Northwest labor press., April 18, 2008, Page 16, Image 16

...Labor leaders promote affordable health care for all
(From Page 2)
Oregon Health Fund’s biggest beneficiaries
could end up being hospitals and insurers.
Hospitals are mostly non-profit, and much
of the justification for that status comes from
the so-called charity care they provide — basi-
cally care to uninsured individuals who don’t
end up paying their bills. If all Oregonians are
insured, then there are no unpaid bills, and thus
a windfall to providers that Crider says could
be in the range of $400 million a year. If the
Oregon Health Fund could figure out a way to
reclaim even two-thirds of that money through
a tax on health care providers, it would go a
long way to pay for the program. The challenge
would be coming up with a way to prevent
them from passing on the tax in the form of
higher prices.
Meanwhile, having 600,000 new insurance
customers could mean a windfall for insurers.
So Harris and Crider want to cap insurance
profits and administrative costs. Harris says oth-
ers on the committee have argued there are no
profits in the system when insurers like Regence
Blue Cross Blue Shield are non-profit organiza-
tions. Harris scoffs at that. She said the Finance
Committee held one meeting at Regence’s Port-
land office, on the 18th floor of its downtown
building. Harris sat at a mahogany table in a
leather chair, her coffee cup on a leather coaster,
the room trimmed in cherry wood and leather
and floored with oriental carpet.
Crider sits on a Finance subcommittee, the
Exchange Work Group, which is fleshing out
plans for an entity through which individuals
and businesses could purchase affordable insur-
ance. The Exchange could be as little as a con-
sumer information Web site enabling individu-
als and businesses to compare competing plans
from private insurers. Or it could be a negotiat-
ing tool, aggregating the buying power of hun-
dreds of thousands of participants to bargain a
very affordable price from the insurance com-
panies. It could even be a regulatory body, cap-
ping insurance profits and administrative ex-
penses and requiring insurers to get approval
before they could increase premiums. But the
question of who could buy through the Ex-
change has still to be determined. If the Fi-
nance Committee can’t reach consensus, Crider
said, it might end up forwarding a menu of op-
tions to the Oregon Health Fund Board.
Meanwhile, the 19-member Delivery Sys-
tems Committee has three labor voices: Diane
Lovell of Oregon AFSCME, Stefan Ostrach of
the Teamsters, and Healey, of Oregonians for
Health Security, who co-chairs the committee.
The Delivery Systems Committee is looking at
how to pay health care providers (mainly hos-
pitals, physicians, and dentists), and how to get
the most bang for the buck. It’s also supposed
to come up with a way to control cost in-
creases. Without cost control, the whole pro-
gram could quickly become unaffordable. SB
329 lays out a specific mandate that costs of the
program not increase by more than the general
cost-of-living index. If the Oregon Health Fund
achieves that, that alone would be an accom-
plishment, since medical inflation has for years
been triple the inflation rate of other parts of
the economy.
The Eligibility and Enrollment Committee,
on which SEIU Local 49 Political Director Fe-
lisa Hagins serves, is working out the subsidy
structure that will enable the health coverage to
be affordable. For example, the plan might of-
fer a health insurance tax credit to individuals
earning up to three or four times the poverty
level, with the goal of limiting insurance costs
to 5 percent of an individual’s income.
Susan King, head of the Oregon Nurses As-
sociation, chairs the Benefits Committee,
which is looking at what constitutes the set of
“essential health services” that would be re-
quired for all health plans offered through the
program. At a minimum, the plans will include
some level of dental, vision, mental health and
prescription drug coverage, preventive care,
chronic disease management and short hospital
stays. But it might not include catastrophic care
or expensive end-of-life care. The benefit struc-
ture will likely have features designed to mini-
mize cost to the program, like zero co-pays for
primary or preventive care, and higher co-pays
for brand-name drugs that are no better than
cheaper alternatives. Nothing would prevent in-
dividuals or employers from purchasing addi-
tional coverage above the minimum level.
The Federal Laws Committee will figure out
what if any waivers Oregon will need to change
the way federal monies are used, and which
federal laws might need to be modified, such as
ERISA (Employee Retirement Income Secu-
rity Act), which governs union health trusts.
The Health Equities Committee will try to
come up with ways to assure that health serv-
ices are delivered in a fair way. Labor has no
representatives on those two committees.
While so much is still to be decided, one
thing is certain: The status quo is becoming in-
tolerable. Last month, Families USA, a non-
profit health care consumer advocate group, re-
leased state-by-state estimates of the number of
working-age adults who are dying because they
lack health coverage. The uninsured die pre-
ventable deaths because their diseases go undi-
agnosed and untreated until a more advanced
stage. In Oregon, the group reported, the figure
is one person per day — dying because they
lack health insurance.
In May and June, the Oregon Health Fund
Board will hold a series of 13 community
meetings across the state to listen to public in-
put on the broad concepts of health care re-
form. The meetings are free and will take place
in Gresham, Newport, Astoria, Klamath Falls,
Medford, Washington County, La Grande, On-
tario, Coos Bay, Eugene, Bend, Portland and
Salem. Each meeting will start at 7 p.m. and
run two hours. Childcare and interpreters will
be available at each meeting by calling 503-
226-7870 or toll free at 1-800-501-4220.
The first meeting will be held Thursday, May
1, at Multnomah County East Building, 600 NE
8th St., Gresham. For a list of all meetings, go
to: www.healthforum.org/events/meetings.html.
SAIF Corporation
honors the memory
of the women and
men who have lost
their lives through
workplace accidents,
and we stand with workers
across the state in our
vision to make Oregon
the safest place to work.
www.saif.com
PAGE 16
NORTHWEST LABOR PRESS
APRIL 18, 2008