The Will to Wellness
Proposals to the Oregon legislature on health care reform, with commentary by experts
in the business of health care
As the Oregon Legislature convenes for the 2007 session, health care still remains one of
the state’s thorniest issues. Costs continue to escalate and the numbers of uninsured
remain unsatisfactory despite the best efforts of many to create change. The once-vaunted
Oregon Health Plan has done much good for Oregon’s low income, but the plan has been
insufficient to substantially stem the tide of rising costs and growing demand.
This is not just an Oregon problem, but like other states across the nation, we may need
to create and build our own new models for health care financing, cost containments,
benefits, and delivery. Many groups are already working on strategies and plans. The four
proposals outlined briefly on the following pages are likely to be presented in some form
to the Oregon Legislature for review. Some offer strategies and concepts, while others
provide more detailed plans.
By the time the session begins it is possible that one, two, three, or all four proposals will
be blended into one final working plan. In any case, it is useful for businesses, employers
and employees to look at the foundation ideas, the strategies and the individual elements
to better understand how any final solution can be reached.
Without initial comment, we’ve provided the summaries of these plans written by the
organizations that present them. After the summaries, we have added three additional
proposals that merit attention, and at that point we provide commentary by four notable
experts in the business of health care. Mark Ganz of The Regence Group; Eileen Drake of
PCC Structurals (a division of Precision Castparts); Stephen Gregg, co-founder of the
Oregon Health Assessment Project; and Russ Danielson of Providence Health System
and take a look at some of the pluses and minuses in each of the proposals.
Can Oregon solve the health care crisis? Can we slow the pace of rising costs? Is the state
the right laboratory for reform? Keep your eyes on the legislature as they try to answer
these questions. We welcome your comments by email or letter. For more detailed
information, please visit the websites of the organizations involved.
Senate Health Care Access and Affordability Commission
The Senate Health Care Access and Affordability Commission has developed a health
care reform concept to ensure that every Oregonian receives essential health care
benefits. The plan establishes the Oregon Health Care Trust Fund, which is a repository
for health care dollars from employers, employees, state workers, public funds, and
individual contributions. From this trust, every eligible Oregonian receives an Oregon
Health Care Card, with a risk-adjusted value, that “purchases” 12-months of health care
services through an Accountable Health Plan (AHP). AHPs are private sector health care plans provided by contractors, insurers, and other providers who compete for individual
The Trust Fund program provides oversight of AHPs to ensure their use of high quality,
evidence-based services as a means of cost-containment and patient satisfaction. While at
a minimum AHPs must provide the essential services, employers and individuals can also
purchase additional benefits and services to supplement the essential benefit package.
The plan also calls for maximizing the amount of Medicaid funding and people who are
eligible for the program to ensure federal match dollars, which will help avoid health care
cost-shifting to employers, employees, state workers, and individuals. The Trust Fund is a
joint private/public entity operated by a commission consisting of employers, labor,
public members, and providers. The program will also implement numerous other cost-
containment measures to curb the escalating trajectory of health care costs in Oregon.
Source: Rick Berkobien, manager, Legislative Committee Services
Oregon Health Policy Commission — Health Care Reform Road Map
OHPC Reform Vision and Approach:
The OHPC vision for reform is to provide all Oregonians affordable access to a high-
value health care system that ensures positive outcomes and promotes healthy lives. The
OHPC believes that sustainable health care reform requires both improved access to care
and real delivery system improvements. The proposed reforms are based on the principle
that everyone participates in both the benefits and costs of the health care system. The
reforms strengthen and build on existing public and private insurance structures and
integrate prevention, cost, quality, and transparency.
OHPC Draft Recommendations (as of December 11, 2006):
The OHPC seeks to provide all Oregonians access to affordable health care through:
- Universal health coverage for children;
- Publicly-financed coverage and private insurance premium subsidies to ensure
affordable coverage for lower-income Oregonians;
- The requirement that all Oregonians purchase affordable health insurance;
- A Health Insurance Exchange, a marketplace that brings together individuals,
employers, coverage options, and public subsidies;
- Broad-based and sustainable financing through which everyone, including employers,
contributes to reform.
