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East Oregonian
Tuesday, June 19, 2018
CHRISTOPHER RUSH
Publisher
KATHRYN B. BROWN
Owner
DANIEL WATTENBURGER
Managing Editor
TIM TRAINOR
Opinion Page Editor
Founded October 16, 1875
OUR VIEW
What should health care
in Oregon look like?
he state’s top health official
is traveling the state, asking
that question at 10 public
meetings. The responses will help
shape health care for about one-fourth
of Oregonians, those who are on the
state Medicaid program known as the
Oregon Health Plan. Many of those
clients work at low-wage jobs that lack
health insurance.
However, the question matters to
all Oregonians. The answers will help
determine how our state and federal
tax dollars will be used and, over time,
how private health care will adapt
and mirror the innovations in the
Oregon Health Plan. Such practices as
developmental screenings for children
can become the statewide norm when
instituted for the health plan, according
to Patrick Allen, director of the Oregon
Health Authority.
Allen has substantially improved
the management, responsiveness and
transparency of the state health agency
since taking charge last year. Starting
Monday, he is on the road to hear from
Oregonians before his agency takes its
T
next steps in transforming health care.
--The public meeting in Hermiston
will be from noon to 2 p.m. Tuesday,
June 19, at the Eastern Oregon Trade
and Event Center, 1750 E Airport
Road. Meetings also are being held in
Astoria, Bend, Coos Bay, Corvallis,
Hood River, Klamath Falls, Ontario,
Portland and Springfield.
In 2012, Oregon took a bold step to
improve health care and control costs.
Coordinated care organizations —
now commonly referred to as CCOs —
were established throughout the state to
ensure that physical, mental and dental
health care worked together for people
on the Oregon Health Plan.
CCOs are to health care what a high-
quality, lifetime bumper-to-bumper
warranty is to auto maintenance.
Traditional health care is fee-for-
service. Hospitals, physicians and other
providers get paid according to the
scope of care provided. (Fees can vary
widely based on government programs,
private insurance or out-of-pocket
payments).
In contrast, CCOs receive a set
Staff photo by E.J. Harris
Umatilla city councilor Selene Torres-Medrano puts up a flyer for a recent mental
health fair at the city hall building in Umatilla.
amount of government money each
month for Oregon Health Plan clients.
The CCOs are responsible for all
the patients’ care regardless of cost.
Their financial incentive is to keep the
patients healthy, thereby saving money
— an incentive that can broaden how
health care is delivered.
For example, consider a person
with high blood pressure who forgets
to take his medications and thus
repeatedly winds up in the hospital
emergency room. It makes more
sense — financially, socially and
psychologically — for a nurse to call or
visit the patient each day to ensure he
takes his medication.
Research indicates Oregon’s CCO
model is effective but imperfect.
Mental and dental health care are not
as well integrated into the holistic
approach. CCOs have saved the
state money, but health-care costs
continue to grow faster than the overall
economy.
State officials have dozens of ideas
for improvement. But they want, and
need, to hear what the public thinks.
OTHER VIEWS
Big business is squashing small
T
YOUR VIEWS
Separating children
unacceptable and appalling
I am appalled, saddened and ashamed that in
recent weeks our country has chosen to abuse
children by unnecessarily removing them from their
families.
The separation of children, including very young
children, from their families strikes me as a close
parallel to the way our country herded and confined
Japanese Americans during the World War II. Plenty
has been written describing what the experience of
those people was like. Their physical needs may
have been taken care of, but the very act of being
incarcerated for no crime of their own was shameful
behavior by the rest of us.
By locking up children and separating them from
their families, we have now entered another dark
period in America. Yes, the physical needs of these
children are being reported by some observers as
reasonably good, and I hope that is true. However,
that does not and can not compensate for the effects
of being placed in large facilities and not having
any contact at all with their parents, no matter how
well the children may be able to understand it. In
addition, not allowing the families any contact with
their children is cruel and frightening to both the
children and the families.
Imagine being taken as a child from your family
with no contact, no way to know if or when you
may see them again, and placed with dozens or
hundreds of other children, none of whom you
know. Recently a reporter described them smiling
and looking happy. However, I know that is often a
survival tool children will use in an effort to please
those in charge and to hide the natural fear inside
that won’t go away.
As a clinical social worker for 45 years, I listened
to many stories from people who much later still
suffered from post-traumatic stress due to separation
from their family when young, whether for a long
or a short period. The negative effects of the current
situation will likely last well into the adult years of
the children now being incarcerated, and for many
of them it will last their lifetime.
The Attorney General’s attempt to quote
scripture to justify incarcerating children away
from their parents is an unacceptable attempt
to rationalize immoral and cruel actions against
innocent children. Mental health professionals and
educators in most states are required by law to report
cases of suspected abuse or neglect of children.
Unsigned editorials are the opinion of the
East Oregonian editorial board. Other
columns, letters and cartoons on this page
express the opinions of the authors and
not necessarily that of the East Oregonian.
What our government is now doing by locking up
these children clearly meets the definition of abuse
and neglect. The federal government is now in the
position of the acting parent of these children, and
is now responsible for their well being. At the same
time, our government claims it’s actions are required
by law. The response from congress and others in
our government is unacceptable and inexcusable.
Bruce Barnes, Pendleton
No more roads to nowhere
I am certainly in favor of jobs in Pendleton. I
just wonder if a $25 million UAS industrial park
is the best use of our money.
