Oregon

Health Policy rankings

Health indicators	Rank
Population	3,600,395
Number of insurance mandates	32
Death rate per 100,000	778.1
Percent of adults overweight or obese	56.50%
Percent of adults who have visited a dentist in the last 12 months	68.50%
Number of births (2004)	45,678

Ranking public policy	Rank
Overall health ownership rank	12
Government health care rank	32
Private health insurance rank	1
Medical tort rank	25
Provider burden of regulation rank	5

Sources

Policy ranks are from the U.S. Index of Health Ownership, published by the* Pacific Research Institute.
Health indicators are from State Health Facts, a service of the Kaiser Family Foundation.
Number of insurance mandates comes from Health Insurance Mandates in the States 2007 (PDF), a publication of the Council for Affordable Health Insurance.

State Policy Network member

Cascade Policy Institute

Government offices

Tuesday, March 4, 2008

Empathy doesn't solve Oregon's health care crisis

By Liberty is For Me .

Categories: Oregon

If you don't have health care insurance in Oregon, don't worry you can enter your name in a lottery to get it.

According to the AP:

"The state will start drawing names this week for the chance to enroll in a health care program designed for people not poor enough for Medicaid but too cash-strapped to buy their own insurance."

I am not opposed to helping 600,000 uninsured Oregonians get health care but this is doesn't address the overall problem...rising cost in health care.

But you know what, who cares, right?

This woman doesn't:

"It's better than nothing, it's at least a hope," said Shirley Krueger, 61, who signed up the first day.

She says, it's better than nothing. This is worse. Her kind of attitude gets us in trouble.

See, the cost of health care is arbitrary because people aren't asking what things cost. Then providers will raise their prices because they know the state of Oregon will pay anything for Ms. Krueger's check-ups.

However, the state will eventually figure out they can't afford to take care of people and will have to increase taxes or shutdown.

Don't believe me?

"At its peak in 1995, the program covered 132,000 Oregonians. State budget cuts forced the program to close to newcomers by 2004."

posted by Liberty is For Me .
4:41 pm
1 comment

Saturday, January 26, 2008

Oregon Tries to Make Health Care a "Fundamental Right"

By Steve Buckstein

Categories: Oregon

The Oregon House Interim Committee on Health Care held a lively public hearing and work session yesterday on a proposed Constitutional Amendment which would declare access to health care to be a “fundamental right.” If approved by the February special legislative session, it would be voted on by Oregonians in November.

The key language of Legislative Concept 91 reads:

The people of Oregon find that health care is an essential safeguard to human life and dignity and that access to health care is a fundamental right. In order to implement that right, the Legislative Assembly shall establish by law a plan for a system designed to provide every legal resident of the state access to effective and affordable health care on a regular basis.

The hearing started with representatives from health care providers and insurance companies testifying in favor of creating this new “fundamental right.”

Then Cascade Policy Institute board member Michael Barton and I testified in opposition. Michael gave the committee a history and philosophy lesson, explaining how the American government was founded on the principle that government does not grant rights, it simply protects our inalienable rights such as those to life, liberty and the pursuit of happiness. He explained that our rights define what we are free to do without interference; they are not goods or services that others must provide for us. He gave each member a copy of his 2006 Cascade Commentary, "Right" to health care violates individual rights, which was published in response to an early version of the current “legislative concept” facing us now.

I followed Michael with a discussion of the political implications. Here is the gist of my testimony:

On a philosophical level, I object to defining health care as a right. On a political level, I understand that government tries to grant such positive rights all the time. In this case, passing this constitutional amendment will make some people feel good. It says that we care deeply about the uninsured, but it only gives intellectual lip service, if that, to the matter of future costs.

More and more people will say "I have a right to not care about the costs, because I have an unqualified right to health care.”

Define health care as a fundamental right and cost control will go out the window - witness the public school system and how the Quality Education Model is now driving massive spending increases for little if any improvement in real quality. I can almost see the just-around-the-corner Quality Health Care Model defining prototype health clinics, with mandated staffing levels, required tests, etc. Innovation will become mired in bureaucratic process.