The OHPC reforms will create a high-value health care system by:
- Supporting public-private collaboration on value-based purchasing, managing for
quality, and making the system more transparent;
- Developing widespread, sharable electronic health records;
- Improving health care safety;
- Helping Oregonians establish a medical home; • Supporting community-based innovations that align resources for more cost-effective,
higher quality care.
Source: Gretchen Morley, OHPC Director
Oregon Business Plan – Health Care Initiative Summary
A private-public initiative is needed to fundamentally redesign the health care system and
fix the three closely-related problems of unsustainable cost increases, inconsistent quality
and lack of access to care by all Oregonians.
- Use of “value-based purchasing” by employers and public sector purchasers to
improve quality and lower costs. Employers should encourage a culture of wellness
and personal responsibility; benefits should be designed to improve health, including
coverage of preventive services, management of chronic conditions, protection from
catastrophic costs, and incentives for wellness. Employers should also create an
effective market for health care: consumer choice of health plans, better consumer
information and appropriate consumer cost sharing. Employers should develop
expectations and incentives for health plans and providers to encourage higher quality
and use of evidence-based care.
- Investment in health care information infrastructure: Encourage adoption of
electronic health records, develop mechanisms for secure exchange of health
information among providers, create standardized quality measures, and publish
transparent information on costs and quality.
- Expansion of a more cost-effective Oregon Health Plan to reduce the number of
uninsured and improve access to care. Additional state revenue should be used to
maximize federal matching funds. In exchange, providers and health plans should
reduce the cost shift by lowering charges to privately-insured employers and
- Increased access to coverage for individuals and small businesses: Require
individuals to have health insurance, subsidize low-income workers and individuals
to enable them to afford coverage, and create an “Insurance Exchange” to make it
easier for individuals and employees of small businesses to purchase insurance.
Source: Oregon Business Council Health Care Task Force
Oregon Better Health Act (The Archimedes Movement)
All Oregon residents will be eligible for the core benefit. This means that we would
eliminate categorical eligibility (including the 28 different eligibility categories in the
Financing Our approach to financing is based on the belief that, in the final analysis, the
responsibility to ensure financial access to a core benefit will fall to the public sector, not
the private sector. It can be done in one of three ways: (1) Public resources can be used to
finance a basic level of care (“core benefit”) for everyone (the “public education” model);
(2) Public resources can be used to provide a sliding scale subsidy to those with lower
incomes to ensure financial access to the core benefit (means testing); or (3) A
combination of these two approaches can be used.
A “core benefit,” which will seek to maximize the health of the population, will be
defined from among health services — both physical (including dental and vision) and
mental health and chemical dependency services — involved with providing nine broad
categories of care.
To define the core benefit, a Health Services Commission will be established. To insulate
the work of the Commission from the political process, it will be modeled after the
Federal Reserve Board. Through a transparent process, the Commission will seek public
input to prioritize these health services from the most important to the least important in
terms of the comparative health benefits of each service to the entire population served
and based on a consideration of criteria that are publicly debated and agreed upon.
How the delivery of care is organized will be driven in large part by the priorities
established in the benefit design, which will be a reflection of what we value in the new
system. We should not necessarily assume what the priorities will be but must build
broad consensus on the process and criteria that will be used to establish the priorities.
Changes in the delivery system will reflect these priorities.
Our biggest challenge is to do with the delivery system what we have been able to do
with the benefit. That is, to provide enough detail to generally shape how the delivery of
care will be organized to reflect the priorities, while not being over prescriptive and
allowing a lot of latitude and flexibility for working out details during the implementation
Payment and Cost-Sharing
The way payment and cost-sharing are structured will help create the financial incentives
for both the supply side (provider) and the demand side (consumer) side. These financial
incentives (market solutions) must be aligned (or realigned) with what we want the new
system to accomplish. Thus, the establishment of payment and cost-sharing parameters
must be done in the context of the priorities set for determining the covered benefit.
