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 October Hospitals see rise in net income, charity care Oregon’s 57 hospitals ended 2004 with an unprecedented $342.6 million (net income) in their bank accounts. Meanwhile, the Beaver state is becoming one of the most expensive places in the nation to spend a day in the hospital, and executive compensation is overtaking physician salaries. As hospitals consume more and more of the health care dollar, financial information about their operations becomes increasingly important. Oregon Health News spent four months analyzing public records in an effort to learn more. PEBB stays steady As employers struggle with rising health care costs in a system where quality remains a lofty goal, they might turn to the Public Employees’ Benefit Board, which is taking aggressive steps to change the marketplace. It decided the health care delivery system needs to undergo fundamental change — with evidence-based care the norm, and consumers offered affordable benefits and knowledge about the cost of health services. After a competitive bidding process, four health insurers survived — Kaiser, Providence Health Plan, Regence BlueCross BlueShield and Samaritan Health Plans. On Oct. 1, they began competing for 105,000 state employees and their dependents. Enrollment numbers will be released in early December. For a comparison of final rates for active employees, COBRA and retirees, click on the link below.
Toxic air bag law spawned by fiction Who says nothing productive comes from reading mystery novels? A murder plot twist compelled Rep. Mitch Greenlick (D—Portland) to sponsor the nation’s first law to regulate sodium azide, a toxic chemical found in automobile air bags. “No other state has begun to deal with it,” he said. Gov. Kulongoski signed the bill in July. Last fall Greenlick read the book Partner in Crime by J.A. Jance where sodium azide obtained from an undeployed air bag caused the death of a central character. The victim consumed merely a teaspoon of the tasteless, odorless powder in a cup of coffee. On the record with Andrew Davidson Andrew Davidson, who takes over as president of the Oregon Association of Hospitals and Health Systems on Nov. 7, is no novice to the industry. In the 1990s, he came on board the Washington Hospital Association to help ward off a ploy by Congress to balance the federal budget on the backs of hospital and physician payments. And if he ever needs to call on a national hospital leader, he’ll look no further than his father, Dick Davidson, who’s been president of the American Hospital Association since 1991 and earlier ran the Maryland Hospital Association for 25 years. Davidson became intrigued with the political process in high school when his mother ran Maryland’s state senate and he’d spend time after school on the senate floor. Later he worked for the Maryland state legislature. During the next few weeks he’ll wind down his responsibilities with First Consulting Group in Seattle, a health care IT software and services company where he’s been developing a technology that creates virtual electronic health records for participating organizations. Davidson spoke with Oregon Health News Editor Diane Lund-Muzikant about his love of politics, his short stint as an owner of Ben and Jerry’s and his goals for the Oregon association. OHN: During the 1990s, you spent time in DC helping draft health legislation. Were you involved with Senator Hilary Clinton’s plan? AD: I worked for a congressman from Maryland—Steny Hoyer. At that time he was fourth in line in the power structure in the House of Representatives. Hoyer’s still in Congress, as the minority whip. Then I was charged with trying to understand what exactly was going on over at 1600 Pennsylvania Avenue as related to Senator Clinton’s efforts around health care reform. It was a frustrating time because even those of us on Capitol Hill couldn’t get a lot of answers. When you make public policy behind closed doors that’s ground breaking, your chances of actually getting it through the process are very slim. FHIAP and CHIP wait for a piece of the pie The Legislative Emergency Board has the power to determine how a $4 million allocation should be spent and could make that decision at its October meeting. It comes down to a matter of principle. The choice is between a publicly subsidized health insurance program for the low-income, known as FHIAP — the Family Health Insurance Assistance Program — or the Oregon Health Plan's standard population or the CHIP program for children. There's no question in the mind of Rocky King, administrator of the Insurance Pool Governing Board, which administers FHIAP. Oregon agreed to a maintenance of effort, known as MOE, whereby it promised to spend $40 million on the program over a five-year period. Without the $4 million, plus federal matching dollars, the state will renege on that agreement. FHIAP provides subsidies to help groups and individuals purchase private health insurance. A chart examining the FHIAP population by age, federal poverty level and coverage type is available by clicking on the link below.
Choose revolution “Death to the employer-based health care system,” declared Andrew Stern, national president of SEIU. “When we can finally say that out loud, we just might find a solution to the problem.” Similar to the way his union boldly broke away from the AFL-CIO, Stern offered sharp ideas on health care at Oregon Health Forum’s annual conference on Sept. 20. Health care costs are landing square on the backs of workers as well. Fewer Americans are insured through their employers than ever before, and benefits are being slashed. Nationwide, the percentage of adults under 65 covered by their employers dropped from 67 to 61 percent from 2001 to 2004. For family coverage, the employee’s share ballooned from $52 in 1998 to $223 in 2004. “If we don’t have a debate about it, just learn to accept paying huge amounts of disposable income for catastrophic plans,” Stern said. Lawmakers keep health care alive in interim The 2005 legislature shut down with barely a peep about health care reform, but Rep. Mitch Greenlick (D–Portland) remains undeterred. Despite criticism the constitutional amendment he launched is too vague, he believes health care is a fundamental right. The amendment would require Oregon’s legislature to create a plan for universal coverage by July 2009. Sens. Alan Bates (D—Ashland) and Ben Westlund (R—Tumalo) are also chief petitioners. Yet critics claim the initiative lacks substance. “Supposedly it builds on the current system but doesn’t say how it will happen, how much it will cost and who will pay; it’s almost like apple pie,” said Doug Barber, who lobbies on behalf of the Oregon Association of Health Underwriters. “I much prefer if people are up front, then we can decide if it’s good for Oregonians.” Goldberg accepts call from the governor Come Nov. 1, Dr. Bruce Goldberg will have 9,500 employees under his wing and a $5 billion budget as director of the Department of Human Services. Those numbers don’t overwhelm him. “It’s an issue of leadership, integrity and vision and more about the ability to get things done.” When Goldberg takes over, two important tasks await him — filling the deputy director’s role now occupied by Barry Kast who plans to retire and choosing a new Medicaid administrator. Lynn Read isn’t seeking the permanent position, and prefers to be the deputy director. In late August, the governor contacted Goldberg. “He didn’t feel any of the people who applied were really in the right place in their career to move on,” he said. “And I saw this as a tremendous opportunity to improve the lives of Oregonians.” Oregon docs help out down south The scene inside Louisiana hospitals during Hurricane Katrina epitomized every health care worker’s worst nightmare. With power lost at 23 of the state’s acute care hospitals, nurses manually pumped ventilators to keep patients alive. Unruly patients took advantage of the chaos, physically and sexually assaulting staff members. Some patients died as helicopters airlifted nearly 30,000 from their beds to terminals at New Orleans International Airport. A day after the hurricane swept past the beltway, a 30-member Disaster Medical Assistance Team (DMAT) from Oregon arrived. “We literally had rows and rows of patients on stretchers," said Dr. Jonathon Jui, an OHSU physician and emergency medical service director at Multnomah County Health Department. “We arrived to find a very chaotic scene with the three teams providing care feeling exhausted, overrun and out of supplies.” Confusion continues in Eugene-Springfield Make room for another seat at the table. As if the McKenzie Willamette-PeaceHealth party wasn’t crowded enough, now the city of Eugene wants in too. The City Council passed a unanimous resolution recently instructing city officials to work with both hospitals on a property deal involving 4.5 acres owned by PeaceHealth eight blocks away from its Hilyard campus. Its number one priority is to make certain there’s a hospital in the city, Planning and Development Executive Director Susan Muir said. Also in this issue...
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