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 March Oregon Health Plan on the brink of collapse Going, going. . . gone. That’s the trajectory of a spiraling Oregon Health Plan, which is in danger of losing the federal waiver that gave it life. A victim of runaway health care costs and a worse than expected budget deficit has left lawmakers scrambling just to pay for mandated benefits. Meanwhile, Oregon’s in danger of reverting back to traditional Medicaid. If the state can't fulfill its promise to expand coverage, a basic requirement to keep the waiver, it could be forced to cut lose more than 100,000 people that comprise the OHP Standard population plus another 50,000 pregnant women, children and poor people — giving Oregon one of the highest uninsured rates in its history — 621,000 people. Mercer survey released Once again employers face escalating health costs. Even more disturbing are indications Oregon and southwest Washington employers are paying more for health benefits during 2003 than anywhere else in the nation. A survey released by Mercer Human Resource Consulting on March 18 found large employers in this region anticipated an 18.3 percent increase compared to 14.6 percent in the West and 13.5 percent nationally. Mercer surveyed 38 regional employers with over 500 employees, representing government agencies, universities and private industry. Bulk buying poses problems, promises savings The Senate. The House. The Governor. Consumer groups. Down every hallway in Salem, lobbyists, legislators and advocates want the state to pool its purchasing power to get bigger discounts on prescription drugs. “There’s a great uproar about the lack of affordable prescription drugs in the state,” said Maribeth Healey, project manager for Oregonians for Health Security. “And there are legislative proposals that can save the state and Oregonians money.” A report from the Northwest Federation of Community Organizations suggests Oregon could save between 5 and 15 percent of its total prescription drug costs with a bulk purchasing arrangement. It estimates savings for Oregon between $55 and $165 million annually. A number of details, however, need to be worked out to make bulk purchasing tenable, as a number of state agencies either don’t fit into a bulk purchasing model or already have significant multi-state purchasing agreements that could be jeopardized by mandating participation in a single state pool. FirstHealth on trial The dark corners of state government are aglow with legislators shining flashlights into forgotten recesses trying to find nickels and pennies to bolster the budget. Rep. Alan Bates (D–Ashland) may have found a treasure chest. “We need to audit our pharmaceutical benefit manager,” Bates said. FirstHealth, the state’s PBM, oversaw $281 million in drug purchases for the Oregon Health Plan’s fee-for-service patients in 2002, said Jim Edge, assistant Medicaid director. Bates has introduced legislation (HB 3323) calling for an immediate audit of FirstHealth. If the audit found even a 1 percent savings in FirstHealth, it would amount to a windfall for the state. Where’s the rebates? As a gubernatorial candidate, Ted Kulongoski repeatedly discussed the need for Oregon to pool its purchasing power with Idaho and Washington so the state could purchase drugs cheaper for the neediest. But now that he’s governor, the idea is taking a back seat to Oregon’s budget woes. “We’re all facing the same problems of huge budget deficits and rising costs of health care,” said spokesperson Mary Ellen Glynn when asked how the governors of Idaho and Washington responded to Kulongoski's proposal for a regional purchasing alliance. In other words — the budget is the first priority. Everything else is secondary. War and health: An interview with Dr. Mike McCally When Dr. Christine Cassel leaves her position as the dean of OHSU’s medical school for a new position in Philadelphia, Oregon will lose two of its best health policy minds. Her husband and OHSU colleague Dr. Mike McCally will be settling into his new position as president of Physicians for Social Responsibility in the City of Brotherly Love too. He sat down with Oregon Health Forum Associate Editor Rory Carroll to discuss his fact-finding mission to Iraq in January. Read the complete transcript of this interview at www.healthforum.org. OHF: What were you doing in Iraq? MM: I was part of a delegation of health experts who were collected and sent by the Center for Economic and Social Rights, which is a small human rights organization in New York that has been concerned about Middle East issues, particularly sanctions on Iraq since the Gulf War. Our task was to try to understand the current public health service status with an eye to what the humanitarian consequences of conflict might be in that country. Washington tort battle Despite the best attempts of Washington’s physicians to turn up the heat on the state’s dialogue for tort reform, not a single bead of sweat sits on the brow of Washington’s trial lawyers. Two bills are pending in the legislature, but trial attorney spokesperson Sue Evans said her organization is comfortable with how the chess board is set up to defeat both measures. Tribal benefits restored Scissors may be the office supply of choice for legislators, but they may get to test their glue sticks in the near future. When the Oregon Health Plan cuts to mental health, chemical dependency, adult dental and durable medical equipment took effect, 2,100 Native Americans lost coverage, said Lynn Read, Medicaid director. After legislators learned the state receives 100 percent reimbursement from the federal government for providing health care to Native Americans, they jumped to attention. E-board vindicated For a case that involved oral arguments alleging “back room maneuvering with a wink and a nod,” the climax couldn’t have been more anticlimactic. Multnomah County Circuit Judge Jean Maurer didn’t even offer a written opinion in ruling for the state in a case resulting from last November’s Emergency Board elimination of mental health and chemical dependency benefits for single adults and childless couples on the Oregon Health Plan. A request for an expedited appeal of the decision before the March 1 implementation of the cuts was also denied. “It becomes a matter of theory at this point,” said Bob Joondeph, who argued the case and is also executive director of the Oregon Advocacy Center. “We argued the cuts should have been made by the legislature.” To protect against future Emergency Board actions of a similar vein, Joondeph will take the case to the Oregon Court of Appeals. Lane County hospital back on its feet McKenzie-Willamette Hospital has a new lease on life. Just months ago, the hospital was the 98-pound weakling in the ring against its rival, the 300-pound PeaceHealth. The hospital even filed an anti-trust lawsuit against PeaceHealth alleging its monopolistic business practices were driving it out of business. Also in this issue...
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