Rates reflect insurance profit peak

Anyone who follows the market knows that the economy rises and falls in cycles over time. The health insurance industry is no exception. Right now, it’s experiencing an upswing in profits, according to data compiled by Oregon Health News, based on filings with the Oregon Insurance Division.

In 2005, the net worth of Oregon’s major health insurers reached $1.5 billion compared to $636.5 million in 2000. During that same period, their net income grew to $275.3 million, up from $32.2 million in 2000. Meanwhile, enrollment numbers dropped from 2.23 million in 2000 to 2.04 million in 2005, representing a net loss of 198,592 people.

Kitzhaber extends hand to business

In early September, the Archimedes Movement released its draft legislative concept that will face lawmakers next January. As expected, it calls upon the federal government to release Medicare and Medicaid dollars and for businesses to forego their health care tax deductions.

Together, those dollars equal more than $6 billion spent in Oregon annually. The tax deduction on individual income alone will total $1 billion this biennium, according to the legislative fiscal office. With those dollars, a basic benefit package —which has not yet been defined — would provide health coverage to all Oregonians.

Its champion, former Gov. John Kitzhaber, has received the welcome mat from providers, insurers and consumers, but has yet to plow much ground with businesses, he told Oregon Health News. In the months to come, he plans to host roundtable discussions with business leaders. But Kitzhaber faces an uphill battle. As of yet, he hasn’t found an influential business CEO to endorse his plan, although he’s never had a negative response.

Action expected over mental health integration proposal

Since the beginning of time, even before the Oregon Health Plan was implemented in the early 1990s, one cardinal rule has prevailed: mental health services would never be trampled on. Either the counties or the mental health organizations [MHOs] would bear the responsibility, while the fully capitated health plans [FCCPs] would reign over physical health.

Now tension is mounting over the integration of those services. The idea has already gone beyond the conceptual stage. Legislators and medical directors believe the time has come to hand mental health services to the FCCPs.

“It absolutely has to happen sooner or later,” said Sen. Alan Bates (D—Ashland), who supports such legislation. “We have to get it integrated somehow so there’s a close association.”

On the record with Ron Saxton

As the battle heats up in the governor’s race, Republican contender Ron Saxton has very strong opinions about Oregon’s health care system. Here, in an interview with Diane Lund-Muzikant, editor-in-chief of Oregon Health News, Saxton shared his thoughts about the Oregon Health Plan, transparency, the Massachusetts health reform plan, employer mandates and the Archimedes Movement led by former Governor John Kitzhaber. Our October issue will feature an interview with Governor Ted Kulongoski.

OHN: What’s your solution to control health care costs?

RS: When I have met with hospitals, insurance companies and others, I come away with the understanding that our reimbursement approach does not make any sense. I have had people tell me cardiac and cancer care are over reimbursed. You have medical facilities all over the state putting in cancer and heart treatment centers. Those are the reasons everyone has their own MRI machine because it’s profitable. Then you have other areas that aren’t profitable and nobody’s offering them. When I ask why the system does not correct itself, nobody feels free to make the correction on their own. So what people have told me is you need someone, the governor, I think me, to sit them in a room and say okay, tomorrow we stop over reimbursing for A and under reimbursing for B. Let’s sit here and hammer out something. I have talked to doctors and insurance companies and lots of groups that say please — be the guy who convenes the meeting because they are all so frustrated.

For the rest of the conversation, that did not make it into the newsletter, please visit the "What's New" section of our Web site.

Patient safety gets real

For the first time, hospitals have begun disclosing their medical errors to the Oregon Patient Safety Commission. But the 18 errors reported during the first eight months of the patient safety program might not tell the whole story, said Jim Dameron, administrator. “We believe there were more than 18 adverse events during that time period.”

Thus far, 51 of Oregon’s 57 hospitals have enrolled in the patient safety program. The six choosing to watch from the sidelines are Lake District, Holy Rosary, Santiam, Curry General, Lower Umpqua and North Lincoln hospitals.

Also in this issue...

• Eugene saga continues
  
• Metro releases report
  
• Providence hospital workers get upgrade
  
• Back to bariatric basics
  
• EMS to stay in DHS
  

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