And who will have the task of controlling the economics? Is this legislature going to assume responsibility for that? An elegantly composed commission? A superhuman future governor? Or do you assume private insurance companies will simply figure it out?

Rather than spend precious political capital trying to create an artificial right to health care, I suggest we spend that capital finding practical ways to drive health care costs down and quality up. Make it easier for more people to afford health care on their own by getting un-needed mandates and insurance regulation out of the way. Then, if you decide that some people still can’t afford it, take a page from the food stamp book, or other such programs where you simply subsidize health care purchases for low-income people. That will distort the economics far less than the route you’re trying to embark on here today.

After our prepared testimony the committee members asked us a number of questions, giving us the opportunity to expand on our position. Chairman Mitch Greenlick seemed to enjoy the back-and-forth; at one point likening it to a good college debate.

Then Rep. Greenlick himself testified in favor of what is really his proposal. The committee then spent a considerable amount of time discussing the pros and cons, before approving it, and the accompanying joint resolution setting the November election (LC 88), on a party line vote.

A key argument against the proposal was made by Rep. Dennis Richardson who observed that, if enacted, a “fundamental right” to health care would seem to trump everything else in the Oregon Constitution. If the legislature comes up with a plan to make good on this “fundamental right” what happens when voters reject the new taxes needed to pay for it?

Since neither education, transportation, criminal justice, or any other state government service is defined as a “fundamental right” in our Constitution, then funding for these services might be cannibalized to fund the one “fundamental right” in that document, health care. But voters won’t be presented with this reality when marking their ballots in November. This potential clash of essential services may make for strange bedfellows in future election battles. Will the teachers union, for example, want to lose funding to the health care providers?

The unintended consequences of this proposal are almost endless. But that’s the way the game is played for now, and the next inning will play out in the Capitol building over the next few weeks. Stay tuned…

posted by Steve Buckstein
6:34 pm
0 comment

Wednesday, January 2, 2008

Government-required Health Benefits in Oregon

By John LaPlante

Categories: Insurance Regulation, Oregon

Among the many new laws taking effect this new year are new mandated benefits on insurance policies. The Salem Statesman-Journal has a short article on some new laws in Oregon.

Looks like another step towards increasing the cost of health insurance by reinforcing the idea that it is actually a means to pre-pay (or actually, get someone else to pay) for predictable services.

posted by John LaPlante
12:27 pm
0 comment

Friday, November 9, 2007

NYT to Oregon Voters: You're Stupid

Oregon Measure 50 and the Times

By Grace-Marie Turner

Categories: Medicaid, Oregon

When asked about raising state cigarette taxes to add more children to publicly-funded health coverage, Oregon voters rejected the plan by a 59% to 41% margin.

Measure 50 would have increased Oregon's cigarette tax by 85 cents a pack. The measure went to the voters for a referendum after Democratic state legislative leaders failed to get enough support to pass the measure outright. They didn't have the three-fifths vote needed to pass revenue-raising bills in the legislature, but they did have the simple majority needed to ask voters to amend the constitution and add the cigarette tax. All they needed was a simple majority of the voters to say yes.

The measure failed in every county but one.

Supporters of Measure 50 blamed a huge advertising campaign financed by tobacco companies for its defeat. But their message must have resonated. Opponents zeroed in on four basic arguments against the tax, according to The Oregonian: They argued that there was no way to account for how the money would be spent; it was inappropriate to stick a product tax in the constitution; it was unfair to smokers; and the program was fiscally unsustainable as costs eventually would outstrip revenue.

The editorial in The New York Times yesterday was predictably scathing: "Big tobacco defeats sick kids." An editorial in The Oregonian offered a similar indictment.