I was impressed with the tour of the UAS
command center. When talking to the people
in charge of the center, the impression I got
was that there would be few jobs for Pendleton
residents and no chance of manufacturing at the
airport. I did write a letter to the editor in favor of
continuing with the UAS project because it could
help make the airport self supporting for once.
That was before the $25 million cost was known.
I think this is to much to spend on a few jobs.
The city has applied for a $3 million federal
grant for this project. This size grant usually
comes with strings attached — like we have
match the $3 million grant with city funds. It
looks like the city has a good chance to get the
grant, and there may be more hoops to jump
through for the money.
If we get the federal grant without having
promises to add more than our own matching
funds, stop there. If $6 million doesn’t make the
airport profitable, we had better look elsewhere
to make the airport self supporting and bring jobs
to Pendleton.
The city council wants to spend another
$11.5 million for water supply and storage
at the airport. Fine — if the city can show us
companies are obligated to build if we put in
the infrastructure. Why does Pendleton do
everything backwards? First get industry to say
we will build if the city puts the utilities in.
I think we are already stuck with spending
the $6 million and higher utility bills. Let’s stop
there until we can see if any industry is willing to
come to Pendleton. Please council members: No
more roads to nowhere.
Rex Morehouse
Pendleton
he next round of media
In the late 1980s, small
consolidation has
companies were still a lot
arrived. AT&T has
bigger, combined, than big
bought Time Warner, thanks
companies. In 1989, firms
to a federal judge’s ruling last
with fewer than 50 workers
week. Comcast and Disney
employed about one-third
are fighting with each other to
of American workers —
buy 21st Century Fox. CBS,
accounting for millions more
Verizon and Viacom, among
jobs than companies with at
David
others, may also get involved
Leonhardt least 10,000 employees.
in a merger. “The floodgates
Since then, though,
Comment
will open,” media analyst
many small businesses
Jessica Reif told The Wall
have struggled to keep up
Street Journal after the judge’s AT&T with the new corporate giants and
ruling.
with foreign competition. You can
All of these companies have
probably see a version of the story
decided that their best strategy for
in your community. The hardware
raising profits involves getting bigger. store has given way to Home Depot.
Larger companies simply have more
The local hospital and bank are
power — to compete with other
owned by a chain. The supermarket
giants, to restrain workers’ pay, to
is Whole Foods, which is now owned
influence government policy and, in
by Amazon. The family-owned
the long run, to increase prices.
manufacturer may simply be out of
It’s true beyond the media industry, business.
too. Airlines, banks and oil companies
The share of Americans working
have merged in recent decades. So
for small companies fell to 27.4
have retailers, hospitals, hotels,
percent in 2014, the most recent year
for which data exists, down from 32.4
manufacturers, drug companies and
in 1989. And big companies have
law firms. The resulting behemoths
grown by almost an identical amount.
have then taken advantage of
Today, companies with at least
their newfound scale, as well as
10,000 workers employ more people
globalization and digital technology,
than companies with fewer than 50
to grow further.
workers.
For everyone else, the
Big companies, to be fair, have
consolidation boom hasn’t worked out
their virtues. They can create jobs,
so well. Since the modern merger era
take on ambitious projects and
began in the 1980s, corporate profits
compete around the world. But the
have surged, while family incomes
have stagnated and income inequality balance in the modern U.S. economy
is off. Large companies today are
has increased. Say this much for
often taking advantage of workers,
the corporate executives who argue
consumers, taxpayers and small
that a bigger company can be more
businesses.
profitable: They know what they’re
“This has been a blind spot for
talking about.
the last 20, 30 years,” Ro Khanna,
In recent months, I’ve spent
a Democratic member of Congress
some time trying to figure out just
who represents Silicon Valley, told
how much bigger — as a share of
me. “One of the things that people
the U.S. economy — big business
are rebelling against in this country
has become. The question has been
harder to answer than I expected. The is large, growing institutions. People
feel that individuals don’t control
Fortune 500 ranking doesn’t answer
their destiny.”
the question, for example, because it
He’s right. The situation will get
doesn’t distinguish between domestic
worse before it gets better, partly
and foreign revenue. And while some
because of the AT&T ruling. But
good academic work has analyzed
corporate consolidation is a problem
consolidation within industries, I
haven’t been able to find an economy- that’s within our power to fix. A
government that wanted to reduce
wide measure.
the power of big business — through
So I set out to create one, with
a combination of new laws, better
help from an obscure Census Bureau
data set known as Business Dynamics regulation and different judicial
appointments — could do so. Here’s
Statistics. It shows how many
hoping we get such a government
American workers are employed by
sometime soon.
different-size companies, now and in
■
the past.
David Leonhardt is an op-ed col-
The changes over the past quarter-
umnist for The New York Times.
century are pretty remarkable.
The East Oregonian welcomes original letters of 400 words or less on public issues and public policies for publication in the
newspaper and on our website. The newspaper reserves the right to withhold letters that address concerns about individual
services and products or letters that infringe on the rights of private citizens. Letters must be signed by the author and include the
city of residence and a daytime phone number. The phone number will not be published. Unsigned letters will not be published.
Send letters to managing editor Daniel Wattenburger, 211 S.E. Byers Ave. Pendleton, OR 97801 or email editor@eastoregonian.com.