Health Care and Compassion

In the May 12, 2013 Metro NW section of the Oregonian, two seemingly unrelated articles can be linked without too much effort.  One pertained to the Dalai Lama’s visit to Portland and the recent event which drew 10,000 people hungry to hear his message of compassion.  The other was David Sarasohn’s column about Governor Kitzhaber’s work to improve health care in Oregon – and a recent study of Oregon Medicaid which some are using to “prove” that expanded coverage and investment in health care doesn’t work.

The critics referring to that study are anxious to use anything they can to prove their case against health care being extended to everyone, and, in this case, are willing to overlook the fact that long term effects can’t be demonstrated with short term data.  (The study examined selected statistics about Medicaid patients added to the rolls since 2008.)  Governor Kitzhaber was right in his response to the critics’ conclusion that the expansion of Medicaid to more Oregonians didn’t work and that only “catastrophic health insurance” was needed by people who can’t afford access to basic health care  – he said that it makes no sense as fiscal policy to rely only on catastrophic coverage, and to deprive people of decent primary health care is simply immoral.

Fortunately, thanks to the Governor and other leaders, Oregon is on the path to health care reform with the advent last year of “Coordinated Care Organizations” throughout the state.  These 15 CCO’s serve Oregon’s Medicaid population, and the hope is that they will be able to serve more people in need of health care while reducing per capita costs by changing the way health care is delivered.  If this works, Oregon will be a model for other states to follow – especially those whose current elected leaders have rejected the Affordable Care Act, from which Oregon’s Coordinated Care Organizations originated.

Unfortunately, CCO’s are only part of the answer to health care reform.  There will still be tens of thousands of Oregonians without health insurance who earn too much to be eligible for Medicaid. Then there are thousands of Oregonians with health insurance through their jobs who are still going bankrupt every year due to medical costs those policies don’t cover. Finally, the number of uninsured workers is growing as health care premiums simply become too expensive for employers and employees to maintain.

What growing numbers of Oregonians understand, represented by organizations like Health for All Oregon and Mid-Valley Health Care Advocates, is that the health care “system” is badly broken and the only way to fix it – to control its skyrocketing costs while providing health care to everyone – is through unifying its administration and reforming the way health care is currently delivered.  Some call the proposed administration component “Universal,” some “Single Payer,” others “Medicare for All.”  Whatever it’s called, its goal will be to reduce the current exorbitant 20-30% overhead corporations charge, to the reasonable 3% rate that Medicare experiences.  Those savings will buy a lot of health care.

The new delivery system, which the new CCO’s will also be implementing, is called “Patient-Center Medical Homes” and will engage health care professionals working in teams, with a patient’s active involvement, providing care based on outcomes and prevention.  This reform, spread to all Oregonians, will be nothing less than revolutionary, and any revolution will be resisted by those who stand “to lose” – the for-profit insurance and hospital corporations, and some nonprofits which act like for-profits. They will not be motivated by compassion for others.

The Dalai Lama’s call for compassion and Oregon’s need for health care reform intersect at an obvious junction:  the need for individual involvement.  As the Dalai Lama suggested, compassion without action is just “lip service” or worse – hypocrisy.  Access to decent health care is a basic human need, and exclusion of anyone affects us all. With health care for all, we all benefit: family, friends, neighbors, strangers, employers, employed – everyone.

So, if you’re looking for an outlet for your sense of compassion, consider joining with Mid-Valley Health Care Advocates - or a local chapter of Health Care for All Oregon where you live - to better educate yourself about health care reform and to add your voice to the growing chorus for change.  As the Dalai Lama told the assembled in Portland (and again in Eugene), “Compassion is the key factor to one’s own well-being.”  So, by working to improve the well-being of others, we work to improve our own.  Not a bad deal...

Bud Laurent, Chair
Mid-Valley Health Care Advocates