Oregon’s new Medicaid system a beacon for nation

Street Roots editorial

Health care costs are sucking the life out of Americans.

It’s true. The United States spends more than any other country on health care: More than $2 trillion each year. That’s 17 percent of our GDP goes into health care costs, according to the Congressional Budget Office, and it’s on the rise.
Health care costs are rising faster than our earnings. In fact, a U.S. Department of Labor study shows that in the past decade, premiums for employment-based private insurance rose 114 percent. Small and mid-sized businesses are looking at double-digit increases in their coverage costs, which cut into earnings and employment opportunities. The cost has expanded far beyond access for many Americans who are now going without insurance, or preventative care — and without jobs. The Oregon Health Authority estimates 16 percent of the state’s population is uninsured.

It is at once a trickle down tragedy and a pyramid scheme we are all paying into, insured or not. On the other hand, the system has also created the irony of the perfect insurance customer: one who has insurance through their employer, but whose deductibles and pharmaceutical costs are high enough to prevent them from using it constructively.

Oregon is poised to show the country that there can be a better system, one that actually encourages health care access, rather than discourages its use. The goals to cut costs mean avoiding the failures in the system. That means keeping patients out of emergency departments and hospital beds and psychiatric wards.

It means keeping them healthy in their homes, and equally important, keeping them informed and engaged in their own well being.

It also means that the very real impact of social and economic disparity can be measured in conjunction with a person’s health. By contracting with social service operators, health care providers will have an even greater investment in alleviating the impact homelessness and poverty may have on a person’s long-term wellbeing.

If the promise bears out, Oregon’s run with coordinated care organizations will prove a working template for the federal health reform movement. So much so that the federal government has invested $1.9 billion into Oregon’s new system over the next five years, on the basis that the system will improve health and lower costs.

We would also hope that it kick starts a new dialogue around health care — one that focuses on the potential of a truly healthy population, rather than political rhetoric and myths of our global superiority in the field.

The coordinated care network is a smart move for Oregon, and for the 600,000 Oregonians on Medicaid who will now be enrolled in coordinated care organizations. It has been years in the making, with a constant push by health care and social service advocates at all levels to put a promise into practice. It will not be without its growing pains, but it has the potential to bridge the gap between believing in a functional health care system, and actually having one.

Read Street Roots in-depth look at healthcare in Oregon.