There are also dramatic disparities in reimbursement between procedural specialties and
primary care — largely because our current system assigns a higher priority to the
former. Thus, the actuarial determination of payment to providers must take into
consideration not just the cost of providing a given service but also the relative
importance of that service towards maximizing population health. In other words, reimbursement policy must create the necessary financial incentives to ensure that the
services in the core benefit are widely available.
By the same token, cost sharing (e.g. co-payments and deductibles) should not be viewed
simply as a tool to shift costs from third party payers to individuals — and thus generate
additional private funding — but rather as a tool to help create the necessary financial
incentives and disincentives to influence consumer behavior.
Sidebar: Other Reform Policy Considerations
These plans are not expected to be formally presented to the Oregon Legislature but may
be used as reference points.
Oregon Health Assessment Project
Oregon Health Assessment Project proposes an alternative system offered for voluntary
election by all Oregonians including employees, Medicaid, Medicare, and self-pay.
Sponsors of benefits (employers, Medicare, etc.) migrate from defined benefits to defined
contribution making deposits to individual, tax-advantaged Health Management Funds
(HMF). All deposits to HMFs are assessed a 10 percent fee to supplement public subsidy
of those individuals with qualified need.
The delivery and financing system is reorganized around three competing segments —
civic, traditional and self-directed. Civic is government run, single-payer-like; Traditional
is access to current plan offerings; Self-directed is high deductible, catastrophic insurance
with aggressive premium incentives to minimize adverse lifestyle risks.
All individuals must have an HMF and may elect from the same spectrum of service
options subject to any limitations by funding source. Participating insurers are obligated
to “guaranteed issue” and procedures designed to mitigate risk selection considerations.
The plan is organized regionally within the state and implemented in a way that invites
experimentation before statewide installation.
Source: Stephen Gregg
Swiss Health Care System
Under the Swiss health care system, individuals pay about a third less on health care than
the average American, in part because of government-enforced price controls.
Every resident of Switzerland is required to buy health insurance. If they don't, they pay
stiff penalties. Companies have no role. Health care plans are chosen at the kitchen table,
not through employee benefit departments. The plans can be costly. A family of four in
Switzerland pays an average of $680 a month in premiums. Government assistance helps
pay premiums for those less well off.
Health care prices are set each year after negotiations between insurance companies and
medical providers. The fee schedule has to be approved by the Swiss canton (or state)
governments. Drug costs are also subject to price ceilings, but they still seem fairly
expensive in the minds of Swiss consumers.
Swiss think the quality of their medical care is among the best in the world. They spend
more of their national income on health care, 11.5 percent, than anyone except
Americans, who spend 16 percent. They have the freedom to see any doctor in their
canton, and they don't have long waits. And Swiss health care providers have much less
paperwork than their U.S. counterparts.
In 2003, Switzerland spent an average of $3,781 per person on health care. The United
States spent $5,635 per person, according to an October 2005 report of the Organization
for Economic Cooperation and Development.
Everyone in Switzerland is obliged to buy insurance, the 87 Swiss health insurance
companies also have to offer a basic health care plan priced without regard to risk. The
companies can't make a profit on this basic plan, and they compete for profits by offering
high or low deductibles and supplemental benefits.
Swiss insurers charge a premium for each family member. Children have a lower
premium than adults, but for a family of four, insurance premiums for the basic coverage
plan are about $8,167 a year. An American family with employer-provided health
insurance pays an average of $2,713 a year in premiums, according to a survey by the
Kaiser Family Foundation. But health insurance premiums are lower than the U.S.
average when employers’ costs are added, according to the survey. For an American
family of four, employers contribute an average of $8,167, for a total of $10,880 a year.
Deductibles and co-pays are comparable to those paid in the U.S.
