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 August Health care reform left on Salem sidelines Health care reform didn’t stand a chance this session. Too many obstacles stood in the way. The Senate Democrats were outsmarted by House Speaker Karen Minnis who held the purse strings; Governor Ted Kulongoski — obsessed with education — didn’t weigh in; while the lobbyists played their hand extremely well. And, with a promise of no new taxes by Minnis and the governor, the scarcity of money turned into a hot commodity. All hope isn’t lost, however. Most lawmakers have returned to their districts, plotting their next political move. Not Sen. Ben Westlund. The Bend Republican is determined to come up with a visionary proposal to reshape Oregon’s health system — even if he has to do it by himself. “I’m going to lead the charge and convene a group of people,” he said. “I expect to spend a lot more time in the valley working on this.” Oregon Health Plan takes national stage The Oregon Health Plan may be far from perfect, but Dr. Frank Baumeister believes it’s the best hope for our nation’s troubled health care system. He’ll get the chance to prove his point on Sept. 23 when a citizens’ health care working group comprised of national policy leaders meets in Portland. Fostered by U.S. Senator Ron Wyden, the group’s charged with coming up with solutions so everyone has access to health care. Its initial report on the nation’s health care situation will be released Oct. 6 followed by community meetings across the country. Workers protest Legacy's salaries With its shiny new exterior and state of the art medical technology inside, Legacy Salmon Creek Hospital is primed to make a splash in southwest Washington. Before its doors opened, the new hospital was already creating a buzz on the other side of the river. The loudest bang occurred at Legacy Emanuel where upset workers recently took to the streets to protest unfair working conditions. On the record with Andrew Stern A bitter divorce with the AFL-CIO catapulted Andrew Stern to the front pages of newspapers across the nation. The national president of the Service Employees International Union, Stern brought along 4.6 million workers including the Teamsters and the United Food and Commercial Workers to create the Change To Win Coalition, which he predicts will overtake the AFL-CIO in membership. Health care remains a dominant theme on Stern’s plate. In fact, his own daughter died because, he said, of the lack of continuity between physicians and hospitals. Stern will appear at Oregon Health Forum’s annual conference Sept. 20. Before then, he had a chance to speak with Diane Lune-Muzikant, editor of Oregon Health News. OHN: Why is health care such a dominant issue for the SEIU? AS: Our members are trading wage increases for health care. At the same time, as the largest health care workers union, they experience problems of a system that doesn’t have enough nurses and has overlapping bureaucratic administrative regulations. It’s a very inefficient system, one they live every day. One saving grace for health care advocates The champagne bottles are corked, and the salmon puffs have been dished out. In a legislative session where gamblers, drinkers and smokers were the biggest winners, the passage of Senate Bill 1 — which requires insurers to recognize mental illnesses on a level par with physical ailments –– gives health care advocates a reason to join in the party.“It’s one of the shining lights [of the session],” said Maribeth Healey, executive director of Oregonians for Health Security. Now it’s time to see what happens once the hangover sets in. According to most lawmakers, it could be a pretty mild one. Pharmaceuticals ‘just say no’ to expansion As the legislature ground to a halt, the pharmaceutical lobby attempted to convince lawmakers the best way to make drugs affordable was for state officials to promote their assistance programs rather than expand the government-run program. Pharmaceutical companies were willing to hand money to the Office of Health Policy and Research to promote their programs. But its administrator, Dr. Bruce Goldberg, saw through them. “Their programs don’t help people who are on generics or lower cost therapies; they only address the new medicines which may or may not offer any benefit over what already exists.” Besides, he added, what happens to people if those assistance programs end? High risk pool is starting to overflow In the athletic world, breaking a record is considered a milestone. When it comes to health insurance, such a concept can prove troublesome. After creating the high risk pool in 1989 (OMIP), lawmakers could never have predicted the pool’s magnitude. Intended for people with pre-existing conditions who’ve been turned away for individual coverage, its numbers have begun swelling. On June 30, the pool reached an all-time high with 12,534 members — 2,500 have joined since January. An extremely high rejection rate in the commercial market has had an impact. Figures gathered by the Oregon Insurance Division for the last quarter of 2004 indicate three domestic carriers ranked at the top of the denial pile — PacifiCare, 54 percent; PacificSource, 29.45 percent and LifeWise Health Plan, 29 percent. Regence BlueCross BlueShield had the lowest score at 17 percent, followed by HealthNet, 20.5 percent. Medicaid budget falls through the cracks Unlike previous sessions where the Medicaid budget is taken apart in excruciating detail, this time around critical decisions fell through the cracks — particularly after House Speaker Karen Minnis split up the Joint Ways and Means Committee. That’s left legislators such as Sen. Jackie Winters (R—Salem) perturbed about the $2 million in hospital and pharmaceutical cuts for Oregon Health Plan members. “It’s appalling someone didn’t want to address the financial piece; it’s an easy way out,” said Winters, who pointed the finger at the Department of Human Services, which now has the authority to determine how those cuts will be made. “Why couldn’t this issue have been addressed by the Legislative Emergency Board? I don’t know who sponsored this bill. To me, it isn’t prudent. Horrible mistakes could be made about patient care.” OptionCare remains a reality for Legacy Everything’s back on track once again. Negotiations had ground to a halt after OptionCare agreed to purchase Legacy’s home health business, a $20 million deal slated to close Aug. 15. The national home infusion company buckled after Legacy’s home health nurses, who were expected to join OptionCare, refused to give up their affiliation with the Oregon Nurses Association, which has represented them since 1904. “The deal could have fallen apart,” said Paul Goldberg, assistant executive director of labor relations. “OptionCare had never worked with a union before. We wrote them a letter stating we have a very good working relationship with any number of companies in Oregon and please reconsider.” Now the deal is expected to close Sept. 30, one day before the retirement of Robert Pallari, Legacy’s CEO. Had the company not changed its mind, the issue would have been taken up at Legacy’s Oct. 1 board of directors meeting. Regence welcomed back to PEBB family Following a protest by Oregon State University faculty and a conciliatory letter from Dr. Larry Mullins, CEO of Samaritan Health Services, tempers cooled and Regence BlueCross BlueShield prevailed. Now it will compete side by side with Kaiser Permanente and Samaritan Health Plans for state employees living in the Corvallis region. When the Public Employees’ Benefit Board tabulated the scoring among the health plans earlier, Regence fell 3.7 points below its nearest competitor Samaritan in overall scoring. However, a closer look revealed the two plans were much further apart when it came to quality, which accounted for 60 percent of the total score, while administration and cost shared the balance. Also in this issue...
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