Campaign for Single-Payer Building Up Steam in Oregon

Inspired by Vermont's success in establishing a state-run program, Health Care for All Oregon to start a grass roots public outreach campaign
Christen McCurdy

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.”

Samuel Metz on the Supreme Court Decision upholding the Affordable Care Act

Affordable Care Act is bad news for American families

Published: Monday, July 02, 2012, on Oregon Live

By Samuel Metz

Is the Supreme Court decision upholding the Affordable Care Act good news or bad? It depends on who you are.

If you are President Obama, the news is good. The highest court in the land just validated the showpiece legislation of your first years in office. Election prospects just got brighter.

If you are Gov. John Kitzhaber or one of the 600,000 Oregonians in the Oregon Health Plan, the news is also good. This decision preserves critically important support from the ACA to the health care transformation process, a dramatic method of health care delivery with potential to provide better care at lower cost for 15 percent of Oregon's population.

And if you are a health insurance executive, the news is spectacular. The Supreme Court just confirmed a law requiring every American to purchase your product regardless of price, or face a penalty. Protests on the Supreme Court steps were drowned out by the clinking of whiskey glasses in health insurance boardrooms around the country.

For the rest of us, however, it is bad news indeed. Yes, the ACA will dramatically increase the number of insurance policies sold, but it won't make policies cheaper, nor will it make health care more affordable or more accessible.

In fact, the ACA will increase health care spending by $400 billion annually. This extra cost will not appear on the federal budget because costs are passed on to us, the patients, via compulsory purchases of insurance, increased premium prices and dramatically increased out-of-pocket spending.

Nor will the ACA protect American families from financial and medical catastrophe if one of us gets the wrong disease at the wrong time. Our most vulnerable families still face the unhappy choice of spending their last dollar on their mortgage or on their health care deductible.

Every industrialized country in the world provides better care to more people for less money than we do. None use our uniquely American style of private health insurance. Let's get real: If we plan a radical and painful makeover of our disastrous health care system, doesn't it make more sense to emulate these systems that work (using publicly funded universal health care) rather than one that doesn't? And the one system that we absolutely know doesn't work is the one we have now.

Unhappily, the ACA is guaranteed to produce one sure-fire result. Americans will become more dependent than ever before on private health insurance for their only access to health care. If you like what private health insurance has inflicted on our society up to now, just wait until you see what the newly approved ACA will do to us in the future.

Neither Congress nor the ACA will save us from health care Armageddon. We in Oregon must take charge of our future. It's time to create our own reality-based, cost-effective, publicly funded universal health care system and say tell the Supreme Court and ACA to take a hike.

Samuel Metz is a Portland anesthesiologist and a member of Physicians for a National Health Program and Mad As Hell Doctors, both advocates for single-payer health care, and of Health Care for All Oregon, an umbrella organization advocating for publicly funded universal care for all Oregonians.

Reform Party
Reform party
August 05, 2012 8:15 am  •  By Bennett Hall, Corvallis Gazette-Times

Nadine Grzeskowiak of Mid-Valley Health Care Advocates hosts a party in her Corvallis home last week. The local group is one of several reform organizations around the state holding house parties to build support for a declaration of health care as a human right, a step toward establishing a single-payer health care system in Oregon. (Andy Cripe | Corvallis Gazette-Times)

Single-payer health care advocates hold house parties to recruit supporters for their cause

On a recent Wednesday night in Corvallis, a dozen people sit around Nadine Grzeskowiak’s living room sipping organic lemonade and munching gluten-free pie while video images flickered on a screen.

But they’re not watching the London Olympics. They’re viewing a Power Point presentation on America’s health care crisis.

After a series of statistics detailing soaring insurance premiums, worsening health problems and widespread medical bankruptcies, up pops a slide on the benefits of single-payer health care.

It’s not a government takeover of private medical care, Grzeskowiak tells the intimate gathering of friends and neighbors. It’s simply a rational response to a national emergency.

