4 A
❘
SATURDAY EDITION
❘ JULY 22, 2017
Siuslaw News
P.O. Box 10
Florence, OR 97439
NED HICKSON , EDITOR
Opinion
Zombie Health Care — BCRA rising from the dead?
O
ne has to wonder in what way did the
Senate’s latest “Repeal and Replace”
proposals “dig” into the real issues,
such as providing the affordable, accessible
and comprehensive health care so many
Americans were not only promised but are in
dire need of?
The key question is how Americans can
secure what every other industrialized nation
is already being provided at half our current
healthcare costs?
Let’s start with the fact that, for normal cit-
izens under the recently “stunned” Better Care
and Reconciliation Act (BCRA) proposal,
essential policy coverage elements and cost
protections could be “waived” by each state.
But, according to law professor and health
care policy expert Timothy Jost, that “waiver
of essential health benefits apparently would
not have applied to ACA plans that cover
members of Congress.”
At 172 pages, crafted behind closed doors,
how did the Senate’s BCRA actually compare
with the 1,000-plus paged Affordable Care
Act (ACA)? A full year of detailed public
debate surrounded ACA’s passage, amid more
than 170 Congressional hearings.
Interestingly, after the passage of the ACA,
lead Democratic Senator Max Baucus retired
to join the insurance industry. It wasn’t the
first time the bronze revolving door appeared.
In December 2003, President Bush signed the
Medicare Modernization Act (MMA) provid-
ing first-time Medicare Part-D pharmaceuti-
cal coverage.
Just like BCRA, it was created without
public hearings and presented to Congress for
a vote — all in the same evening. MMA
barred Medicare from negotiating lower drug
prices. It also denied Americans ability to
import cheaper drugs. By comparison, the
Veterans’ Administration negotiates prices,
the result of which are drastically reduced
drug pricing scales.
Within days of passing the MMA, lead
committee member Congressman Billy
Tauzin (La.), a 25-year “Democrat-turned-
GOP” resigned his $150,000 a year
Congressional seat, joining PhRMA — a
powerful pharmaceutical trade-lobby group,
where his annual income skyrocketed to more
than $2 million.
Today, as drug costs increasingly eat away
at U.S. health funding, each zombie-like
GUEST VIEWPOINT
R AND D AWSON
R ETIRED INSURANCE COMPANY LITIGATOR
“Repeal and Replace” version rises from the
dead, retaining MMA’s 2003 pharmaceutical
price protections and drug importation bans.
The BCRA also overlooked complex drug
pricing and payment schemes designed to
profit everyone except the American con-
sumer. It ignored the hidden issue of drug
industry “rebates” to care providers, insurance
companies and pharmacy benefit managers
(PBM), who prescribe or otherwise decide
which drugs will be approved for policy hold-
er payment.
Some “rebate” programs exceed 40 percent
of labeled drug costs. Meanwhile, consumers
pay full price, unaware such “kickbacks” may
influence prescribing higher-priced drugs
rather than equally effective, lower-priced
drugs.
As for carrier administrative costs, BCRA
eliminated the ACA’s “80/20 Medical Loss
Ratio” (MLR) rule. These discourage carriers
from charging — and pocketing — excessive
revenue above actual health costs.
They require payout of at least 80 percent
of premiums for actual health costs, not carri-
er administrative costs or profits. If a carrier’s
administrative costs or profits exceed 15-20
percent of premium charges, consumers
receive rebates for the excess. Rebates now
top $2.4 billion. Under BCRA, MLRs and
rebates ceased unless each state created its
own MLR program.
Long-term and nursing home care were
also at risk through BCRA’s deep Medicaid
cuts. Effective after the next election cycle,
cuts then deepened. Approximately 64 percent
of nursing homes residents are dependent on
Medicaid. BCRA removed requirements that
state Medicaid programs cover such care. The
respected Medicare Rights Center predicted
BCRA “Will end Medicaid as we know it.”
As for ACA cost-sharing for “individual
market” deductibles and co-pays, BCRA
would have phased out all support after the
2018 elections — and ACA premium support
would have been reduced significantly.
BCRA also lifted ACA rules limiting carri-
ers from charging older consumers more than
three times the rates paid by younger policy
holders. Under BCRA, “age-rating” price
ratios would have risen by five times or more.
