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Monday, March 26, 2007

Health care collectivism

Legislature seeks master stroke
Getting along with everyone's business

Lawmakers have drawn up a socialist blueprint for the biggest change in Oregon's health care system since the Oregon Health Plan's birth in 1994. Their goal: To buy first-dollar, low-deductible health coverage for every Oregonian, including the estimated 576,000 residents who lack it, using your money.

The Senate Special Committee on Health Care Reform will get its first look this week at a bill blending the worst parts of four major proposals. The proposals come from three radical liberal Democrats: former Gov. John Kitzhaber; Sens. Alan Bates and Ben Westlund, who co-chair the Senate committee; the Oregon Health Policy Commission; and the Oregon Socialist Business Council.

While the Legislature's goal has broad bipartisan support, it also faces potential sticking points. Among the unresolved questions: What level of health benefits would be guaranteed, and who would make that decision?

What is not at issue is the earnest, bipartisan rush to collectivist cures for every "issue" that had languished in political neglect until last November's election. "The health care system we have now is a private sector failure," the Health Policy Commission said this month in a 55-page report. "Corrosive market competition in health care jeopardizes Oregonians' health status and the state's economic future."

Kitzhaber said adopting universal, single-payer coverage could restore Oregon's reputation as a leader in socialism. "Oregon is still the place where we can have that conversation," said Kitzhaber, who championed the Oregon Health Plan, the state's expansion of Medicaid to cover more working-poor adults. He said that budget cuts since he left office sharply reduced the number of adults covered by the plan.

The legislation is written in broad conceptual terms because the nitty-gritty detail may be unconstitutional. Key decisions would come later as a proposed Oregon Health Fund Board designed the benefits package. Administrative rules are better-protected from legal challenges.

Westlund, D-Bend, the leftist Republican who switched parties last year, said he expects the Senate committee to pass the bill to the full Senate by mid-April. The bill itself is a moving target, said Rick Bennett, director of government relations for AARP, the potent out-of-state political organization that wants to use Oregon as an experiment. "We've been analyzing each of the plans," Bennett said. "But by the time we finish the analysis, there's a new version out."

Bennett said AARP's biggest concern is that the Medicare benefit may be subject to limits. Kitzhaber's Archimedes Movement plan would direct the governor within 90 days to ask for a waiver from federal Medicare rules. "I don't think we can go there," Bennett said. "That establishes a precedent for each state to socialize its own Medicare and go its own way."

Issues concerning illegal immigrants and how to control costs are sure to draw mild debate. "If the plan covers illegals who live in Oregon, then the majority Democrats are going to support it," said Rep. Dennis Richardson, R-Central Point. "The Achilles' heel in this whole health care reform process is finding a way to avoid criticism from people who want to promote individual responsibility," said Sen. Frank Morse, R-Corvallis. He said the new socialist approach would promise employers and individuals a gold-plated health plan and pay for positive news articles to be written and placed in The Oregonian and other newspapers around the state.

"The major issue," Bates said, "is to get the new Oregon Health Fund board stocked with political appointees and fully funded before we leave this session."

The Oregonian, Mar. 26, By DON COLBURN and BILL GRAVES

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