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The House Health Care Committee plans to introduce legislative concepts for the 2009 session later this year that could change the structure and oversight of the state’s health licensing boards, including citizen representation and how the recovery programs of clinicians with substance abuse problems are disclosed and monitored. The committee is specifically interested in the boards that oversee licensed health professionals rather than other state health boards that oversee barbers, aestheticians and other non-clinical providers that also hold licenses, according to committee chair, Rep Mitch Greenlick (D–Portland).

Although local and national media, the Governor’s office, legislators, consumer advocates and other stakeholders continue to closely scrutinize the State Board of Nursing, Greenlick said the changes in health licensing boards that he and his committee plan to propose are unrelated to scandals that have rocked Oregon’s nursing board for the past two years.

Last year was another expensive one for health insurers in Oregon, with many reporting to the state higher medical-loss ratios and lower profit margins than the year before.

But there were no tectonic shifts in the health care marketplace between 2006 and 2007, as Oregon employers and insurers continued their search for better ways to control the cost of medical services, drugs and serving an aging population.

"The Oregon market is very competitive and very vibrant when you look at the presence of some excellent local carriers," said Jon Jurevic, senior vice president and chief financial officer of ODS, a major dental insurer that also maintains a commercial medical plan and a large self-insured business (132,000 members). "I don’t think anybody is going to grow their business significantly unless it’s at the expense of another [local insurer]."

With Gov. Ted Kulongoski prepared to again tackle health coverage for Oregon’s uninsured children in 2009 using a tobacco tax hike, some are questioning why he is staking part of his political legacy on a policy that was unpopular in the Legislature and among voters.

In March Kulongoski, halfway through his final term, used his State of the State speech to revive the Healthy Kids initiative. His proposed budget for the 2009-11 biennium will include around $40 million to cover 45,000 to 60,000 of the estimated 116,000 children without health insurance. The remaining kids, he said, would get coverage that is paid for by a tobacco tax increase, though one that is likely less than the 84.5 cents a pack voters rejected in November 2007.

"The failure of Measure 50 last November was a setback," he said in the speech. "But I refuse to treat it as a defeat. If the tobacco companies think that the $12 million they spent to defend the bargain-basement price of their product – which happens to hook kids and destroy lives – bought them a permanent victory in this battle, they are sadly mistaken. Measure 50 was not the end. Measure 50 was just the beginning of this fight."

Eleven months after starting the Northwest branch of Project Access Now (PAN), the local collaborative of physicians, hospitals, clinics and health conglomerates is poised to grow into the national model’s most ambitious program.

Based on a physician-created network in North Carolina, PAN coordinates charity care for uninsured people in Multnomah, Washington and Clark counties earning at or below 200 percent of the federal poverty level and who have a confirmed medical necessity. Patients sign an agreement regarding program expectations and their participation for the six-month enrollment period.

Executive director Linda Nilsen-Solares founded the local chapter along with Lorraine Williams; working out of their office in northwest Portland, the duo have enlisted 1,500 willing doctors so far from Tuality, Providence Health & Services, Legacy Health System, Oregon Health & Science University and the Oregon Clinic, along with several private specialty groups. The volunteer network could, once at full strength, help as many as 250 people a month get timely care. All of this occurred before PAN’s official launch date of March 8.

• Linking social settings and health disparities
• Many hands in the health IT pot
• Maribeth Healey: Good news from the Delivery System Committee
  
• Denise Honzel: Exploring the dynamics of a health insurance exchange