January 2007

Health care reform picks up steam in Oregon

Not since the buildup up to the Oregon Health Plan have the state’s leaders been so committed to revolutionizing the health care system. Bold proposals took shape over the summer, mostly in the open, from public commissions to Internet blogs.
But some of the most important work occurred behind closed doors.

In mid-December, one such meeting brought together former Gov. John Kitzhaber, Sen. Alan Bates (D—Ashland), Sen. Ben Westlund (D—Tumalo) and Dr. Rick Wopat, vice president for community benefit at Samaritan Health Services, who has been active on several reform plans. Also in December, a similar gathering took place at the Governor’s office, attended by representatives from the Oregon Health Policy Commission, the Senate Interim Commission on Health Care Access and Affordability, and the Healthy Kids Program.

Insurers tighten policy for parity

Evidence suggests the mental health parity law might be having the opposite effect that lawmakers intended, limiting access to mental health care rather than expanding it, as insurers make it harder for doctors to prove medical necessity.

The law took effect Jan. 1, but in the months leading up to that date, some insurers announced new policies that force mental health providers to skip through additional hoops if they want to get paid. As a result, some psychiatrists have terminated their contracts with certain insurers forcing patients to seek care elsewhere.

The Oregon Insurance Division has received several phone calls and complaints in recent months.

On the record with U.S. Senator Ron Wyden

In mid-December, U.S. Senator Ron Wyden (D—OR) unveiled a plan that boldly goes where no federal lawmaker has gone before. Not since “Hillary Care” has such a specific plan for universal health care reform been put on Congress’s plate. But Wyden’s plan has several striking differences from the former first lady’s proposal. It doesn’t require businesses to “pay or play,” meaning it doesn’t have an employer mandate, nor is it a single-payer system. Rather, it puts strong restrictions on health insurance underwriting, refocuses spending priorities on prevention and forces everyone to enroll in a health insurance plan. The busy Wyden spoke with Oregon Health News while on his way to Corvallis for one of his town hall meetings. The week before that he was in Israel, Jordan and Morocco taking on world peace.

OHN: Your announcement seemed to take some people by surprise, even those in Oregon who are working closely on major reform. How did you come up with this plan? Where did you hash it out?

RW: I did tell people at speeches that I was working on broader reform. What really drove it were the town hall meetings I hold each year. I would listen to what people said about health care and ask them about various approaches. When you come to one of my town hall meetings, very often someone will say they want a single-payer in health care. Then after a little bit someone says, no, they don’t want all that government and bureaucracy, and there’s a little bit of a stand off. Quite often people would say what I really want, Ron, is what you have in Congress. Everything I read says you guys have a good deal. I took what I heard from those town hall meetings and went from there. That’s what I’m doing in the legislation, guaranteeing coverage at least as good as Congress gets through a delivery system much like members of Congress use with choices in the private sector.

Advocates question judge reassignment

Mental health advocates in Multnomah County were dismayed to learn that a circuit court judge who ruled over civil commitment cases for eight years and gained favor by the mental health community had been reassigned by Presiding Judge Dale Koch.

Judge Pro Tem Lewis Lawrence, a “temporary” judge in Multnomah county since 1985, will now work cases involving probation violations, pleas and felony sentences. Lawrence as well as Koch did not return phone calls.

“Judge Lawrence was excellent in doing the extra leg work, taking into account the clinical aspect of the situation,” said John Holmes, executive director of the Oregon chapter of the National Alliance on Mental Illness. “He just didn’t consider legal facts. He considered medical information, and that’s really important. Word on the street is that new judges won’t do that.”

OHP reductions close to losing their benefit

A yet-to-be implemented state statute requiring the elimination or reduction of four Oregon Health Plan benefits is starting to lose its, well, benefit.

That’s because the law, which passed last session, is still waiting implementation. Officials from the Division of Medical Assistance Programs originally planned for the reductions to start Feb. 1, but have since delayed them to March 1. Some now question if it will ever happen. The reductions expire June 30.

“I think it’s really a toss-up at this point,” said Jim Edge, deputy assistant administrator of DMAP.

Also in this issue...

• State’s insurers pad their bankrolls, study finds
  
• Consumer feels left out of reform talks
  
• Dossia draws concern from privacy advocates
  
• Rates now less of a liability for docs
  

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