Announcements

“Our current system is based on structures and assumptions that are now 40 to 50 years old and
reflect the realities of the last century, not the realities of today,” said Kitzhaber, who practiced
emergency medicine for almost 20 years before becoming governor. “Without finding the
courage to rethink these assumptions in light of today’s realities, we will be unable to meet the
health-care challenges facing our state and the nation.”

Download the full news release as a PDF.

Read what the Oregonian had to say:
The ex-governor wants to use Medicaid and Medicare cash to heal the staggering system ::  By Bill Graves :: The Oregonian, Thursday, January 18, 2007

by Maribeth Healy, Oregonians for Health Security

Earlier this year, Governor Kulongoski directed the Oregon Health Policy Commission to develop a plan to achieve universal health coverage within five years. For discussion purposes, they have spent the last few months developing a straw plan to arrive at universal insurance coverage.

The Commission has developed a straw plan that incorporates many of the reforms recently enacted in Massachusetts. With funding from a grant provided by the Northwest Health Foundation, the Commission is in the process of determining the costs for enacting such a plan.

From time to time, we will bring your attention to resources and books about health care reform. Our inaugural entry is a new book: Redefining Health Care: Creating Value-Based Competition on Results by Michael E. Porter and Elizabeth Olmsted Teisberg, published by the Harvard Business School Press (2006).

Here is the description of the book:

The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums--not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael E. Porter and innovation expert Elizabeth Olmsted Teisberg reveal the underlying--and largely overlooked--causes of the problem and provide a powerful prescription for change.

Check out the lively debate sparked by the book on the blog of Health Affairs.

"In their recently published manifesto, Redefining Health Care (2006), Michael E. Porter and Elizabeth Olmsted Teisberg — hereafter simply PT — offer a utopian vision of a health system that might occur to anyone possessed of a modicum of common sense but not too familiar with the real world of health care," according to a post by Uwe Reinhardt.

Or this one from James Robinson: "Redefining Health Care is a tour de force, a magisterial analysis, and a long-overdue application to the health sector of core principles of business strategy. It’s also a bit of 'Goldilocks and the Three Bears.'"

Rx for Healthcare will periodically post job or volunteer opportunities related to improving access to our health care system. Please send your notices to shareit@ohsu.edu.

The Commonwealth Fund is searching for a Program Officer for our State
Innovations program, which identifies, evaluates, and helps disseminate
promising state-based programs designed to improve quality, access,
coverage, equity and efficiency of health care. This program is integrally
related to the Fund's Commission on a High Performance Health System.  The
Program Officer will report to Anne Gauthier, Senior Policy Director for
the Commonwealth Fund's Commission on a High Performance Health System and
will work closely with both of us in developing strategic program plans and
program reviews, projects and budgets for the program area and in
supporting the Commission's work. Read complete job description at The Commonwealth Fund site.

Project Access is looking for a project manager. Project Access is a community driven volunteer model for providing coordinated, streamlined health care services to the uninsured. The overarching goal is to improve access and continuity of care for people without insurance who live in northwest Oregon and southwest Washington. This collaborative effort currently includes the Clackamas County Medical Society, Clark County Project Access, Coalition of Community Health Clinics, Medical Society of Metropolitan Portland, the Project Access of Washington County, and the Tri-County Health Care Safety Net Enterprise collectively referred to as the Project Access Operations Council. The expected outcome is the creation of an expanded system of care for the uninsured through coordinated volunteer physicians, unified hospital charity care referral and integrated pharmacy and ancillary services participation. Download complete description.

by Kathleen O'Connor, Founder and CEO CodeBlueNow!

The year is 1932, The Committee on the Cost of Medical Care said there were four reasons America¹s health care costs so much:

1. There are too many medical specialists;
2. There were too many infectious diseases;
3. We have a disease based system of care not prevention; and
4. Total lack of community-based health care delivery.

All this is pretty much still true, except for two things. Chronic diseases have replaced infectious diseases and Oregon is taking the lead in getting communities involved in health care. 19 of 36 counties in Oregon have taken matters in their own hands to address health care needs in their communities and over 10 other groups are working on system transformation.

