|
Last Updated:
Apr 21st, 2005 - 21:10:55
Affiliates
Powells.com
Favorite Links
American Friends Service Committee
Friends Committee on National Legislation
National Catholic Reporter
British Broadcasting Company
The Guardian
Christian Science Monitor
LA Times
SF Gate
Oregonian
The Register Guard
Environmental News Network
Sojourners
Orion
Swans Commentary
Federation of American Scientists
Car Free Times
Indy Media
AlterNet.org
Common Dreams
The Nation
Utne Reader
Eugene Weekly
Willamette Week
Portland Tribune
Bitter Lemons.org
The Travels of our First Webmaster
|
|
|
Voices of the Northwest
 |
| The Eye Exam, photo courtesy of the White House, Office of Management & Budget |
I met Ruth Duemler at her house on a cool rainy afternoon of early summer in Eugene, Oregon. She greeted me with warm blue eyes and wore a bright orange tee-shirt that read Health Care for All. She explained she just got back from signature gathering. Initiative ballot measures must have 80,000 valid voters' signatures to qualify for the ballot. She and many other volunteers worked thousands of hours to have a healthy margin of valid signatures.
I have heard about her and her work for years. She was an editor of the alternative newspaper, The Other Paper, for eight years. She helped to provide a forum for many a grassroots campaign, using the The Other Paper to reach out to the public and to build a kind of coalition among various progressive community groups. But now, I wanted to learn something about this woman and her current work.
We sat in a bay window seat overlooking a verdant view of glistening treetops and gardens. It was a lovely place to discuss some of the life and death issues of health care of the nation and of Oregon. Her remarks resonated for me. Here is a summary of Ruth's Duemler's dream.
Ballot Measure 23 will create the legal mandate and structure for health care insurance reform. The people of Oregon can form a non-profit corporation for the benefit of all. The risks are spread out over the whole population. Instead of a hundred plans with wildly varying coverage, there can be a general standard of quality care under the Oregon Comprehensive Health Care Finance Plan.
All Oregonian are eligible, it pays for all licensed practitioners and medical services, including dental, mental, alternative health care as well as nursing homes, and hospice care. There will be no exclusion by pre-exisiting conditions. You can go to any doctor of your choice. Your doctor or practitioner directs your health care, not a faceless bureaucrat who has no medical training.
Ruth explained that the Oregon Comprehensive Health Care Finance Plan has been twenty years in the making. There will be a Board of Directors, two elected members per congressional district and five appointed by the Governor from health care advocacy, health service providers, alternative health care providers, labor and employers organizations. The first phase of transition will be to have the Plan operating by January 1, 2005. There must be a balanced budget for the Plan. But wouldn't this new Plan be expensive?
Ruth gave me an example of a failure of the current health care system. "I knew a hardworking, lovely family. The mother had been ill. They applied for the low-income public health plan. But their income was thirty dollars over the income limit. They didn't qualify. The mother got terminal very fast--cancer. Then she got help. Too little, too late. She received chemotherapy and died in hospital. Besides the loss of her life, her children motherless, the way she got help was much more expensive than a decent screening and prevention program she would have had in decent medical care." This is just one case she knows out of 400,000 un-insured, many of them children. The emergency room visit is the only means to get medical attention. And all too often, the illness, which may have been caught, treated easily and with little expenditure becomes an expensive crisis.
How will this Plan be financed? The funds will be separate from the General Fund, to be used only for health care benefits, capital expenses and administration of the Plan. Administrative costs are limited to 5% after 3 years. Government funds will be transferred from federal, state and local budgets (Medi-caid, Medicare, etc.), a progressive income tax, and an employers payroll and income tax.
Ruth explained how the top 500 Oregon employers and their employees are seeing a reduction of benefits in their current plans. We looked at the payroll taxes for employers versus the projected 20% increase in health insurance plan premiums they will be paying in the next year. The issue of additional income or payroll taxes is perhaps the biggest hurdle to overcome.
