Tag Archives: Healthcare

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. Continue reading

Oregon’s great health care experiment: State puts $240 million on the line with coordinated care

By Amanda Waldroupe, Staff Writer

Starting in September, the Portland metropolitan area’s largest private and public health care providers will forge a new way of delivering health care to some of the neediest and most vulnerable patients in the state, and they’ll do it in a way that seems impossible: by working together.

The organization the providers have created is called the Tri-County Medicaid Collaborative. It is one of dozens of coordinated care organizations, or CCOs, forming throughout Oregon to change how patients on the state’s Medicaid program, the Oregon Health Plan, receive health care.

Coordinated care organizations form the backbone of ambitious changes to the Oregon Health Plan pushed by Governor John Kitzhaber and bipartisan legislation the Oregon Legislature passed during the 2011 and 2012 sessions—an effort to not only provide higher quality care, but also to drastically reduce the state’s Medicaid expenditures by millions of dollars.

The Collaborative, like the rest of the state’s CCOs, does not have time to dally. CCOs are expected to save the state $239 million dollars in 2013 alone; if those savings are not made, it could be catastrophic for the state’s budget. Continue reading

Health care champion Margaret Flowers talks w/SR

Dr. Margaret Flowers has become a leading voice in a movement for single-payer health care. In 2006, she left behind a medical practice to take up the fight and has become a hero of sorts for millions of uninsured Americans.

Flowers obtained her medical degree from the University of Maryland School of Medicine and did her residency at Johns Hopkins Hospital in Baltimore.

After being arrested in 2009 for advocating for single-payer she wrote, “In that moment, it all became so clear. We could write letters, phone staffers and fax until the machines fell apart, but we would never get our seat at the table. The fact that thousands of people in America are dying every year because they can’t get health care means nothing. The fact that over one million Americans go into bankruptcy every year due to medical debt — even though most of them had insurance when they got sick — means nothing.” She has dedicated her life to changing this.

Flowers currently works with the Physicians for a National Health Program, a non-profit research and education organization made up of more than 18,000 physicians, medical students and health professionals. She was recently in Portland as one of the speakers at a daylong Single Payer Conference at the First Unitarian Church.

Street Roots’ Jay Thiemeyer talked with Flowers about her commitment to single-payer health care over the phone last week.

Jay Thiemeyer: What particular reasons do you have for supporting single-payer as a solution to the health care crisis in this country?

Margaret Flowers: Single payer is the only approach to financing health care that actually uses our health care dollars in a way that’s accountable to the public, that’s transparent, that’s the most cost effective way to finance health care. It’s also the simplest way for patients and health care professionals to interact with each other. There’s one set of rules. Every health profession is in the system, so you don’t have to worry about where you can go. You can choose where you want to go. And it allows a direct relationship between the payer and the provider, so we don’t have this middle person, this insurance company administrator in the way, telling us what we can and cannot do. So it allows us to focus on taking care of our patients without the hassles of dealing with all these health insurance plans.

After practicing for 15 years and being in this situation, which is really driving us in the opposite direction of not being able to take care of our patients well, I felt like this was something I needed to leave practice and work for to achieve in this country. We’re the only country that doesn’t have a health system.

J.T.: Is it fair to say that, as I understand it, a third of the health-care dollar that people who are covered by private insurance spend, is spent on that administrative layer, which is basically devoted to denying coverage to the people who subscribe to private health insurance?

M.F.: Right. It’s really a very perverse and wasteful situation. It’s at least a third of our health-care dollars overall that are going toward marketing and administration of all of these various health insurance plans, both from the health insurance company side, where they have to develop their products and market them, to the provider side, where we have to interact with them and figure out their rules which are often changing or obscure and very difficult to figure out. It’s also a waste of our time and very stressful on both patients trying to deal with this mess when they need health care and for health professionals to deal with that. And it’s perverse because an insurance company makes a profit, which they’re required to do for their stockholders, by denying and restricting health care instead of actually paying for health care, which is the opposite of what we should have. Continue reading