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 December Flashback: Howard Dean blasts Medicare at OHF event Twelve years ago, a young organization called Oregon Health Forum brought the newly elected governor of Vermont, Dr. Howard Dean, to Oregon to deliver a keynote speech at its first annual conference. At the time, Dean was an emerging and outspoken advocate for health care reform, and promised to deliver universal access at affordable prices to all Vermonters. Today Dean is leading the pack of Democrats seeking the presidential nomination, and his opponents are searching for weaknesses in his armor. Health care might seem like an unlikely point to challenge the doctor/candidate on because of his record in Vermont, where 92 percent of adults and 96 percent of children have health insurance, but that’s just what his opponents are doing. Cases of autism on the rise, cause remains a mystery Hans Vanderwey can blow bubbles. He can also ride a tricycle. For a four-year-old, that may not seem like much. For one with autism, it’s nothing short of “miraculous,” according to his mother, Michelle Vanderwey. She credits Dr. Tim Buie, a pediatric gastroenterologist at Massachusetts General Hospital, for the success. Buie performed an endoscopy and colonoscopy over the summer to alleviate gastrointestinal pain related to Hans’ autism. Talking with Dr. Tina Castañares No matter what language she chooses, Dr. Tina Castañares is outspoken. She has devoted her career to helping Oregon’s poor migrant workers while maintaining an active role in health policy decision making. Her wealth of experience in policy and practice has earned her the respect of her peers and patients alike. She was among the first 11 members of the Health Services Commission that developed the initial priority list of services. She recently spoke with Oregon Health Forum Associate Editor Rory Carroll about toxic hospitals, health care marketing and defining basic health care. OHF: You’ve written about the interconnectedness between health and environment. One topic you spoke about was hospital pollution. Can you elaborate? TC: I’m no expert on this, nor aware of specific problem spots in the West, but I was alluding to the research of groups like Green Health that are trying to merge public health and environmental concerns because there are so many obvious synergies. Health care providers, like all businesses, influence water and air quality, sanitation and other things that are the bailywick of public health departments and state health divisions everywhere, but conversations with the environmental advocacy community are just beginning. “Greener” practices by hospitals are among the ideas being championed. Where hospital incineration practices have proved to be polluting, as in areas of the Midwest, it’s obviously a great irony. Quit Line returns For the last eight months, the sound advice of a tobacco specialist on the other end of the Tobacco Quit Line has been replaced with a terse recording of a woman relaying news the program had been shut down by the legislature. But on Dec. 16, the Quit Line was back in action, thanks to a reduced funding package. Created in 1996 when Oregonians passed Measure 44, the program is being funded with $5.8 million allocated to tobacco prevention this biennium. More than 40,000 people have called the Quit Line, according to the Department of Human Services. OHP’s fuzzy future The “what if” game has taken over the conversation around the Oregon Health Plan’s future. If voters turn down the $800 million tax on the Feb. 3 ballot, the Oregon Health Plan goes away, predicted Rep. Alan Bates (D-Ashland). That’s what’s holding up the decision on the waiver by the Centers for Medicare and Medicaid Services, he said. “My guess is they’re burying it until February 4. If the election goes the wrong direction, who needs the waiver?” At a bare bones minimum, most officials believe the standard population — adults without children — will lose coverage. That population, which numbered 50,673 on Nov. 29, represents half the bottom line at Lebanon Community Hospital, which currently is 2-3 percent, said Dr. Rick Wopat, medical director of IHN, a health plan based in Corvallis. Rebalancing the Oregon Health Plan When the Legislative Emergency Board meets Jan. 22 — just 12 days before the election on the $800 million tax surcharge — it’s unknown whether lawmakers will hear a rebalance plan identifying cost savings from the Oregon Health Plan because of declining enrollment. State Republican Chairman Kevin Mannix has insisted the state can save at least $15 million because of lower enrollment, but state officials haven’t calculated those numbers. What they do know is the entire Oregon Health Plan, excluding the CHIP population, has a $3.5 billion budget this biennium. Fluoride battles Tort reform may not be the only contentious health issue on the Oregon ballot next November. Activists are collecting signatures in Hillsboro for a measure that would put fluoride in the city’s drinking water. “We're a group of mostly health care professionals and concerned citizens working to bring water fluoridation to communities in Oregon,” said Kurt Ferre, chair of the Tri-County Fluoridation Forum and a Kaiser Permanente dentist. Addressing obesity The Legislative Emergency Board seems like a fitting place to address Oregon’s obesity epidemic. With the state leading the West in beer bellies, Oregon’s ever-expanding waistlines are in dire need of emergency intervention. Twenty-two percent of Oregonians are obese. Another 38 percent are overweight. “Obesity is the leading emerging public health problem,” said Dr. Melvin Kohn, the state’s epidemiologist. Legislators frustrated Kohn and his colleagues when they refused to approve two federal grants that would have brought over $8 million into the state for obesity-related programs. Also in this issue...
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