August 30, 2012 -- The effort to establish a single-payer system in Oregon isn't dead. A group called Health Care for All Oregon has existed in Oregon for about 20 years, but its corporate identity was
passed on to a newly formed group this January, said Dr. Mike Huntington, a Corvallis oncologist who serves as the organization's chair. So far the group includes a board and a coalition of 53 groups – including healthcare organizations, community groups and labor organizations – devoted to educating the public and eventually attempting to pass legislation guaranteeing healthcare for all of Oregon's citizens.
Huntington said the renewed campaign has taken inspiration from what organizers in Vermont were able to accomplish. Single payer bills were introduced in Vermont for more than 25 years, but were
unable to get legislative approval until a widespread public education campaign around the theme of health care as a human right raised enough public interest that voters put pressure on legislators to pass the bill.
“It takes more than just very good, logical, irrefutable arguments,” Huntington said. Right now, the group is focused on talking to coalition members and in the coming months will provide training and public outreach events to discuss its public education campaign, which will still emphasize healthcare as being a human right – but also differentiate the proposed reforms from those that have already been passed at the state and federal level.
“Our focus is, first of all, educating, informing the population about the need for universal access and a good quality healthcare system, in addition to the state and federal legislation that has already been passed or is in the process of being implemented,” Huntington said. “Even with the best possible system there will be huge problems or huge deficits.”
Huntington said the Oregon Health Plan was originally designed with some tools similar to those used in countries with single-payer care systems, including a list of procedures that should be prioritized for coverage, with immunizations and other preventive treatments taking highest priority. That reform was hamstrung because officials intended to fine-tune the list every year based partly on public input, which violates a clause in the Americans with Disabilities Act, which prevents the state from discontinuing coverage for services it has covered in the past.
“There were a number of reasons it was shackled, really, that had little to do with how well it was designed,” Huntington said.
Part of the success of the campaign message is that it's simple, Huntington said, adding that proponents of healthcare reform have to become more comfortable speaking in sound bites. Even so, he added his own qualifier to the message:
“I would qualify that 'healthcare is a human right,' it doesn't mean you get an MRI if you have had back pain for two weeks,” Huntington said. “It means you get the healthcare you need, when you need it.”
“Conservative critics would respond, Healthcare is not a human right,” said Portland anesthesiologist Dr. Samuel Metz, who’s involved with coalition but clarified that he was speaking on his own behalf to The Lund Report. “Here's where I'm in the minority: I believe we can be more successful if we point out that providing healthcare is not a goal, it's a tool.”
Even if people are ideologically opposed to the idea of providing healthcare for others, pointing out that they're already paying for care for the uninsured – in the form of higher insurance premiums and higher costs for services – can help persuade them that providing insurance upfront will help control those costs.
In 2011, House Bill 3510 – which was introduced by Rep. Michael Dembrow (D-Portland) proposed single-payer healthcare in Oregon – failed, but went further than sponsors expected. Part of the problem, Metz said, was that the bill's sponsors were mostly Multnomah County Democrats, but some Republicans showed interest in its potential to control costs: he estimated that 40 percent of the cost of healthcare is administration. Metz also noted that CEOs of three major Oregon insurers – Providence, Kaiser and Legacy – have been quoted on record as favoring single-payer healthcare, even while lobbyists for the insurance industry fought it.
“These are all fairly insightful people, and they're not speaking for the industry,” said Metz, adding that the Canadian healthcare system actually started with one province – Saskatchewan – creating a single- payer system, with several others following suit until the country decided to nationalize the program.
“We're the only country that lets 44,000 people die each year because they don't have insurance. We think it's normal in the United States that if your insurance won't pay, you have raise $150,000 at a bake sale. We think that's normal,” Metz said. “It doesn't have to be this way.”