Initiative for state-funded health care died in legislation last night

Welcome to Oregon, where residents have the right to an education, religious tolerance and free speech – and if Rep. Mitch Greenlick, D-Portland, ever succeeds in getting one of his controversial resolutions through a senate committee, the right to state-funded health care for all its citizens.
One of those plans was House Joint Resolution 100, which would have designated health care as a constitutional right to Oregonians. But as of 8 p.m. Thursday, when legislators adjourned, HJR 100 had not been heard by the Senate Rules Committee, effectively killing the resolution, according to Molly Woon, spokeswoman for the Senate Majority Office.
This Democratic House member, who holds a doctorate in medical care organization, has championed three initiatives in the legislature that, if passed, would have put the issue of state-funded health care to citizens for a vote.
If approved by voters, the state’s constitution would have been amended to read: “Health care is an essential safeguard to human life … and is a fundamental right.”
The resolution passed the House on Feb. 13, but on a strictly party-line vote. It was referred to the Senate Rules Committee and then Ways and Means, a budgeting committee.
Because legislators are in a shortened “special session,” timeliness plays a major factor. All bills and resolutions had to pass out of committee by 12 a.m. Friday in order to qualify for a floor vote in the House or Senate.
The resolution was the same as HJR 18 , which was introduced in the 2007 legislature, passed the House in a near-party-line vote, but later died in the Senate Rules Committee.
In 2005, Greenlick began Measure 40, which would have put the health care issue to voters, but he failed to get enough signatures for his “Hope for Oregon Families Initiative” to make it on the November 2006 ballot.
Some 600,000 Oregonians – about 16 percent of the state’s population – are currently uninsured, and while Democrats have pushed for state-covered health insurance, House Republicans have raised serious questions about the infrastructure of HJR 100.
Republican representative Dennis Richardson, R-Central Point, called HJR 18 “a road to disaster” in his weekly newsletter and has openly opposed this year’s HJR 100.
The resolution offered no plan as to who will pay for the health insurance, what benefits will be covered and how much will it cost taxpayers.
Richardson asked these questions in his newsletter and then served up some hefty figures to reinforce his hesitation.
He stated that it would cost approximately $3 billion per year to fund such a program, and asked, “What would prevent Oregon from being a magnet for sick people from other states who move to Oregon to become eligible for” the universal health care?
If Oregonians reject tax increases to pay for such a program, the money would take funds away from other programs, such as education, public safety, seniors and children, Richardson said in the newsletter.
Richardson has said lawmakers should let the Oregon Health Fund Board continue its progress.
The board was created through Senate Bill 329 in 2007, with the purpose of developing a comprehensive plan to ensure access to health care for all Oregonians, contain health care costs and address issues of quality in health care.
The seven-member committee of the OHFB will gather data, evaluate sub-committee reports and make final recommendations for health care reform legislation. These recommendations will be considered in the 2009 legislative session.
While HJR 100 withered in the Senate Rules Committee this shortened legislative session, there is the possibility of Greenlick reintroducing the issue in the 2009 session. Greenlick would have the reinforcements of the OHFB data that could help a new initiative pass by adding a structured plan to his goal of every Oregonian receiving health care.
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A consumer-driven health care system may not lead to cost cuts, experts say

Although many believe consumer-driven medicine may cut health care costs, recent studies suggest a capitalist medicine market might not reduce national health care prices in the long run.
In a world controlled by consumers, health plans require more out-of-pocket spending, which can make those consumers more hesitant to buy the prescriptions they want or need. If prices go up and buying goes down, it follows logically that health care costs will decrease.
“Having people pay higher co-payments does save health care dollars,” said University economics professor Robin McKnight, “but the co-payment deductibles are more effective for some people than others.”
In a study that examined trends among retired California public employees on Medicare, McKnight conducted with other researchers at Harvard University and the Massachusetts Institute of Technology , she found that patients with chronic diseases who were covered for less were less willing to pay for doctor’s office visits and prescription drugs. The patients deferred appointments and sometimes didn’t show up for fear of the bill.
“My experience has been that individuals who have limited income often will not buy medication,” said University Health Center Medical Director Ben Douglas. “If they have to make a choice between buying food and buying medicine, they’ll buy food.”
“We found that people are price-sensitive, and they will cut back on their use,” said McKnight.
But chronic diseases that aren’t treated generally get worse, and patients may find themselves footing an even larger bill when all is said and done. The study found a small increase in hospitalization costs among the chronically ill.
Niko Karvounis, a researcher at The Century Foundation, said another problem with a consumer-driven medicine market is the prescription drug market’s motivation for profits. “In a market-driven health care system, businesses try to maximize revenue and minimize cost,” Karvounis said in an entry on www.healthbeatblog.org. “The quickest way to do that is to market what’s already out there, rather than waste time on true innovation.”
Karvounis cited a January study conducted by York University in Toronto, which concluded that pharmaceutical companies in the U.S. spend almost twice as much on promotion than on research and development. That means the medicine people pay for might not even be as effective, resulting in higher bills while the medical problem isn’t treated effectively, Karvounis wrote.
The Oregon Legislature is tackling cutting health care costs with House Joint Resolution 100, which may be voted on in the Senate and House floor this month. The measure proposes to make a law requiring the state to offer “effective and affordable” health care to all legal Oregon residents.
McKnight says it’s an appealing concept, but “the difficulty comes in deciding what’s affordable.”
Douglas said he supports the idea of universal health care, but he said it might not offer enough assistance to low-income citizens to make a difference in a consumer-driven market.
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