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Health care reform is a priority right now in Oregon .
So we invited some of those most involved in the numerous reform efforts being considered by the 2007 Legislature to share their thoughts on what needs to be done.
These days, it seems like everyone has a plan to fix our health care system.
There are at least four major reform plans currently in play in Oregon . Some are being discussed in Salem while others are sponsored by or aimed at federal decision-makers in Washington , D.C.
This activity is good in several ways.
It shows broad recognition that our system needs significant change. The status quo is not an option.
Also, it has brought all the parties to one discussion or another. Providers, payers, patient groups, business and labor all have a role in any meaningful solution.
All of us have to roll up our sleeves, sit at the same table and truly put aside our own self-interests.
As a starting point, here’s where Oregon ’s hospitals weigh in.
First, we’re focused on accountability. Recently, we introduced legislation in Salem requiring every Oregon hospital to issue a Community Benefits Report.
This inventory, based on nationally recognized definitions and criteria, will provide a full accounting of the programs and services that Oregon ’s hospitals provide their communities either free of charge or below actual costs.
What is your hospital contributing to meet local health care needs? The inventories will present a clear and consistent picture for all to see.
Quality also is at the top of our list. Your doctors and hospitals need to continue to refine meaningful ways to measure and report the quality of the care we receive.
This must be done in a way that patients can understand, so that we can factor the quality of care provided into our family health care decisions.
Cost is another area where we must do more. Oregon ’s hospitals and doctors are recognized nationally for efficiency and quality. Yet costs continue to rise, driven in part by new technology, increasing manpower needs, buildings that need upgrades or replacement, and the huge increase in uncompensated care.
Cost increases also are driven by chronic underpayment of providers’ actual costs by the Medicare and Medicaid programs.
The cost increases drive insurance premiums higher. As premiums rise, fewer companies offer health insurance.
The number of people without insurance rises, and they ultimately end up at the emergency room —and that is the most expensive “access point” in the system. Without insurance, many cannot pay the high cost of emergency room care.
These costs are then shifted to those who have insurance … causing premiums to rise again. And so the spiral continues.
That spiral leads directly to discussion of appropriate access to health care services — something everyone is talking about.
The details may be complex, but at least for hospitals, the goal is simple. We believe every Oregonian should have access to coordinated health care services that are focused on keeping people out of the hospital emergency room for ailments and chronic conditions that are more appropriately managed in a setting such as a primary care clinic.
We also believe that every Oregonian must have some form of insurance — through stable, well-financed government programs or through employer-provided coverage.
Finally, all of this attention is shining a light not just on the health care system, but also on our expectations as users of that system.
The crucial question may come down to you and me: what do we want from our health care system, anyway? If the answer is “everything,” we may be in for a long discussion. And we can’t simply rely on someone else to ask the hard questions and to provide the solutions.
The truth is, we created this system together and we’ll have to work together to fix it.
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