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What went wrong with the Oregon Health Plan, and what does it say about the prospects for coverage expansion initiatives in other states? Those are the questions addressed by Jonathan Oberlander in a Health Affairs Web Exclusive published today.

When it was first enacted in 1989, and approved by the federal government as a Section 1115 Medicaid demonstration project in 1993, OHP represented a leading state policy innovation that sparked a national debate on rationing health care. OHP was "intended to expand Medicaid to more people by covering fewer services," says author Jonathan Oberlander. But now the plan is "covering both fewer services and fewer people, and the elimination of entire benefit categories and rollback in enrolled beneficiaries looks more like the arbitrary cuts common in other states than the rational and equitable model of prioritization to which Oregon aspired."

You can read the article at: http://content.healthaffairs.org/cgi/content/abstract/hlthaff.26.1.w96

Continue reading Health Affairs Article Dissects The Rise And Fall Of The Oregon Health Plan


According to a recent article by Bill Graves in the Oregonian, the proposal would give every Oregonian access to a card that could buy complete health care coverage at a lower cost.

On the surface, it seems a terrific idea. As explained by Graves, the Senate commission's plan would require all employers and individuals to contribute money to a common pool called the Oregon Health Care Trust Fund, but people with low earnings relative to the federal poverty level would not have to pay (thereby "solving" the problems facing 600,000 uninsured Oregonians). The fund also would include public employee and federal Medicaid contributions.

But the devil, as they say, is in the details....and working out the details will not be easy but it is at least something, right? Still, questions fly: Is it workable? Is it affordable? Have we been down this (dead-end?) road before? How will it fit in with national proposals? Will it drive physicians out of state?...and so on.

Continue reading Oregon Senate panel endorses universal health care plan, will submit to Legislature


There is an old folk tale about the peasant wife and how she solved a problem. Every night, she and her husband found that their feet were cold while they slept, because their blanket was not long enough to tuck in.

To solve the problem, she cut off a wide strip from the top of the blanket and sewed it on the bottom. That way, she reasoned, there should be enough blanket at the bottom to tuck it in at night.

This kind of thinking seems to be what is going on in "health care reform."

Solving the whole health-care conundrum all at once would be too much to ask, but what about starting with one significant change?

Continue reading Health care reform could start with one significant change


A new national survey finds widespread support across the political spectrum for a number of health initiatives likely to be taken up by the new Congress, as well as a widely-held view that government should do more to address the high cost of health care. At the same time, the war in Iraq continues to play a dominant role among the public’s priorities, with economic and health concerns following distantly.

The poll, conducted November 9-19 by the Kaiser Family Foundation and the Harvard School of Public Health, included a nationally representative sample of 1,867 adults. The survey looks at the public’s priorities and views on health issues as a new Democratic majority takes the leadership of Congress and as the 2008 presidential campaign begins to take shape. It focuses, in particular, on differences and similarities among Democrats, Republicans, and those who identify themselves as Independents or something else.

When asked to pick their top health care priority, most people point either to expanding coverage for the uninsured (35%) or reducing health care costs (30%). Fewer (18%) choose improving the Medicare drug benefit. And, while policymakers struggle with the budget deficit, few people (6%) rank reducing spending on government health programs as their top priority. But partisan differences emerge on priorities, with Democrats placing a much higher priority on expanding coverage, Republicans emphasizing reducing costs, and Independents split.

Continue reading Public Sees Health Care Prices as Unreasonable and Wants Government to Take Steps to Lower Them


Although the budget announced this week by the Governor is by no means the final product, the Governor's budget sets the tone for the legislative session. The proposed new $700 million will be used to provide health insurance coverage to 117,000 uninsured children, expand Oregon Health Plan/Medicaid to up to an additional 65,000 Oregonians, improved mental health services, train more health care providers, lower prescription costs and more. Unquestionably, these are welcome proposals, but is more needed to address the health care access crisis in Oregon?

Read more on the budget in the Oregonian article or read the governor's budget summary.

Continue reading Oregon Governor's proposed budget provides additional $700 million for health care



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