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.
On this consequential election day, and at a perilous moment for our state and our nation, I want to share some thoughts on where we go from here. Early last Spring, in a letter I sent to several large Oregon foundations, I expressed concern about the health and integrity of our communities—a concern that economic stress, social isolation and prolonged uncertainty could tear apart the fabric of our society, and erode any sense of shared purpose.
As a parent, a doctor and former Governor, I urge Oregonians to vote “no” on Ballot Measure 110. I understand that a central motivation behind this ballot measure is to help reverse the disaster caused by the War on Drugs, which incarcerated people suffering from addiction and had a disproportionate impact on Black and Indigenous […]
The fatal shooting last weekend of a protestor in downtown Portland should give all of us pause, regardless of which side of the “political divide” we find ourselves. What we are witnessing here in Oregon is the ultimate test of the great American experiment, launched almost two and a half centuries ago. The central question is whether it is possible to establish a government “ruled not by accident and force, but by reason and choice.” How we choose to proceed in Oregon will, at least in part, answer that question. And the nation is watching.
This week’s decision by the Oregon Health Authority (OHA) to allow Trillium Community Health Plan to begin enrolling Medicaid members in the Portland area starting on September 1 threatens to disrupt important care relationships in the midst of the COVID 19 pandemic. Of even greater concern is the fact that this decision seems to have been made in a vacuum that ignores both the need for patient protections in a very vulnerable population and the intensified call for equity in our health care system