“People in this country don’t want anybody to take their freedoms away,” she says. “The thing is, we actually lost our freedom in this country a long time ago when it comes to health care.”

Statewide push

House parties like this one are being organized all over Oregon by reform advocates like Grzeskowiak, a registered nurse whose struggles with undiagnosed celiac disease soured her on a system she believes puts profits before patients.

“Why should I look for celiac disease,” she said one doctor asked her, “when there’s no treatment I can bill for?”

Grzeskowiak is the vice chair of Mid-Valley Health Care Advocates, one of several regional organizations working under the umbrella of Health Care for All Oregon in a statewide push to declare health care a human right.

The grassroots campaign is modeled after a successful effort in Vermont and is seen as a stepping stone on the road to establishing universal, taxpayer-funded health insurance for all Oregonians — a single-payer system.

Mid-Valley Health Care Advocates has held more than a dozen house parties to date, said Bud Laurent, the organization’s chair. Each one usually attracts 12 to 15 people, and they seem to create a self-sustaining momentum.

“We’re averaging about three a month,” Laurent said. “Often what happens is that a house party will spawn a house party.”

It’s a bottom-up strategy calculated to win a few supporters at a time. Attendees are encouraged to get involved in various ways, from distributing promotional materials and writing letters to the editor to recording video testimonials and posing for a photo holding a “Health Care Is a Human Right” placard.

The idea is to gradually build a groundswell of support for single-payer health care in this state, then push for legislative action.

New momentum?

Previous efforts to promote the idea in the Legislature have fallen short, and voters roundly rejected a Health Care for All Oregon ballot measure in 2002. Oregon reformers want to make sure they have public opinion firmly on their side before going back to the political well again.

“In my mind, we need to work at least a year, maybe two,” Laurent said, before introducing another single-payer bill or launching another initiative petition.

Not everyone at Grzeskowiak’s party was ready to jump on the single-payer bandwagon, with some of the guests asking pointed questions about the advisability of scrapping private insurance and replacing it with a government-run system financed by tax money.

That was a cue for some of the other reform advocates at the gathering to jump into the fray.

Private insurance is wasteful, argued Paul Hochfeld, an emergency room physician who co-founded a single-payer advocacy group called the Mad As Hell Doctors.

The mishmash of health plans we have now takes money away from patient care and diverts it to overhead, while the payment system creates perverse incentives to do costly and unnecessary procedures, Hochfeld said.

Meanwhile, those who can’t afford insurance put off treatment until they get desperately ill and show up in the ER, driving up the amount of uncompensated care hospitals must provide and pushing up costs for everyone else.

“What we have to do is get people to understand that we are all paying for everybody anyway,” he said.

“We just have to find a way to get value for our money.”

Eventually the conversation becomes more general, with many of the guests sharing personal horror stories of rejected insurance claims, crushing medical bills and illness left untreated for lack of coverage.

There’s also a lively exchange of ideas on different ways to improve the system.

Hochfeld said he doesn’t expect to change anyone’s mind about health reform at a house party. Most people, he believes, stake out their positions based on political ideology or personal values. But some are receptive, and those are the ones he’s hoping to reach.

“It’s not about converting people,” he said. “It’s about talking to the people who haven’t made up their minds yet one way or the other.”

Cheryl Lohman came to Grzeskowiak’s house willing to be persuaded. A small business owner with no health insurance, she recently helped her mother through a health crisis and worries about what would happen if she got sick herself.

“I’m kind of scared,” she told the group. “And I wonder what the United States would look like if we didn’t have to worry about health care.”

By the end of the meeting, Lohman is aflame with enthusiasm for single-payer health care. She grabs a stack of promotional literature, picks up some “Health Care Is a Human Right” buttons featuring a Rosie the Riveter look-alike in a nurse’s uniform, and gets her picture taken for the photo petition.

Before she leaves, Lohman tells Grzeskowiak she’s determined to do something to help promote the cause.

“It’s bubbling up inside,” she says. “I know I want to make a difference.”

Contact reporter Bennett Hall at or 541-758-9529.