Swiss cantons subsidize health insurance premiums based on income. With premiums
climbing an average of 5 percent a year over the last decade, subsidies now go to nearly a
third of Switzerland’s 7.5 million residents.
Massachusetts Health Care Reform
The enactment of comprehensive health reform puts Massachusetts on the path to make
breakthrough strides in health access. The law’s backers hope to cover 95 percent of the
uninsured in the Commonwealth within three years.
The law’s premise is shared responsibility: Individuals, employers and government all
have a role in advancing affordable coverage.
The statute, a compromise among proposals advanced by the Republican governor, the
Democratic legislature and a broad coalition of health advocates, relies on a number of
unique mechanisms to expand access to affordable coverage:
- Medicaid expansions will cover low- and moderate-income children and a new
outreach campaign will find unenrolled people and get them to sign up for
- Subsidized private coverage with sliding-scale premiums will cover those up to
three times the poverty level ($60,000/family of four);
- An individual mandate requires all adults to maintain coverage, provided an
affordable plan is available;
- Insurance reforms and a state-sponsored marketplace called the Connector will
allow individuals to get insurance at group rates and ease purchase for small
- A modest employer assessment requires firms with 11 or more workers to pay a
fee if they do not provide reasonable coverage to their employees;
- A new “Quality and Cost Council” will set performance benchmarks and
publicize how providers are doing, and a Disparities Council will prioritize ending
racial and ethnic health disparities.
Implementation presents many difficult challenges. The Massachusetts experiment is
provoking exciting conversations nationally, as the public demands action on health.
Source: Brian Rosman, research director at Health Care For All, a Boston-based non-
profit health advocacy group
A CRITICAL LOOK AT HEALTH CARE PROPOSALS BEFORE THE 2007
Mark Ganz is president and chief executive officer of Regence, a regional not-for-profit
health and life insurance company based in Portland. Regence serves approximately
three million people in Oregon, Washington, Idaho, and Utah. Ganz has participated in
the region’s ever-evolving health care community his entire life, and health care is his
personal and professional cause.
The current health care system is broken and in need of major structural change. All
stakeholders — patients, employers, physicians, hospitals, and health plans — have
contributed to the dysfunctional health care system we have today. Regence is actively
participating in all of Oregon’s major reform efforts and work groups: Archimedes,
Oregon Business Council, the Oregon Health Policy Commission, and The Senate
Commission on Health Care Access and Affordability.
All of these efforts focus on the need for universal access to care. Getting everyone
covered by health insurance is important and something we absolutely support. But, it is
not enough that health care access be extended to include coverage for all uninsured; real
reform will only be accomplished when we create an affordable, sustainable health care
system built on the foundation of patient-focused competition, consumer choice and
shared responsibility for health and wellness. For these reform efforts to work, we will
need accountability, full transparency of provider quality, and cost and engagement of the
patient and physician in evidence-based health care decision making.
Regence also sees a need for collaboration among these many Oregon health care reform
work groups. It is critical that these competing reform efforts be at the same table and
engage in a collaborative process to define a single vision that will lead to a sustainable
health care system. If we end up in a legislative free-for-all between the competing
reform proposals, there is a real likelihood that we will have little or nothing to show for
all the effort.
None of the Oregon health care reform proposals is an ideal vision of a future health care
system. For every stakeholder, each proposal contains provisions they like and provisions
they don't like. But we all must recognize the difference between what we want from our
health care system and the reality of what we can afford. Each of us must also take
accountability for improving and maintaining our health — and move from a mindset that
says, “How can I get my share?” to one that says, “How can I improve my health and
create a sustainable community of care that serves everyone?”
The health care reform proposal that I find particularly compelling is proposed by the
Oregon Business Council (OBC). It expands access and comes closest to creating a fair
market where everybody is motivated to improve health, ensure quality and tame costs.
The OBC proposal recommends the following:
- Use value-based purchasing by employers and public sector purchasers to drive up
quality and lower costs.