CodeBlueNow! is working to find what Oregonians want in a health care system by using our new survey tool, an Opinionnaire®, which helps us find areas of common ground or disagreement.

Peter Kohler recently chatted with reporter Kayley Mendenhall about this blog for an article in The Bulletin. He commented that, unlike most blogs, we all seem a bit formal. What do you think is the best way to encourage participation? How can we make this blog more welcoming for you to post your ideas for change in the healthcare system?

Nicole
Blog technical adviser

The people take to the streets to enact their own solutions.  That is just what has happened with health care this year.  During the 2005 legislative session a myriad of reform proposals were proposed, many passed the Senate, but were ultimately killed in the House.

The legislature’s failure to address the skyrocketing cost of health care left a void advocates are attempting to fill through the initiative process.  Seven ballot measures were proposed this year to address the health care crisis.  They include measures aimed at reducing cost, increasing access and ensuring accountability.  Many of them are modeled after or exact replicas of legislation that failed in 2005.  Four of the seven initiatives are racing toward the July 7 deadline to gather signatures.

To help people learn about the measures and share their ideas for health care reform, Oregonians for Health Security and our allies across the state have been holding a series of health care forums.  In addition to sharing their own experiences, voters discuss proposed solutions and offer their own ideas to make health care more affordable and accessible.  We are holding a Portland Health Care Forum Tuesday, June 13 from 7-9 PM at the St. Andrew’s Catholic Church (806 NE Alberta).  The Portland Forum is sponsored by Oregonians for Health Security, Oregon Action and Jobs with Justice.

Below is a taste of each of the initiatives, more detailed information and links to their websites are available at www.OregoniansForHealthSecurity.org or by contacting Oregonians for Health Security at 503-655-2793.

Awhile back, the consensus was that America was facing a surplus of health care providers. A popular refrain then was that new nursing grads would be “driving taxis” for a living.

Turns out, the rhetoric worked and too few people entered the health care field. Now, just as the baby-boomers reach the age when they need health care more than ever and as the health care system is besieged with other cost and access challenges, we also now face a serious shortage of both nurses and physicians, said OHSU President Peter Kohler during his remarks at a recent Oregon Health Forum meeting in Portland. Nurses will definitely not be driving taxis in the future.

Kohler agreed with Kitzhaber’s premise that fundamental change to the health care finance system is needed (see Part 1: “What’s Wrong With That Fish?”). Kohler then talked about delivery models, which both speakers also said need to evolve to meet current and future needs.

At a (very) early breakfast put on today by the Oregon Health Forum, former Governor John Kitzhaber and OHSU President Peter Kohler talked about their visions of health and health care in the future. General agreement: the system must be fixed.

Both men spoke eloquently; there were many memorable lines and anecdotes but two in particular seem to encapsulate their respective thinking: “What is wrong with that fish?” (John Kitzhaber) and “Nurses will not be driving taxis.” (Peter Kohler).

First, we unravel the fish anecdote (what follows is a brief summary of Kitzhaber’s presentation. Check out www.archimedesmovement.org for more information).

Kitzhaber described a boat trip down the Rogue River with a friend from New York. A large salmon floated by, lethargic, scales falling off, a shadow of its former glory. The friend asked:” My gosh, what is wrong with that fish?” and Kitzhaber responded: “Nothing. It is just dying.” Having spawned, it was at the end of its natural life-cycle.

Kitzhaber used this anecdote to shine a light on the ineffective allocation of health care funds in the current system. “We think death is optional,” he said. And we use a huge amount of public money to prove it.

On April 12, Massachusetts Governor Romney signed into law a plan to extend health insurance coverage to the state's nearly 500,000 uninsured people. How? The law makes health insurance compulsory, like auto insurance. Every "body" is required to have it. The law also requires the state government to figure out ways to make sure insurance is available and theoretically affordable to employers and individuals. 

At first, the new law resulted in tons of favorable media coverage and general jubilation. Since then, on closer scrutiny, Massachusetts’s law has sparked debate, and not all of it is complimentary. Why?