But it is always a mistake to tell voters that they are stupid, which is what these editorials basically do.

posted by Grace-Marie Turner
5:55 pm
1 comment

Thursday, November 8, 2007

The SCHIP Went Down in Oregon

Voters reject plan by 3-2 vote

By John LaPlante

Categories: Oregon, SCHIP

Today's OpinionJournal.com offers some lessons from the recently defeated SCHIP expansion in blue-state Oregon.

What I didn't know is that although not all families would be subsidized (the subsidies would "only" be given to those with incomes up to 3 times the poverty level), anyone could sign up. Talk about a death spiral.

There are many possible reasons for voters to have rejected the plan. Like the federal version, the Oregon expansion would rely heavily on cigarette taxes. Perhaps voters didn't want to rely on cigarette taxes, which are not only regressive, but causing the number of smokers to decline. Perhaps--one could hope--that a number of people understood the folly of expanding a government program when there are so many other things that could be done.

Regardless, it give me hope that voters aren't always fooled.

posted by John LaPlante
9:12 am
0 comment

Wednesday, November 7, 2007

Oregonians Vote Down SCHIP-like Measure

By Steve Buckstein

Categories: Oregon, SCHIP

Oregon voters sent Congress a message on Tuesday when they voted down a new cigarette tax to pay for children’s health insurance. The vote was 60% against and 40% in favor of funding the so-called Healthy Kids Plan.

Measure 50 would have locked an 84.5 cent per pack increase into the Oregon Constitution to fully fund health insurance for children in families up to 200% of the federal poverty level. It would have partially subsidized insurance for kids in families from 200% to 300% of the poverty level.

Voters apparently weren’t willing to saddle just smokers with the cost of this expensive new government program, and they didn’t buy claims that a declining revenue source could cover rising health insurance premiums for very long.

Oregon U.S. Rep. Earl Blumenauer said before the vote that passage would be "a shot in the arm" for federal SCHIP efforts. On the flip side, Oregon’s Democratic Governor Kulongoski warned, "If you can defeat it here in Oregon, you send a chilling message to the rest of the country."

Well, it was soundly defeated here in liberal-leaning Oregon. The resultant chill of federal SCHIP efforts will hopefully encourage consumer-driven health care advocates to redouble our efforts.

posted by Steve Buckstein
1:43 am
1 comment

Wednesday, June 6, 2007

KidCare Craze in Oregon

Constitutional maneuvering underway

By John LaPlante

Categories: Oregon

Advocates of politicized medicine (i.e., taxpayer paid and government run programs) are targeting "cover all kids" campaigns. Children, most of whom have not yet lived long enough to develop chronic diseases, are relatively cheap to tuck into insurance programs. They also serve as a wedge for later expansion of public programs.

One of the latest advances in "cover all kids" came in Oregon. Last week, a legislative committee took action to refer a proposal to voters in the fall, as a constitutional amendment.

The reason? Gain a parliamentary advantage.

Democratic proponents have all but given up hope of winning enough Republican votes in the Legislature to pass a tobacco tax increase to pay for expansion of state-subsidized health insurance for children.
So the Senate Rules Committee approved a resolution Tuesday to make the governor's Healthy Kids Plan -- and the tobacco tax to pay for it -- part of a constitutional amendment that would go before voters in November. The resolution must clear the Senate Revenue Committee before reaching the Senate floor.
Proponents framed the measure as a constitutional amendment because referring it to the ballot that way would require a simple majority, instead of the three-fifths majority required to pass or refer measures that include a tax increase.

The plan is fairly ambitious, requiring a tax increase on cigarettes (84.5 cents per pack) to pay for state-subsidized insurance. Families of four with an income of up to $62,000 -- three times the federal poverty level--would be eligible.

Recently, the Oklahoma Council of Public Affairs published a brief critique of cover all kids. (Scroll down to "'All Kids' is All Wrong.") Among the points that the group makes: expansion is fueled by the enticement of federal matching funds, it encourages businesses to drop coverage, and it diverts funds away from Medicaid's original purpose of providing assistance to the poorest of the poor.