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 June CARE Assist HIV program hits tough financial waters Careless. That’s how as many as 300 Oregonians suffering from HIV and AIDS could end up if the CARE Assist program isn’t bailed out soon. The seven-year-old program that uses federal funds to help 1,100 people purchase health insurance is facing an unprecedented financial crisis. For the first time, enrollment has been frozen, and many fear cuts are just around the corner. Waiting for the waivers Federal officials have begun deliberations about the future of the Oregon Health Plan expansion. On May 31, documents were sent to HHS Secretary Tommy Thompson’s office, with the expectation of approval by Aug. 1, according to Jean Thorne, who’s heading the expansion project. Assuming there are no hitches, enrollment for the Family Health Insurance Program will get underway on Oct. 1, adding 19,000 group members to its rolls, with those qualifying for the Oregon Health Plan Standard Plan (up to 110 percent of federal poverty level) coming on board Dec. 1. In early 2003, FHIAP will add another 6,000 individual members. Medical malpractice rates squeeze doctors Governor Kitzhaber is expected to announce a professional liability task force to examine the growing crisis surrounding medical malpractice insurance in mid-June. The announcement will come on the heels of an $8.5 million malpractice judgement against Dr. William Hayton, one of the senior members of Roseburg Women’s Healthcare. The clinic will close next month as a result of ensuing increases to its medical malpractice insurance. Task force members announced The task force considering malpractice insurance reform formed by Governor Kitzhaber has no consumer representation. That irritates Jason Reynolds, executive director of the Oregon Consumer League. “This is a stacked deck with a predictable outcome,” he said. “Once again, corporate America is sitting down with the insurance industry to protect profits at the cost of injured patients.” He suggested the governor appoint a consumer from either the Oregon Law Center, the Oregon Health Action Campaign or the Oregon Advocacy Center. Focus on health care shortages Expect a heated and meaningful exchange at Oregon Health Forum’s upcoming breakfast forum on work force shortages in the health industry. Thomas Aschenbrener, president of the Northwest Health Foundation will moderate the event from on June 25 at the Multnomah Athletic Club. Panelists include Deborah Burton, PhD, RN, executive director of the Oregon Center for Nursing; Dr. Christine Cassel, dean of the School of Medicine at OHSU; Wayne A. Kradjan, PharmD, dean of the College of Pharmacy at Oregon State University, and Dr. Janet Peterson, chair of the Oregon Dental Association’s Work Force Issues Task Force. Please call 503-226-7870 or go to www.healthforum.org to register. LifeWise conversion sparks debate Consumer groups worry the pending conversion of Lifewise’s parent company, Premera Blue Cross, will negatively affect Lifewise’s 160,000 Oregon members. “It’s no longer going to be a mutual company,” said Jason Reynolds, executive director of the Oregon Consumer League. “It’s no longer responsible to the people who buy the policies. It’s responsible to Wall Street.” Gordon Smith: Moving target Who is Gordon Smith? His critics dismiss him as a wealthy businessman willing to bend to the Republican party wheel. But attempts to pin a partisan bull’s eye on him have mostly backfired. He’s built strong ties to leading Senate Democrats, notably Ron Wyden and Dianne Feinstein, despite working in a Senate whose split rests on a hairpin. He regularly defies his party’s leadership by voting with his conscience. The day he spoke with Oregon Health Forum Associate Editor Rory Carroll, he had just left the floor where he was one of only four Republicans to vote for a bill that would classify crimes motivated by gender, sexual orientation or disability as a federal hate crime. He’s also cosponsored legislation with Feinstein aimed at curing and preventing cancer despite opposition from large employers and big tobacco. OHF: The last time we spoke, you defended employer mandates within your cancer bill. You said there were times when they could be justified. Do you favor a mandate for mental health parity? GS: Yes, I will continue to vote for that. As we learn more about the human mind and health care, it’s clearly related. They can no longer be responsibly divorced. Transplants under review An oncology task force is being organized by Dr. Andrew Glass, chairman of the Health Services Commission. Starting this fall, the five-member group will advice the commission on transplants for cancer patients, particularly pancreatic, liver, gall bladder and esophageal. “These oncologists will help us decide whether there should be special consideration for these cancers even though they have a low rate of response,” said Dr. Kathy Weaver, the commission’s medical director. “We want to make certain we cover those that are evidence based but don’t put on the list those that are experimental, such as stem cell transplants for auto-immune disease.” The truth about Celebrex Never underestimate the influence of the pharmaceutical industry. That’s the message policymakers learned when they read the June 2002 issue of the British Medical Journal. Two years earlier, a widely distributed study had touted the effectiveness of Celebrex (Celocoxib/generic name) in reducing gastro-intestinal complications compared to Ibuprofen and Diclofenac following a six-month trial. Resources Commission reveals findings Meanwhile, the evaluation has been completed on another two drug categories. And, the findings surprised no one. The analysis of anti-ulcer drugs (proton pump inhibitors) and long-acting opiod analgesics showed that none of the brand-name drugs differed in effectiveness. Therefore, a decision to only pay for the lowest cost drugs is expected to prevail for Medicaid patients with open cards starting Aug. 1, unless physicians authorize an exception. “For the first time in the history of the United States, a state Medicaid program will include a prescription drug plan that utilizes evidence-based evaluation of the effectiveness of similar medications,” Governor Kitzhaber wrote physicians on June 5. Also in this issue...
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