Oregon's Health Care Crisis

Oregon's health care system is in crisis. Read the facts right here, and see what can be done about it further down on this page.

Quality health care that once seemed secure is quickly being priced out of reach for hardworking Oregon families and businesses.

Here are the facts:

Health Care Costs are Skyrocketing
Health care cost increases are easily outpacing wages. These rising costs make it difficult for businesses and working families to find affordable coverage.

• Health insurance premiums increased over 90% since 2000. 1
• The average health insurance premium for a family of four is now $12,106. 2
• 33,055 Oregonians declared medical bankruptcy, half of all filings. 4

Insurance, Hospital and Drug Companies are Raking in Profits
Oregon families and businesses are struggling while insurance, hospital and pharmaceutical company profits soar. Increasing accountability and price transparency will ensure fairness within the health care system.

• Oregon hospitals made $384.7 million in profits in 2005. Oregon is the second most expensive place to spend a day in the hospital. 3
• The U.S. Department of Health and Human Services projects national prescription drug spending will increase 148 % from 2005-2016.

More Oregon Families are Losing Health Care Coverage
Increasing out-of-pocket costs are making health insurance unaffordable for many Oregonians and businesses. Over 60,000 private sector workers lost coverage in recent years and 85,000 have lost coverage under the Oregon Health Plan.

• Over 600,00 Oregonians lack health care coverage, including 114,000 children. 5
• 4 out of 5 uninsured Oregonians are working or have a family member who is working. 6

Health Care is Integral to Oregon’s Economy
Health care is an economic engine that could benefit everyone. Reducing health care costs will allow families and businesses to invest more in their local communities.

• Every $1 million invested in health care results in $3.1 million in associated economic activity and 30 jobs. 7
• Small business owners identify health care cost as their number on concern, even over taxes.8

Senate Bill 329 of the 2007 Oregon Legislature created the Oregon Health Fund Board. The board is a 7 member commission, appointed by the Governor and confirmed by the Oregon Senate. Over the last year and a half, the board listened to thousands of Oregonians as it developed a comprehensive plan to ensure access to health care for Oregonians, contain health care costs, and address issues of quality in health care. The plan will now be considered by the Oregon Legislature in the 2009 session.

You can read the entire 163-page report here. We have also summarized the board's recommendations here.

The centerpiece of the board's recommendation is the creation of an Oregon Health Authority. The envisioned authority will have a strong citizen board and experienced nonpolitical leadership to coordinate the state’s existing patchwork system of purchasing and regulating health care, community services, and workforce training. The Authority will:

• Become the organizer and integrator of Oregon health care purchasing and policy
• Coordinate the State’s investments in health service innovation
• Focus on quality, costs and the health of the population
• Build the system for 100% access to health care on the foundation of a transformed health care system.

The Authority will be charged with using seven additional strategic building blocks for change:

1. Bring "Everyone Under the Tent":
   • The board recommends that in 2009, the legislature reduce the number of uninsured by nearly 200,000 people by providing health insurance for all the children of Oregon and bringing additional adults into the Oregon Health Plan
   • Define, implement and maintain an essential benefits package, a minimum level of coverage that plans in Oregon must provide.
   • Continue to expand coverage once cost containment plans have been implemented. This portion of the plan includes requiring all Oregonians obtain health coverage; state contributions for low and moderate income families; reform of the individual (non-group) insurance market; a "pay or play" payroll tax; an insurance exchange, which may include the option of a publicly owned and operated plan.
2. Set High Standards - Measure and Report: Ensure transparency of costs and health outcomes throughout the system.
3. Unify Purchasing Power: Coordinate State purchasing strategies to stimulate implementation of new models of care, reduction of unnecessary administrative costs and reasonable price setting.
4. Stimulate System Innovation and Improvement: Improve health outcomes and reduce costs through new models of care, including prevention and management of chronic disease.
5. Ensure Health Equity for All: Address the root causes of ill-health by including the principle of health equity in every aspect of health care.
6. Train a New Health Care Workforce: Encourage existing and newly trained professionals to work at the top of their licenses and rethink the work itself.
7. Advocate for Federal Changes: Pursue federal waivers, additional funding and policy changes to support Oregon’s health care goals.

The board’s plan includes a time-line for implementing the various recommendations. In 2009, the board believes we can and should achieve 100% access for all children and adults currently eligible for federal matching funds under existing waivers by funding the Oregon Health Plan and Children’s Health Insurance Plan. 2009 is also when the board recommends creating the Create the Oregon Health Authority, which will then begin to create the infrastructure for a world-class health and health care system.

In 2011, the authority and other entities should be fully operational and implementing the building blocks for change, including final development of an essential benefit package.

In 2013, the authority should have in place an insurance exchange, an essential benefit package and other strategies designed to achieve 100% access to health care for all Oregonians.

For more information on the recommendations of the Oregon Health Fund Board, please see the full report. You may also call Oregonians for Health Security (503-239-8800) for more information, and for advice on how to take action to ensure the Board’s recommendations are implemented by the legislature in the coming session.