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 cardholder customers.

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 individuals.
  • 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 Medicaid program).

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 phase.

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.

Source: swisshealth_07bus.ART0.State.Edition2.21730ee.html

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 coverage;
  • 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 firms;
  • 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


Mark Ganz

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

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 drugs.

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” policy?

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 equitable manner.

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 medical economics.

Russ Danielson

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 adverse selection.

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 more definition.

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 disparities.

We look forward to Oregon leading the country in writing a new chapter in health care reform.

BrainstormNW - January 2007

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