OPINION
Blue Mountain Eagle
A4
Oregon’s move
to cap health
care costs could
have benefits
and trade-offs
T
he cost of health care
has been growing
faster than wages and
faster than the state economy.
Some Oregonians cannot get
the health care coverage they
want or worry they can’t afford
going to the doctor.
There are numbers that back
up those concerns. Deductibles
in Oregon are the third highest
in the nation, according to the
Oregon Health Authority. And
Oregon is fourth highest in the
country for the percent of indi-
viduals with high out-of-pocket
costs relative to their income.
Oregon is looking at doing
what Delaware, Massachusetts
and Rhode Island have done:
put a cap on the increase in
health care costs. A state com-
mittee is charged with coming
up with a plan to present to the
Oregon Legislature.
One real benefit could be the
incentives the cap creates to
change how providers are com-
pensated for patient care. One
real worry is the unintended
consequences any reforms may
create along the way.
The magic number for Ore-
gon may well be 3.4% for
2021-25, and then 3% for
2026-30. That’s how much
costs would be allowed to go
up. What happens if the cap
breaks? Would it be enforced?
Will quality of care suffer?
Those are questions that need
to be answered.
Massachusetts got off to a
start with cost controls in 2012.
Other states followed. So, did it
work in Massachusetts? Costs
did decline. For instance, that
state stayed below a benchmark
of a 3.6% increase in overall
health care spending in 2013,
2016, 2017 and 2018. But if
you look into the data a little
deeper, there were also worri-
some trends. For instance, costs
for consumers and patients rose
more quickly in 2018. Indi-
viduals with private insurance
had their out-of-pocket costs
increase by 6.1% and premi-
ums rose 5.2% from 2016-18,
according to the Boston Globe.
More residents also signed up
for high-deductible plans.
Those changes should not
be discounted. The theory has
been if overall costs are con-
trolled it will translate eventu-
ally into lower insurance costs
for consumers. That logic is
hard to argue with. But there
do seem to be unintended con-
sequences, such as cost-shift-
ing to consumers. And if more
people move to high-deductible
plans, should that be consid-
ered victory?
SEIU Local 49 expressed
concern at the committee’s
last meeting that health care
workers will see their wages
get squeezed as Oregon health
care providers cut costs. The
Oregon Association of Hospi-
tals and Health Systems said
it was worried that because of
the pandemic the state and pro-
viders may not have the money
to quickly ramp up spending
to do more data collection and
analysis.
Surely, though, there is room
in Oregon’s health care system
to save money and improve
quality. There are too many
perverse incentives driven by
the fee-for-service model. It
can drive providers to do more
tests, for instance, because
more tests mean more revenue.
Instead, the committee wants
Oregon to move in the direc-
tion of a payment model that
bundles payments for treating
groups of patients. That trans-
formation may be the biggest
benefit of Oregon’s pursuit of
a cap.
Blue Mountain
EAGLE
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Wednesday, September 9, 2020
FARMER’S FATE
The fork theory meets my knife hypothesis
I
t’s been raining silverware at my
house lately. One can barely go
from swather to tractor without
being bombarded by forks and but-
ter knives — although the spoons
seem surprisingly absent. But before
you start worrying about reinforcing
your umbrellas, the sky isn’t really
throwing down a 16-place setting of
Oneida.
Ever hear of the spoon theory?
It basically says that each person
wakes up with a limited number of
spoons, representing energy, that are
consumed by activities throughout
the day. Each activity uses up your
spoons and when they are gone, so
is your ability to keep up with the
demands of life.
The fork theory comes from
the phrase “stick a fork in me; I’m
done.” This theory says that everyone
is stuck with forks, large and small,
all day — and sometimes they reach
their limit. Everyone has a fork limit,
and when that limit is reached, the
person either falls apart or retreats
from the fray.
The forks haven’t all been huge
affairs — although some have been
pretty horrific — but they all add
up to a state of tender exhaustion.
This is not an unusual state to be in
mid-summer for farmers and ranch-
ers — it’s just one of the less fun
realities with our chosen profession.
It’s the harobed that seems to have
gremlins that come out at night, it’s
the rain on nearly dry hay, its the goat
that chronically gets her head stuck
in the fence, its nearly rolling your
swather down the hill and your favor-
ite pair of boots that finally wear out.
