Imagine walking to class, and just as you are trying to cross the street, a bicyclist comes bearing down on you out of nowhere and, quickly dodging them, you twist your ankle.
You try to shake it off, but as the day continues, the seemingly benign injury really starts to bother you.
If you have private insurance, you would be able to go to a doctor. However, if you are one of the the 200,000 Oregonians who are members of the Oregon Health Plan, it’s not quite that easy.
Only certain medical providers will accept OHP-covered individuals, and even those that take the insurance don’t provide all the services necessary when patients fall ill, hurt themselves or suffer from a mental condition.
The Oregon Health Plan first started in 1994 and was conceived and realized by emergency room doctor-turned-state senator John Kitzhaber. Kitzhaber first became governor of Oregon in 1995 and has remained active in making health care accessible to all residents.
In the same vein as the federal health care reform passed last year, the state legislature is looking to streamline the way resources are provided to patients by building a better, less costly health plan, which would provide care through a coordinated care organization.
Oregon senators and House health committees are working on a piece of legislation — Senate Bill 99 — that would give all Oregonians access to health care through a type of insurance marketplace called an “exchange.” This measure will be part of the federal health reform passed last year and should come into effect by 2014.
“SB 99 allows Oregon to create a central marketplace that meets the needs of our community rather than waiting for federal reform to create one for us,” Kitzhaber said in a release.
This bill would go hand in hand with another proposed measure transforming health care for Medicaid and the Oregon Health Plan by providing a coordinated care organization for patients.
This organization would comprise teams of physicians, dentists, nutritionists and therapists who will operate with a lump sum of state money to spend as they choose; this will be helpful mainly to patients with multiple health problems, such as those suffering from asthma, diabetes or substance abuse.
Bruce Goldberg, director of the Oregon Health Authority, said the care teams will focus on the 20 percent of the people who account for 80 percent of health care costs.
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