Oregonians historically have been extremely resistant to new taxes. As one of the few states in the nations with no sales tax, Oregonians have paid a high price by tolerating unstable state education funding. How would this proposed new income tax affect the average working family? Following federal guidelines of a progressive tax, the family with a taxable income of $50,00 would pay $60-70 a month. Keep in mind, Ruth cautioned, this will be instead of your share of insurance premiums, co-pays, medicines, deductibles and out of pocket costs for medical and dental care. There is a cap at 8% for the highest income bracket.
Employers would be spared paying their share of ever rising health care premiums and seeking decent plans from a shrinking benefit world. Instead, they would funnel their share into the general pool for the state as part of doing business in Oregon. The progressive employers' payroll tax would be capped at 11.5% maximum for very big companies. To be more competitive in offering benefits, some employers may choose to pay employees' health income tax. All existing health insurance contracts would be honored and given payroll tax credits.
What kind of benefit costs are employers paying now? The City of Portland pays out over 10 million dollars a year in premiums, 4-J School District (Eugene area) 2 million dollars. Declining coverage of benefits is becoming an issue of contention with many public and private employees. The financial advantage of becoming a self-insured public corporation will leverage all of the funds ( employer and employee premiums and federal funds already allocated for health care) currently scattered to various insurance companies. The Springfield School District is already self-insured and is saving 30% of associated costs.
I asked Ruth why she thinks health care costs are soaring. Is it the role of technology, inflation, drugs costs, an aging population or what? She replied that plan administration is where the new costs are contained or expanded. Or padded. The US General Accounting Office (GOA) reported in 1991 that 10% of all costs were administrative. Now a decade later, it is estimated to be at 50%. A single-payer system can cut paper/computer shuffling by 50% or more.And what if we could eliminate the CEO's who average $20 million dollars a year! An other problem of HMO's is that so many of them are for-profit businesses. Health care administration has been commodified into a marketable product rather than a not-for-profit service accountable to the public. Funds collected but not spent in medical services are a "profit center." Your HMO not paying for a doctor ordered test may increase its profit for this year. You may be able to pay this out-of-pocket cost. Or not.
We talked about places where a single-payer system has had a long history. In Europe and England, and in Canada. Ruth pointed out that 45-55% of all US bankruptcies are due to medical bills. Old people have to "spend down" their life savings to get long-term nursing home care. This often leaves the spouse at home in poverty.The transition, from profit motivated health care insurance as we know it to one of self-insured non-profit corporations, would save enough funds to offset the expenses of universal coverage.
What about the displaced workers from the insurance industry? Ruth thought that many of them would find employment in the new system. After all, many have experience and expertise. The Oregon Comprehensive Health Care Finance Plan has provisions for displaced workers retraining.
Will a new health care insurance system be perfect? No. Will there be adjustments, fine-tuning? Yes. Will more people have a chance for a better life in real, measurable ways? Yes. Health care is one of the vital needs in daily life. Like clean air, water, shelter, education, safe food, libraries, police and fire services, it is a matter of public concern and well-being. How do we as a society craft an equitable solution?
I wrapped up my visit with Ruth Duemler by asking her why she has been involved, working so long and so hard for Health Care for All. Her blue eyes sparked. She smiled and said, "Justice."
To learn more visit Health Care for All
and Health Care for All Oregon.
The full text of the Oregon Comprehensive Healthcare Finance Act is in the Oregon State Voter's Pamphlet, Ballot Measure 23.
Also visit the US General Accounting Office: a quick search on "universal health care" brings up a great index of slow-loading but very informative reports.
More West By Northwest.org articles on health care:
Why I Support Measure 23, the Oregon Health Care Ballot Measure -- Health Care Insurance Reform is Possible Now By Dr. Roberta Palmer, M.D.
Consider the Case of Patricia Sweets and The Failing Safety Net of Our Publicly Financed Health Care System By M.G. Hudson
Pickets & Policy: A Brief Look at the Current Crisis in Public and Private Health Insurance and Care By Nona Glazer, Ph.D.
© Copyright 2000-2004 by West By Northwest.org
Top of Page
untitled
|
|
|
