A4
BAKER CITY
Opinion
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Tuesday, November 1, 2022 • Baker City, Oregon
EDITORIAL
Deciding who
gets health care
when it’s scarce
W
hen there isn’t enough health care to go
around, how should Oregon decide who
gets it?
Would flipping a coin be better than what Oregon does
now?
A state committee for the Oregon Health Authority is
looking at how medical providers should make triage de-
cisions. It meets again this week.
The concern is the current tools Oregon has for mak-
ing triage decisions were not developed with much input
from the community, there may discrimination, the tools
are at risk for bias and there is just not much experience
or research to lean on.
For instance, during the peaks of the pandemic across
the country there were sometimes hard choices that
needed to be made about who gets access to ventilators.
So if the pandemic fell disproportionately on disadvan-
taged groups, did the decisions about who gets a ventila-
tor exacerbate that problem?
The state could take various approaches for triage:
• It could choose survivability – what saves the most
lives.
• It could aim to reduce or eliminate health inequities.
• It could try to reduce the risk for essential workers.
• It could do it randomly, flip a coin.
• Or it could do some mix of the above.
The approach most often used in the country is surviv-
ability. That is typically based on what is called a sequen-
tial organ failure assessment, SOFA. It looks at various
indicators of health and body function. For instance, one
part of that assessment is the Glasgow Coma Score. It’s a
way of looking at levels of consciousness and brain func-
tion. Patients doing poorly on that and other tests would
be more likely to be denied resources based on the as-
sumption they would be less likely to survive.
But there have been equity concerns about how that
is used. People with disabilities may do more poorly
on scores like the Glasgow Coma Score. And sequen-
tial organ failure assessment has also raised other con-
cerns. One study looked at 2,982 patients admitted
with COVID-19 in the Yale New Haven Health System.
Non-Hispanic Black patients had greater odds of having
higher SOFA scores than Non-Hispanic white patients.
So they would be more likely to be denied resources.
Oregon’s existing triage guidelines try to recognize the
limitations of the various approaches. It uses a modified
organ failure assessment. It makes adjustments for peo-
ple with chronic diseases and disabilities. There’s a pause
built in to try to look for biases. And if multiple individ-
uals get the same score for prioritization, coins could be
flipped.
The committee, the Resource Allocation Advisory
Committee, is not going to make a final decision this
week on what approach Oregon should use. And it is go-
ing to allow public comment.
What causes you concern about Oregon’s triage ap-
proach? What should Oregon’s policy be? The email for
the committee is OHAResourceallocation@dhsoha.state.
or.us.
█
Unsigned editorials are the opinion of the Baker City Herald. Columns, letters
and cartoons on this page express the opinions of the authors and not necessarily
that of the Baker City Herald.
YOUR VIEWS
Mental health crisis
could have local effects
The people of Baker County received sev-
eral million dollars recently from a federal
program to compensate for losses during
the government mandated shutdown of the
economy and society due to the declaration
of the COVID-19 pandemic emergency.
Baker County Commissioners decided to
spend a large portion of our emergency
money, $1.45 million of it, to payoff a 70-
acre land purchase. That’s about $20,750 per
acre for ground that had been used as farm-
land. And, it was reported that the commis-
sioners have no set plans for the property.
If there are no plans, then why was the pur-
chase made with such importance and ur-
gency that they’d spend our COVID emer-
gency money to pay it off?
I notice also that New Directions North-
west — NDNW — recently received a
large amount of money from the federal
government and I think it was some sort
of housing grant. NDNW contracts with
Baker County to provide this county’s men-
tal health program under the title New Di-
rections Northwest Behavioral Health and
Wellness-NDNWBHW. NDNWBHW op-
erates under Oregon’s “Community Men-
tal Health Treatment Law” passed back in
the 1990s. These programs, like the one in
Baker County run by NDNWBHW, brings
into the communities the people who would
once have been housed in a lockdown, state-
run mental hospital. As you can imagine,
NDNWBHW clients sometimes have diffi-
culty securing housing.
It is these community mental health
laws and county contracted programs that
I think have created what the bureaucrats
call a “homeless crisis.” It is not a “homeless
crisis” it is a “mental health crisis” created
by the failing system of community mental
health treatment. Severely mentally ill pa-
tients and society at large are no longer pro-
tected by housing the mental ill in state-run,
lockdown mental hospitals. Instead, sever-
ally mentally ill adults in Oregon are usually
arrested, cycled through the legal system,
and eventually placed into community men-
tal health programs and shipped into small
towns like Baker City and their dangerous
and/or unacceptable behaviors are con-
trolled by prescribing to them powerful psy-
chotropic drugs.