- Invest in health care information infrastructure development, including widespread
adoption of electronic medical records, exchange of health information among
providers, standardized quality measures, and transparent information on provider
costs and quality.
- Expand Medicaid to reduce the number of uninsured and improve access to care. Use
additional state revenue to maximize federal matching funds that are currently
available to the state, and increase payments to providers who serve Medicaid
patients to improve access to care. The plan should recognize that providers will
benefit from expanded coverage for patients who currently receive charity care
thereby creating an opportunity to reduce the cost shift to private sector purchasers.
- Increase access to coverage for individuals and small businesses.
- Require individuals to have health insurance.
- Subsidize low-income workers and individuals to enable them to afford coverage.
- Create an “Insurance Exchange” for individuals and employees of small businesses.
The OBC proposal is built on the concept of engagement and value-based purchasing.
This is a very simple concept we apply all the time in business and in our personal lives:
engaging in the decision-making process and balancing cost and quality to find value.
The health care system can be transformed to foster community access and consumerism.
This is the value proposition for health plans in the future. We should take pride in the
innovation that is occurring throughout our state to improve our health care system. We
have before us an unprecedented opportunity, but we need to find the common ground
that exists within all of these proposals and use that as the foundation for change.
Working together, I believe we can transform health care into a functioning, sustainable
marketplace where consumers and purchasers truly take charge.
Eileen Drake is the vice president of administration and legal affairs for PCC
Structurals, Inc. (A Precision Castparts Corp. business). Her responsibilities at PCC
Structurals include human resources, environment, safety, and legal matters. She is also
the industry chair for the workforce development committee of the Manufacturing 21
Coalition and an industry lead on the workforce initiatives of the Oregon Business Plan.
There are, of course, good ideas in all four proposals — and remarkable similarities
across them. All call for “affordable basic” health insurance for all Oregonians, effective
cost containment and quality control, evidence-based service delivery, sharable electronic
patient records, maximizing Medicaid funding, and public/private oversight. Three call
for combined public and private funding; the fourth would rely only on “public”
financing. Only one explicitly emphasizes consumer education, wellness and preventive
services incentives, and chronic condition management, but, presumably, the others
would incorporate these concepts within their larger scopes. All deserve further
consideration by the legislature — at least in terms of their fundamental concepts.
At the same time, the four proposals share the same shortcoming. They represent
“tinkering” with today’s programs to fill gaps when what we need is a broad re-thinking
of the fundamentals of health care service delivery and insurance. Even if we agree that
“gap filling” is the best we can do short-run, to move forward in the direction urged in
these proposals, we need to be able to answer several key questions:
What do we mean by “affordable basic” health insurance?
It is easy to support the idea of affordable basic health insurance for all Oregonians.
Indeed, who could say “no” to that principle? Stating the objective, though, begs the
question of what services and what levels of cost are included in “basic” coverage. As a
society, we have shown we are not ready to address tough ethical choices about access to
health care services, drugs and treatments. We do not want to view health care service
access as we do other consumer choices. We seem incapable of saying “no,” yet costs
continue to escalate with increasingly more expensive improvements in treatments and
Several years ago there was great public outcry over a decision that “basic” health
insurance did not cover a multi-organ transplant procedure, and public sentiment
overrode the decision. The concept of “basic” insurance coverage implies access or
reimbursement limits, but we should have no reason to believe that there will be public
tolerance for such limits. Unless we can address this consideration, how are we not right
back where we are today with people seeking and receiving treatment and drugs that are
not covered by their own “basic” insurance or funds?
What are the viable funding sources?
Again, it seems intuitive that funding for the proposed reforms will require both “public”
and “private” dollars. (The proposal that purports to rely only on public funding
presumably does not ignore the fact that “private” monies are the source of all public
funds.) What are these funding sources and how will they be generated? We cannot
simply add another budget item against the state General Fund and call this “covered.”
We cannot comment on the feasibility of the funding propositions without much more
detail on the proposed sources.
