"Total reform of health care"

Senator Westlund says I have it wrong about health care reform in Oregon. Just giving insurance cards to the uninsured would actually be more expensive.

He says we have to do more to pay less.

“We need fundamental, systemic, health care reform,” says Westlund without apology, without hesitation. “This is huge.”

What this writer advocated yesterday, and what some others are suggesting, of just insuring those without insurance, would simply be a case of throwing more money into an already dysfunctional system.

“Where does that money come from?” he asks. He says the state would have to take a greater role in funding, tobacco taxes would not be enough, and sacrifices would have to come from somewhere, such as K-12 education.

Westlund claims we need to start over, and that there is enough money already in the system to pay for necessary changes.

“The discussion (about the health care delivery system) needs to be as comprehensive as possible. We need to ask ourselves this question: If we had a blank canvas, how would we paint a health care delivery system in this state? Once you have that defined, and it is defined well in both Senate Bill 27 and Senate Bill 329, then you let the committee process work, you take the best out of both, and you take the result as far as you can.”

Senate Bill 27 is the bill promoted by former Governor John Kitzhaber. He wrote a good opinion piece in Wednesday's Oregonian about why his plan includes Medicare dollars. (Read it here). We tried to reach Kitzhaber today but he has a packed schedule.

There are many strong similarities between the two bills, and Westlund noted that it is a sign that two processes operating independently of each other came fundamentally to the same conclusion.”

“In 2004 Oregonians spent $10.6 billion on health care, twice the amount of the biennial state budget. There are hundreds of millions (that could be saved with a revamped system)” in such areas as administration, which eats up 30 percent of each health care dollar. Doing away with enrollment eligibility would help, as would introducing standardized forms for both billing and insurance.

Westlund was blunt about doctors prescribing unnecessary procedures for profit. Bend, Westlund’s home town, has nine MRI machines, he says. He doesn’t think Bend needs that many, that some MRIs are prescribed so that those machines can turn a profit for doctors who own them.

He advocates a program of “certificate of need,” where the need for such a machine would be proven before a community is saddled with the cost.

Unless we embark on reform now, Westlund says, “we will have the same conversation in five years ...”

But in five years, everyone acknowledges the system will either be bankrupt, or it will bankrupt us.