And BCRA’s big picture for rural commu-
nities? National Rural Health Association,
representing nearly 2,000 rural and small-
town hospitals, said it would lead to more
uninsured people, greater health disparities
and “...ultimately be a death sentence for
[many] rural hospitals across the country.”
Beyond BCRA, the GOP is also exhuming
its 2015 “repeal-and-delay” proposals, killing
significant parts of the ACA, without any
immediate replacement. On July 19, the bi-
partisan Congressional Budget Office (CBO)
issued their analysis of this. According to the
CBO:
— “Average premiums in the nongroup
market (individual policies in ACA and pri-
vate market) increase roughly 25 percent ... in
2018, 50 percent in 2020 ... and double by
2026...”
—”Half of the nation’s population would
live in areas having no insurer participating in
the nongroup market in 2020 ...[increasing] to
about three-quarters of the population by
2026.”
One can see why interest and poll-approval
is growing for an expanded “Medicare-for-
all.” Traditional Medicare has demonstrated
administrative costs of under 5 percent.
In the Harvard Business Review published
July 18, the Boston University School of
Public Health Dean wrote, “The core of the
ACA framework is unstable — a hostage to
the market and political fortune. By contrast,
a single-payer model stands to be much more
durable and provides a chance to build a
healthcare system around the well-being of
patients rather than the profits of providers
and insurers.”
Senate Bill 1046, in the Oregon
Legislature, supported by more than one-third
of all Legislators, outlines such an approach.
Health care alternatives exist. The logic and
dimension of future care will reflect the level
of concern and engagement demonstrated by
ordinary Americans.
Otherwise, our health care will remain
hostage to a multitude of “market-based” risk
pools and zombie-like special interests con-
tinuing to spread their infection throughout
our healthcare system — one bite at a time.
VIEW FROM UPRIVER
Just the facts
W ESLEY V OTH
For the Siuslaw News
M
ost readers of this col-
umn probably drive
through
Mapleton
somewhat regularly on the way
to or from Eugene or other
points. Fewer of you take the
more scenic and meandering
route of Highway 36 that begins
by going straight at the blinking
light and that passes our house.
The upriver community has
struggled for some time eco-
nomically, and one of the ways
that has been obvious is the
number of vacant houses and
shuttered businesses.
Here are a few recent
changes, both positive and sad:
Following the passage of our
school bond and matching
monies from the state, construc-
tion work is underway at the
Mapleton
schools;
the
Gingerbread, a Mapleton icon
that was revisioned a couple of
years ago as Pop’s Gingerbread
with smoked barbecue as a fea-
ture, has closed (ignore the bill-
board just outside Florence) and
is for sale according to the mes-
sage board in front; Alphabit, the
purple café and gift shop run for
more than 40 years by Alpha
Farm in the strip of storefront
businesses, closed more than a
year ago.
That building has been pur-
chased by a Mapleton family
with ties to a Florence restaurant
from years ago, the Blue Hen.
(I hear they plan to open a gift
shop with soup and sandwiches
somewhat in keeping with
Alphabit’s traditions.)
Lastly in Mapleton, its infa-
mous blue apartments, con-
demned and abandoned for
some years, are now gone (well,
at least the burnable parts)
thanks to a “Burn to Learn.”
I have only heard that spoken
of positively, with no nostalgia
for their heyday.
In Swisshome, American
Laminators — there since 1979
and the only mill still operating
in this area — has a sign out
front that indicates they are hir-
ing. I can’t remember seeing that
before.
For a company that claims
that the average tenure for its
line workers is 15 years, that
seems significant.
The long reddish building
across from the Swisshome Post
Office, where that community’s
grocery and gas station long
operated but unused for that pur-
pose for several years, has a new
owner with a different purpose
in mind for the space.
When I met and spoke with
him this week, he was enthusias-
tic about moving his soy product
manufacturing business here
from the Eugene area. The
building’s large concrete pad
apparently makes it ideally suit-
ed for the heavy equipment used
in the production of tempeh,
where whole soybeans are inoc-
ulated with a mold culture, fer-
mented at a warm temperature,
allowing
the mycelium to
envelop the beans into a dense
mushroom-like solid that is a
highly nutritious food — and a
staple of vegetarian and vegan
diets.