How do we make provider quality and cost data transparent?
The premise is that it is impossible for health care consumers to make good choices
without access to reliable data about quality and cost of services. Yet the reality is we use
health care services without regard to, and without knowing, the cost. This may be due
simply to the fact that consumers do not have access to this information. If, however, this
relates back to the ethical standard that cost is not an issue when it comes to any
individual’s treatment, then providing more “data” will not alter consumer behavior.
While quality and cost transparency is important, we also need more insight into how
health care consumers make choices.
Is it really possible to reform health care access and affordability in Oregon without
re-engineering the U.S. health care system?
Although we think of health care for Oregonians as a “local” issue (and indeed, our
contact with providers and insurers is primarily local), the system in this state is solidly
intertwined with that across the U.S. We do have a “national” health care system in the
U.S., just not “nationalized” health care. It would have been valuable to include Sen. Ron
Wyden’s recently announced proposal for national reform in this article. His plan merits
serious consideration. It shares the same fundamental objectives as these four proposals
but in the framework of a systematic re-structuring of health care access in a way that is
both radical and pragmatic. We would do well to follow his lead and pursue health care
reform that works for Oregonians and the rest of the country. Incorporating his proposal
with these state-level approaches would be time and effort well spent.
Stephen A. Gregg
Stephen Gregg was the founder and CEO of the Ethix Corporation, a Portland-based
national managed care company, which was sold to a national health insurer in 1994.
Gregg has been a senior vice president of a hospital management company and an
administrator of a 400-bed acute care hospital in Minneapolis, Minn.
Gregg is the co-founder of the Oregon Health Assessment Project (OHAP), a community-
based initiative concerned with the development of an actionable and comprehensive
redesign of Oregon’s health care system. OHAP produced its first suggested plan for
actionable reform in 2003.
The Oregon legislature and governor will be deliberating health care reform during the
upcoming political season. The debate will focus on a hybrid of a few homegrown
options. If these options represent the policy choices to be made, then Oregon will have a
revised health care system likely characterized by:
- An individual and employer mandate to purchase health insurance with
benefits and a target price prescribed by the state.
- An escalation of the state’s control, responsibility, and administrative
bureaucracy for the collection and redistribution of premium dollars, in a
manner it determines equitable.
- A minimized disruption of the current insurance and delivery systems.
- A troubling lack of proven strategies to control costs
In the minds of many, this is an organizational precursor to a single payer system.
There could be a dark side to these good intentions. All Oregonians will be required to
purchase a liberally defined insurance policy and to support an inordinately expensive
health care system with few structural limitations on future spending. Is this “smart”
Reform proposals represent solutions to an unstated problem. Could we agree to the
following problem statement? Oregon must find a way to change its health care system,
such that universal access is achieved, costs are controlled, and financing is shared in an
These proposals offer decent prospects for universal access and perhaps more equitable
financing. Each offers vague and undemonstrated methods of controlling costs. Covering
the uninsured and “rounding up” benefits to cover prevention, mental health and dental
will be inflationary. State government, on the heels of PERS, a troubled education system
and a decomposed Oregon Health Plan has wobbly credentials as the focus of leadership
for health care.
Health care cost is the elephant in the room, and everyone knows it. The brightest people
involved greatly underestimate the challenge of controlling costs. Otherwise we would
not tolerate the populist group-think that if we eliminated smoking, provided just a little
more financing for prevention, and placed everyone’s medical record on a computer,
premium dollars would decrease. As strategies to control costs, such ideas are trite,
faddish, unproven, and so much wishful thinking.
If we are serious about costs, and indeed we may not be, the legislature’s reform proposal
should suffer the requirement of a “proof of concept” before statewide implementation.
Otherwise, we just create a larger mess than we started with.