Register to vote,
fill out census
Nothing big. Noth-
ing unusual — just a
lot of little forks.
Although some
of the forks stab a
little deeper. Like
finding one of the
triplets of our mini-
Brianna
goat with a cold
Walker
mouth. Warm baths,
warm towels and a
box near our bed, and within a couple
days she was up. Then came scours.
She combated that like a champ with
an old home remedy using buttermilk
and baking cocoa. Eventually she
was back in the barn with her mom
— only to be killed when a piece
of plywood fell on her. That fork
brought tears.
I used to take those metaphori-
cal forks and use them to dig holes
in which to bury garden seeds. I’d
tell people that way I could bury my
problems and eat them later — but
over the years my garden has grown
into the acre-size range. I need a new
way to deal with forks.
As we head deeper into har-
vest season, our days are longer, our
nights almost non-existent and our
number of spoons each morning
seems to decrease almost inversely
proportional to our workload. Which
means that at this rate we should be
walking zombies by the end of the
month — if it weren’t for the knives.
I have come up with my own but-
ter-knife hypothesis. Butter knives
are used to spread butter or jam,
honey or Nutella — things that are
deliciously sweet and cover an object
with delightful goodness. They pro-
vide salve to the fork wounds, and
increase the reproductive life of
spoons. And this month, while the
forks were bombarding us, the knives
seemed to ramp it up also.
My Flower Fairy (neighbor)
dropped off an unexpected bouquet
of her farm-fresh flowers on her way
to market. Another friend dropped
off a bottle of hair conditioner for
my tangled summer tresses — sim-
ply because she’d seen me struggle
to get a brush through my hair after a
long day in the wind. Another friend
invited me on a kayak adventure,
and friends have provided my fam-
ily meals the last several Saturdays,
knowing our summers are so busy
we don’t spend much time cooking.
Knives have also come in the form of
dishes done by my 4-year-old, laun-
dry done by my 11-year-old, a gen-
erous gift card from my boss and a
couple of letters from dear friends.
You’ll never put a better bit of
butter on your knife than that of a
kind or thoughtful gesture to a fam-
ily member, friend or neighbor. I
challenge you to take a stab at it this
month. Smother someone’s fork
wounds with a little Nutella kindness.
One never knows how many spoons
a person has left for the day, or how
many forks they’ve been stuck with
— but you have an unlimited ares-
nal of knives at your disposal. Even
if it’s a bit out of your comfort zone
— just remember, the Lord loveth a
cheerful giver, but he also accepteth
from a grouch!
Brianna Walker occasionally
writes about the Farmer’s Fate for
the Blue Mountain Eagle.
LETTERS TO THE EDITOR
demic brought out the worst: selfishness Lack of COVID-19
over altruism, power grab over collab-
care concerning
oration, exclusiveness over representa-
To the Editor:
Citizens of Oregon House District
60 can do two things that will ensure
that their voices are heard in Salem.
First confirm you are registered to vote.
Check your status at https://secure.sos.
state.or.us/orestar/vr/showVoterSearch.
do?lang=eng&source=SOS. If not reg-
istered to vote, submit your registration
by Oct. 13, 2020. If submitting by mail
it must be postmarked no later than Oct.
13. If registering online submit your
registration no later than 11:59 p.m. on
Oct. 13. Instructions for registering to
vote may be found at https://sos.ore-
gon.gov/voting/Pages/registration.aspx-
?lang=en. A link is included for regis-
tering with a voter registration form.
If you have no access to the internet,
contact your county clerk’s office for
instructions.
The second thing residents of Dis-
trict 60 can do is to fill out the 2020
Census form and submit it. You can
find the information on reporting at
https://2020census.gov/en/ways-to-re-
spond.html. If you do not have access to
the internet you have the option of com-
pleting the questionnaire by phone. To
begin, call 844-330-2020. Federal dol-
lars are allocated to counties based on
current census information and amount
to over $3,000 per person per year for
10 years. Legislative districts are recon-
figured every 10 years based on current
census information. Legislative districts
with smaller populations run the risk of
being incorporated into larger districts if
accurate census information is not avail-
able, which in turn weakens your voice
in Salem. Grant County’s response rate
is far below the state average.
