Oregon. The OHP is Oregon’s Medicaid program and operates under an 1115 waiver granted by the Clinton Administration in 1993. There were several key elements. Eligibility The 1989 legislation extended eligibility to all Oregonians […]
The three legislative concepts discussed in this paper build on the Affordable Care Act and are consistent with, and enhance, President-elect Biden’s health care proposal as described in his campaign. These concepts also compliment the initiatives in the House Democratic Leadership health care proposal introduced last year. A centerpiece of both proposals is to expand […]
The State of Oregon has done a good job conveying the importance of wearing masks and following social distancing measures, but official government communications alone may not be enough. Trust in government is at an all-time low, especially within minority communities, which have been disproportionally impacted by COVID. This problem has been exacerbated by the unfortunate politicization of public health during the recent national election cycle and the resistance in parts of our society to being “told what to do” by government. There are other, perhaps more effective, messengers that have not yet been fully mobilized—the trusted local leaders living in every community across our state, whose voices may carry more weight than directives from the state.