Powder River Correctional Facility, ad-
ditionally, has brought a constant revolving
population of at least 286 inmates to town
and New Directions brings in hundreds
more not only through its contract as the
county’s mental health program provider
but through numerous programs for the
transient, drug addicted, and incarcerated
population. This brings clients in from all
over Oregon and beyond. If you see a young
mother pushing a stroller in Baker City
there’s a 90% chance it will be an incarcer-
ated woman brought to town for the incar-
cerated mother program. Most young men
in town between ages 19 and 30 are likely
incarcerated or enrolled in rehabilitation of
one form or another.
We no longer are allowed to harvest trees
in this region, so we’ve shifted to harvest-
ing human lives and Baker County and city
have embraced the human harvest industry.
Boy, I bet there are some current day regrets
for this town passing on Eastern Oregon
Normal School, known today as EOU.
That 70 acres urgently purchased by
Baker County sits fairly close to New Direc-
tions’ treatment empire on Midway Drive. It
is conceivable that there could be plans for
the organization to expand toward Hughes
Lane. With all the talk lately of “affordable
housing” in Baker County and with New
Directions handing out affordable housing
surveys, it’s even conceivable that such a
land purchase could be used to build hous-
ing for the overflow of the mentally ill living
on the streets of Portland. If you follow the
style of Oregon’s government, the good of
the many outweigh the comfort of the few
— Bakerites are few but many are the men-
tally ill on the streets of Oregon’s western
cities. So, it’s conceivable that local govern-
ment might foster a plan to house a couple
hundred or thousand of Portland, Medford,
and Eugene’s mentally ill adults.
Hope not.
Brian Addison
Baker City
Based on fire dept. mess,
Garrick best choice for county
Recently councilor Alderson criticized
candidate Dan Garrick for not favoring
forming a countywide fire district. This
spring I was very much in favor of forming
a fire district when the city was struggling
with the burden of managing an ambulance
service. At that time I felt forming a district
was the best way to utilize the efficiency of
having dual trained firefighters and EMTs.
The incentive was to put the ambulance
service under the management of a district
board, allowing them to capture the reve-
nue stream generated by providing ambu-
lance service. Those conditions no longer
exist. I pleaded with city council to keep
the fire department whole continuing to
provide ambulance service long enough to
pursue creating a district. My pleas along
with those of the majority of citizens was
ignored. Now that the city fire department
no longer provides ambulance and has lost
a significant portion of their dual trained
staff it doesn’t make sense to form a district.
The city has an understaffed fire depart-
ment relying more and more on volunteers,
the only thing the city did retain is the same
1.2 million dollar liability to fund the de-
partment. Now councilor Alderson wants
to use the county rural fire departments and
the County Chair position to fix the mess. I
strongly urge everyone to vote for Dan Gar-
rick for county commissioner position 3.
Kody Justus
Baker City
CONTACT YOUR PUBLIC OFFICIALS
President Joe Biden: The White House,
1600 Pennsylvania Ave., Washington, D.C.
20500; 202-456-1111; to send comments,
go to www.whitehouse.gov.
U.S. Sen. Jeff Merkley: D.C. office: 313
Hart Senate Office Building, U.S. Senate,
Washington, D.C., 20510; 202-224-3753;
fax 202-228-3997. Portland office: One
World Trade Center, 121 S.W. Salmon St.
Suite 1250, Portland, OR 97204; 503-326-
3386; fax 503-326-2900. Baker City office,
1705 Main St., Suite 504, 541-278-1129;
merkley.senate.gov.
U.S. Sen. Ron Wyden: D.C. office:
221 Dirksen Senate Office Building,
Washington, D.C., 20510; 202-224-5244;
fax 202-228-2717. La Grande office: 105
Fir St., No. 210, La Grande, OR 97850; 541-
962-7691; fax, 541-963-0885; wyden.
senate.gov.
U.S. Rep. Cliff Bentz (2nd District): D.C.
office: 1239 Longworth House Office
Building, Washington, D.C., 20515, 202-
225-6730; fax 202-225-5774. Medford
office: 14 N. Central Avenue Suite 112,
Medford, OR 97850; Phone: 541-776-4646;
fax: 541-779-0204; Ontario office: 2430
S.W. Fourth Ave., No. 2, Ontario, OR 97914;
Phone: 541-709-2040. bentz.house.gov.
Oregon Gov. Kate Brown: 254 State
Capitol, Salem, OR 97310; 503-378-3111;
www.governor.oregon.gov.
Oregon State Treasurer Tobias Read:
oregon.treasurer@ost.state.or.us; 350
Winter St. NE, Suite 100, Salem OR 97301-
3896; 503-378-4000.
Oregon Attorney General Ellen F.
Rosenblum: Justice Building, Salem, OR
97301-4096; 503-378-4400.
