Selling Oregon’s Health Care System to the Highest Bidder
Oregon has become part of an accelerating national trend in which huge insurance conglomerates, retail chains and private equity investors are buying up physician practices and other parts of Oregon’s health care infrastructure. These trends represent an alarming acceleration of health care “corporatization”— the transfer of power away from patients and their doctors to Wall Street and other financial investors
Statement on Proposed CareOregon-SCAN Merger
After careful consideration, I cannot lend my support to the proposed CareOregon-SCAN merger. First and foremost, I believe this merger runs counter to the original vision for Oregon’s Coordinated Care Organizations (CCOs), and instead, represents a de facto shift towards traditional Medicaid managed care. Such a change in public policy should be led by Oregon policymakers, […]
Carpe Diem – Seize the Day
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.
Taking Charge of Oregon’s Health Care Future
State of Reform – Portland, Oregon Good afternoon. Thank you for inviting me to join you today. I haven’t been able to attend all the sessions but I assume you have spent a lot of time talking about our acute workforce shortage, the hospital discharge and capacity problem, and the growing realization that the cost […]
Universal Coverage, Health, Equity, and Value: Moving Beyond a Divided Congress
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.
Oregon Coordinated Care Organizations
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 […]
The Oregon Health Plan
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 […]
Legislative Concepts for 2021
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 […]
Vote No on Measure 110
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 […]
Undermining Equity and Patient Protections
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