As with Hans Christian Anderson’s fable, “The Emperor’s New Clothes,” perhaps the
predominant culture of Oregon prefers shared deception over the painful realities of
Russ Danielson serves as chief executive for Providence Health System in Oregon. He
has responsibility for all health system operations in Oregon, including Providence’s
seven hospitals, long-term care facilities, statewide home health agency, clinics, and
health plans. Providence Health System is the largest health system in the state and is
Oregon’s second largest private employer, with more than 15,000 employees.
As Oregon’s largest health system and second-largest private employer, Providence
Health System believes that health care reform should be a key priority at the state,
regional and national levels. For more than a year, leaders and physicians within
Providence have been working to develop our own elements of reform. These elements create a platform from which we can review the important work being done by others
who consider health care reform essential.
We developed Providence’s reform elements through the participation and insight of
some of Oregon’s best and brightest health care leaders, including physicians,
economists, health plan executives, hospital leaders, and our financial experts.
We agreed from the start that our goal was health care reform to ensure access and
affordability, with an emphasis on accountability and transparency.
To us, access means universal coverage for all. It should be portable and not exclusively
linked to employment. We believe a basic benefits package is needed. That package
should be developed through a public process that makes benefit decisions explicit and
rational. Evidence-based guidelines should be used, and we must respect the intrinsic
value of each person’s life.
We believe those currently covered by Medicaid should be included in the universal basic
package. The state should purchase health care in the same manner as it is financed for
other state residents.
Providence believes insurers must have a role and must participate in providing the basic
plan. Consumers must be able to choose from any basic plan offered by those insurers
and must be able to buy additional coverage beyond the basic package.
We are also focused on affordability. Cost control is paramount and must be built in to
any proposal. While reform might result in an initial investment, we should see it lead to
more predictable and affordable costs of care for employers and consumers. Any
consumer financing needs to be based on income level; only the lowest-income
consumers would not share costs.
Providence also believes that health insurance premiums should be community rated.
This would broadly share risk with premium risk adjustments to prevent problems of
Government should continue the Medicare program — but it too should be reformed so
that it is financially sound and not subsidized by the private sector.
In the areas of accountability and transparency, consumers deserve quality care based on
the best available medical evidence and practices. Health care providers and insurers
should provide consumers with easy access to information about quality, standards of
care and cost information.
Hospitals, other providers and insurers should collaborate and share responsibility for
effective cost containment. If reforms result in lower rates of charity care and overall
community benefit burden, providers and insurers should pass that on through lower
costs, premiums and rates.
Providence is sharing these elements and working closely with those who are
championing reform. We support three specific efforts because we see them all pulling in
the same direction — working to ensure a healthy Oregon.
Providence Supports the Current Model of the Senate Commission on Health Care
Access and Affordability
The commission’s work closely mirrors Providence’s elements, and we will continue to
share information from our own reform work with the commission in addition to
supporting its efforts. We will look forward to working with Sens. Bates and Westlund as
they pursue a commitment to reform in the 2007 legislative session.
Providence Supports the Archimedes Movement
Providence supports the vision of Dr. John Kitzhaber. Through the Archimedes
Movement, he has been able to galvanize many leaders to support the need for health care
reform. We are continuing our conversations with him as his concept evolves and gains
Providence Supports the Oregon Business Council
Providence supports the work being done by the Oregon Business Council on incremental
health care reform. We recognize the key role business leadership plays in this
discussion, and we are encouraged by the council’s focus on such areas as improving
quality, lowering costs and expanding Medicaid.
Providence will also review the ideas put forth by the Oregon Health Policy Commission,
Sen. Ron Wyden and others. As additional proposals arise, we will compare them to our
own elements to see where we can find common ground for discussion.
Providence Health System in Oregon has one of the best financial assistance programs
for the poor and vulnerable in the country. It is a vital component of our mission, and we
hope it serves a model for others. We also know that every day many thousands of
Oregonians worry about how to get health care and how to pay for health services, and
some delay getting care because of these worries. Health care reform can eliminate these
We look forward to Oregon leading the country in writing a new chapter in health care
BrainstormNW - January 2007