So, register to vote and fill out and
turn in your census form.
Beth Spell
John Day
‘Cronyism, nepotism
and rascalism’
To the Editor:
In an election year, the civic minded
thoroughly assess their government and,
as per recommendations of old, replace
it if it’s rotten. Numerous commentaries
lately in this section of the Eagle speak
to that. While a crisis should bring out
the best in local government, this pan-
tion, secrecy over education.
Elsewhere, such has been described
as government by “cronyism, nepotism
and rascalism.” Our county government
freewheeled on taxpayer funds (rascal-
ism), got friends (cronyism) and rela-
tives (nepotism) into this green pipeline
and got away with it (rascalism again).
The recent flurry of “good cop”
reporting in the Eagle tries to balance
out this well-deserved criticism, even
though the heroics are based entirely on
an accident of geography and involve
out-of-state agencies (Smith murders),
or are portents of a neglected, impover-
ished economy (drugs, domestic abuse),
not an accident: The latter correlate pos-
itively. Even the myth of satanic cult
cow mutilations found itself resurrected.
Of the three government undesir-
ables, nepotism is surely the most
despicable. Paying a county employee
a living wage, a nice retirement, is
good, and customary practice. Dou-
bling that for one family when the job
market is poor or non-existent takes
that living wage, that nice retirement,
away from a main provider, along
with fostering elitism and a defi-
nite sense of entitlement which are
self-propagating, non-transparent and
tend to be permanent. On taxpayer
funds.
Someone told me, “Nepotism is
not illegal for counties.” That does not
make it right. It is not a democratic or,
as I understand it, Christian, thing to
do, and with 12 different denomina-
tions in a town of 1,700, the latter at
least should be a factor.
Vega Nunez
Ritter
Editor’s note: The Eagle does not
try to “balance out” positive and neg-
ative stories. We report facts. Nepo-
tism is illegal for counties in Oregon,
but the restrictions do not apply to
unpaid volunteers. Oregon law states
public officials may not appoint,
employ or promote a relative or mem-
ber of the household to, or discharge,
fire or demote a relative or member
of the household from, a position with
the public body that the public official
serves or over which the public offi-
cial exercises jurisdiction or control,
unless the public official complies
with conflict of interest requirements.
To the Editor:
In regards to last week’s front page
article of large and serious criticism of
Blue Mountain Hospital and clinic, I
add my own enthusiastic amen!
A concern my wife and I have is
the serious lack of capability of the
local hospital and clinic in regards to
in-depth COVID-19 care and treat-
ment. In spite of the PR song and dance
of local administrators, there is virtu-
ally no capability or intention of the
local Blue Mountain Hospital to pro-
vide significant local care or treatment
to locals who display obvious evidence
of COVID-19 symptoms.
In their own words, in a recent Blue
Mountain Eagle piece regarding their
COVID-19 care capabilities, Rebekah
Rand, director of Emergency Medical
Services and emergency preparedness,
said: “the hospital has three negative
pressure rooms to contain the virus and
that the hospital would air ambulance
those who have been infected to Bend
or elsewhere for more intensive care.”
Put plainly, anyone showing up
at the local Hospital with obvious
COVID-19 symptoms will be sent to
some facility far distant to this area
— assuming that those distant facili-
ties even have available space if they
are having COVID-19 capacity prob-
lems of their own! Additionally, there
aren’t likely very many locals prepared
to make the trip and an extended stay
in support of a family loved one who
is shuttled to a facility 150 or more
miles away from this area — and many
elderly are not capable of transportation,
self care or treatment on their own.
Added to all the above, though this
area has been spared the increases in
infections seen in other parts of the
state and nation, the reopening of local
schools and approaching winter sea-
son will likely expose us all to a spike
in COVID-19 cases that may well far
exceed the intentions or capabilities of
the local health care facilities.
The local hospital and clinic admin-
istrators we trust with our lives have
been seriously slipping in their abili-
ties and responsibilities to the John Day
area they supposedly serve. Let’s hope
these recent events and concerns get the
response they seriously deserve!
Gary Davidson
Canyon City