The day this column is due to
be circulated, Relay for Life will
be held in Florence, an event
that unites us all in concern
about cancer and its causes and
treatment.
I am the only member of the
nuclear family of six in which I
grew up to have so far not been
diagnosed with cancer; half of
us are dead from it.
None of those cancers were
caused by engaging in risky
behaviors other than perhaps liv-
ing and working in environ-
ments where there was exposure
to chemicals known to cause
cancer. If there was no other rea-
son and argument for universal
healthcare than that, it would be
sufficient to get my vote.
LETTERS
H APPY AND SAD
What a wonderful day for Florence. The
Coast Guard makes us their 24th Coast
Guard City. These men and women are
among the best we have; challenging and
defeating mother nature on the sea in all her
fury is no easy task.
I applaud them all and thank them for the
comfort they give to those in need.
At the same time, I learned that we have
lost two local motorcyclists. As a rider
myself, it never goes without notice that our
love of the ride is not without danger. All it
takes is for someone to be in a little too
much of a hurry, checking Facebook on their
phone or any number of distractions to be
the cause of a fatal accident. And it should
be said that yes we are also the cause of our
own demise on occasion.
We should all take this unfortunate time
to give pause to those we love that ride on
two wheels — and yes, we who ride need to
practice the same caution. My condolences
to the families of the lost.
— David T. Eckhardt
Florence
F ROM BELIEVER TO QUESTIONER
In my younger years I was a certified
speech-language pathologist. Many of my
clients were throat cancer patients with
laryngectomies. Their voice boxes, neck
muscles and lymph nodes had been surgical-
ly removed. I taught them esophageal
speech where they learned to vibrate their
esophagus (swallowing tube) for vibratory
sound on which to form their speech.
At that time, I became curious about the
American Cancer Society, hoping ACS
could be of benefit to my patients. I sent for
ACS’s literature and realized it was largely
promotional for donations.
Yesterday, I went online after reading
Siuslaw News editor Ned Hickson’s well-
crafted “Spreading Ripples of Hope,” and
ACS Community Development Manager
Amy Bickleman’s contributions in Color
Me Purple (Siuslaw News, July 19).
Online, I found that the terms of the com-
pensation package for American Cancer
Society CEO, Gary M. Reedy, “are confi-
dential.” Previous CEO John Seffin report-
edly earned $856,442 annually, plus
$77,859 — equaling $934,301.
Cancer is a unifier and Relay for Life is
an internationally popular event of hope. We
all have lost friends and family to cancer.
Bickleman states, “Remember, we walk
as a symbol of our unwavering effort and
hope to one day live in a world without can-
cer.”
I, however, cannot fund “nonprofits”
such as The ACS, whose net worth is stated
to be $1,281,000,000, and in which CEOs
are paid outrageous salaries funded by loss
and hope.
— Kathryn Dawson
Westlake
❘ 541-902-3520 ❘
NHICKSON @ THESIUSLAWNEWS . COM
The First Amendment
C
ongress shall make no law respecting an estab-
lishment of religion or prohibiting the free exer-
cise thereof; or abridging the freedom of speech, or of
the press, or the right of the people peaceably to
assemble, and to petition the Government for a
redress of grievances.
USPS# 497-660
Copyright 2017 © Siuslaw News
Published every Wednesday and Saturday at 148 Maple St. in Florence, Lane County, Oregon. A member of the
National Newspaper Association and Oregon Newspaper Publishers Association. Periodicals postage paid at
Florence, Ore. Postmaster, send address changes to: Siuslaw News, P.O. Box 10, Florence, OR 97439; phone
541-997-3441; fax 541-997-7979. All press releases may be sent to PressReleases@TheSiuslawNews.com.
Oregon Group Publisher 541-265 8571
Publisher, ext. 318
Editor, ext. 313
Consulting Editor 831-761-7353
Email: echalhoub@register-pajaronian.com
Marketing Director, ext. 326
Office Supervisor, ext. 312
Production Supervisor
Press Manager
James Rand
Jenna Bartlett
Ned Hickson
Erik Chalhoub
Susan Gutierrez
Cathy Dietz
Ron Annis
Jeremy Gentry
DEADLINES:
Wednesday Issue—General news, Monday noon; Budgets, four days prior to publication; Regular classified ads,
Monday 1 p.m.; Display ads, Monday noon; Boxed and display classified ads, Friday 5 p.m.
