Health care reform: Too much, too soon

Last evening this writer attended a meeting in the capitol on Senate Bill 329. This is the bill championed by Ben Westlund to provide health care for all Oregonians. We have lauded this in the past.

We worry now that it is too much, too soon.

We referred previously to the plan, and others like it, as “just insurance,” and favored it because we all pay the bill for the uninsured anyway. But we were depending on the word of others, and had not read the entire bill at that time. Sloppy. Mea Culpa.

We have, now. And it appears that SB 329, along with amendments offered last night, goes far beyond the already ambitious goal of insurance for everyone.

Senators discussed issues of whether the public should know how many perforated bowels a doctor offering a colonoscopy had to his credit, how much each procedure should cost, whether those in rural areas should have clinics and hospitals.

All of these may be wonderful goals. But they are too much, too soon.

Look: We have tens of thousands of uninsured in this state. An excellent editorial in this morning’s Oregonian points out that Washington is far ahead of us in caring for children (read it here). A piece in the March 5 New York Times by Robert Pear states that 17 million of the nearly 47 million without insurance in the U.S. have family incomes of $40,000 or more (read it here).

Health insurance costs are increasing out of the reach of the middle class.

So the senators and representatives in Hearing Room 50 last night need to focus more tightly on the problem at hand -- lack of health insurance -- rather than a full revamping of the health care delivery system in Oregon.

If they go after peer review and transparency of care, transparency of cost, delivery of health care in Hermiston, etc., etc., then they will have outlined a task too great that will take too long to accomplish. That will leave thousands without health care needed today.

Our suggestion? Any insurer who provides health insurance in the state of Oregon to anyone must offer it to everyone, at a basic level that includes the “list” of basics outlined by Kitzhaber and the Oregon Health Plan. Any insurer offering insurance in Oregon must include everyone in Oregon in the actuarial “pool” i.e., there shall be no cherry picking of the healthy, no penalty for the sick when getting this insurance.

Everyone shall pay something for their insurance and their doctor's visit on a sliding scale, with the poorest paying little, the wealthy paying more, and any insurer can offer expanded plans to anyone at any price they can charge.

Stick to the basics, for now. See what happens in Lakeview and Halfway, Northeast Portland and Coos Bay, when everyone qualifies for insurance, see if clinics spring up, if care follows the money.

Yes, we all want to know what our care will cost, we all want to know if our doctors are drunks or incompetent, we all would like a hospital within waking distance of our children.

But right now, our needs are more basic. Our goals need to be more modest.