State Sen. Lynn Findley (R-Ontario):
Salem office: 900 Court St. N.E., S-403,
Salem, OR 97301; 503-986-1730. Email:
Sen.LynnFindley@oregonlegislature.gov
State Rep. Mark Owens (R-Crane):
Salem office: 900 Court St. N.E., H-475,
Salem, OR 97301; 503-986-1460. Email:
Rep.MarkOwens@oregonlegislature.gov
Baker City Hall: 1655 First Street, P.O. Box
650, Baker City, OR 97814; 541-523-6541;
fax 541-524-2049. City Council meets
the second and fourth Tuesdays at 7 p.m.
in Council Chambers. Councilors Jason
Spriet, Kerry McQuisten, Shane Alderson,
Joanna Dixon, Kenyon Damschen, Johnny
Waggoner Sr. and Dean Guyer.
Baker City administration: 541-523-
6541. Jonathan Cannon, city manager;
Ty Duby, police chief; Sean Lee, fire chief;
Michelle Owen, public works director.
COLUMN
Look past midterm crazy season for inflation relief
BY BRUCE YANDLE
T
hough apparently dedicated to
winning the battle against in-
flation, Fed Chairman Powell is
fighting a lonely battle that will be dif-
ficult to win, at least with an election
taking place. There are limits to what
the Fed can do when Congress and the
White House are busy printing more
money. Yes, even after a six-month long
Fed effort to raise interest rates, U.S. in-
flation is still running at a hot 8.2%.
It will take time and restraint from
Washington before things have a
chance to calm down. Because infla-
tion’s causes lie in politics as much as
economics, let’s look past election-dom-
inated 2022 for possible relief. There are
some early data to support this hope.
For all the talk about what’s behind
the diminishing buying power of our
money — war, supply chains, energy
prices — inflation can still be thought
of simply. Flood the economy with
enough money and it will start to lose
its value. That’s how White House and
congressional efforts to forgive debt
and increase spending have been coun-
tering the Fed’s action.
In just the last six months, the Biden
administration has initiated massive
student debt write-offs as well as for-
given billions of dollars of farmer-owed
debt and assisted drought-distressed
people in the Southwest by way of the
misnamed “Inflation Reduction Act.”
(It is worth noting that the Wharton
school’s dispassionate review of the act
found the effect on inflation to be “in-
distinguishable from zero.”)
Whatever one thinks of these pol-
icies, they mean that while the Fed is
hitting the brakes, the White House
— perhaps fearful of what midterm
elections will bring — is goosing the
accelerator. And Heaven help us to get
past efforts by Democrats and Repub-
licans alike to spend and score political
wins with their constituents and secure
majority positions in the House and
It is for this reason that some are
suggesting the Fed should be happy
with 4% inflation rather than 2%.
After all, this thinking goes, living
with a little more inflation might be
preferable to sustaining the bitter
medicine of an economy slowed
down by the Fed. But it’s also possible
that war-caused disruptions in
energy and other markets will
eventually disappear, making the
job of hitting the ideal target easier
(though by no means painless).
Senate. Once midterm “crazy season”
is over, it’s clearly possible that some of
the inflation heat may subside.
We can also see data backing this
up. Inflation, as reflected by the Con-
sumer Price Index (CPI), could hit the
healthier 2% range again late in 2023.
Hope comes from examining another
measurement — M2 — which tracks
the U.S. money supply by accounting
for U.S. cash, deposit assets and other
near-money accounts.
The money supply exploded in early
2020 with COVID-19 relief spending;
CPI-registered inflation accelerated
about 12 months later. It was a textbook
case of too much money chasing too
few goods. Now, the latest M2 reading
is back at a pre-COVID level. That sug-
gests more normal inflation levels about
12 months from now.
Of course, some of those aforemen-
tioned other inflation factors must still
be noted.
There is always more to the story,
including Ukraine-war driven energy
price increases, supply chain disrup-
tions, and labor market challenges that
emerged during the pandemic and re-
main to deal with.
It is for this reason that some are
suggesting the Fed should be happy
with 4% inflation rather than 2%. Af-
ter all, this thinking goes, living with a
little more inflation might be prefera-
ble to sustaining the bitter medicine of
an economy slowed down by the Fed.
But it’s also possible that war-caused
disruptions in energy and other mar-
kets will eventually disappear, making
the job of hitting the ideal target easier
(though by no means painless).
Yes, we can be optimistic that infla-
tion will be under control in 2023. That
is, if the Fed is not forced to hit the
brakes harder to offset an election-year
spending binge. Let’s just hope Con-
gress will not be inspired to write an-
other so-called Inflation Reduction Act
any time soon.
█
Bruce Yandle is a distinguished adjunct fellow
with the Mercatus Center at George Mason
University, dean emeritus of the Clemson College
of Business, and a former executive director of
the Federal Trade Commission.