Saturday Issue—General news, Thursday noon; Budgets, two days prior to publication; Regular
classifiedad,sThursday 1 p.m.; Display ads, Thursday noon; Boxed and display classified ads, Wednesday 5 p.m.
Soundings, Tuesday 5 p.m.
NEWSPAPER SUBSCRIPTION RATES:
In Lane County — 1-year subscription, $71; 10-weeks subscription, $18; Out of Lane County — 1-year subscrip-
tion,$94; 10-weeks subscription, $24; Out of State — 1-year subscription, $120; Out of United States — 1-year
subscription, $200; E-Edition Online Only (Anywhere) — 1-year subscription, $65.
Mail subscription includes E-Edition.
Website and E-Edition: www.TheSiuslawNews.com
L ETTERS
TO THE
P OLICY
E DITOR
The Siuslaw News welcomes letters to the editor
as part of a community discussion of issues on the
local, state and national level.
Emailed letters are preferred. Handwritten or
typed letters must be signed. All letters need to
include full name, address and phone number; only
name and city will be printed. Letters should be
limited to about 300 words. Letters are subject to
editing for length, grammar and clarity. Publication
of any letter is not guaranteed and depends on
space available and the volume of letters received.
Libelous, argumentative and anonymous letters
or poetry, or letters from outside our readership
area will not be published.
P OLITICAL /E LECTION L ETTERS :
Election-related letters must address pertinent or
timely issues of interest to our readers at-large.
Letters must 1) Not be a part of letter-writing
campaigns on behalf of (or by) candidates; 2)
Ensure any information about a candidate is accu-
rate, fair and not from second-hand knowledge or
hearsay; and 3) explain the reasons to support
candidates based on personal experience and per-
spective rather than partisanship and campaign-
style rhetoric.
Candidates themselves may not use the letters to
the editor column to outline their views and plat-
forms or to ask for votes; this constitutes paid polit-
ical advertising.
As with all letters and advertising content, the
newspaper, at the sole discretion of the publisher,
general manager and editor, reserves the right to
reject any letter that doesn’t follow the above crite-
ria.
Send letters to:
nhickson@thesiuslawnews.com
WHERE TO WRITE
Pres. Donald Trump
The White House
1600 Pennsylvania Ave.
NW
Washington, D.C. 20500
Comments: 202-456-1111
Switchboard: 202-456-1414
FAX: 202-456-2461
TTY/TDD Comments:
202-456-6213
www.whitehouse.gov
Gov. Kate Brown
160 State Capitol
900 Court St.
Salem, Ore. 97301-4047
Governor’s Citizens’ Rep.
Message Line:
503-378-4582
www.oregon.gov/gov
U.S. Sen. Ron Wyden
221 Dirksen Senate Office
Bldg
Washington, DC 20510
202-224-5244
541-431-0229
www.wyden.senate.gov
U.S. Sen. Jeff Merkley
313 Hart Senate Office
Bldg
Washington, DC 20510
202-224-3753/FAX: 202-
228-3997
541-465-6750
www.merkley.senate.gov
U.S. Rep. Peter DeFazio
( 4 th Dist.)
2134 Rayburn HOB
Washington, DC 20515
202-225-6416
541-269-2609
541-465-6732
www.defazio.house.gov
State Sen. Arnie Roblan
( Dist. 5 )
900 Court St. NE - S-417
Salem, OR 97301
503-986-1705
FAX: 503-986-1080
Email: Sen.ArnieRoblan@
state.or.us
State Rep. Caddy
McKeown
( Dist. 9 )
900 Court St. NE
Salem, OR 97301
503-986-1409
Email: rep.caddymckeown
@state.or.us
West Lane County
Commissioner
Jay Bozievich
125 E. Eighth St.
Eugene, OR 97401
541-682-4203
FAX: 541-682-4616
Email:
Jay.Bozievich@
co.lane.or.us