For healthcare: Everybody in and nobody out.
The expectation is that the state will publicly fund the Health Care for ALL Oregon Plan, as required by SB 770. The model will be equitable, affordable, comprehensive, and high-quality.
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Glendora was born and raised on a plantation in Blytheville, Arkansas. She endured social injustices, school segregation, and other Jim Crow racial discrimination.
Oregon cannot celebrate its “quality of life” without taking steps to make sure that every Oregonian has the access to healthcare that they deserve and require to thrive. Given my perspective as a Board member of the Healthcare for ALL Oregon (HCAO) board, I am optimistic that we can realize our quality of life goals here in Oregon by transforming updating our healthcare system to be more efficient, equitable, and patient-focused.
The Oregon Health Authority (OHA) reports that our legislators and governors implemented its first state Medicaid publicly-funded Oregon Health Plan in the 1980s. The purpose was to help address the nation's growing threat of its socio-economic health conditions. The rapid, phenomenal growth of the healthcare delivery system's increased medical costs and the healthcare consumers' inability to pay for their primary and essential healthcare services presented themselves as challenges for both our state and country.
These challenging conditions resulted in more than 40 million Americans lacking healthcare coverage, thus subjecting them to inadequate access to medical services and coverage, including preventative care, diagnostic testing, and timely treatments. During this time, according to OHA's report, 18% of Oregon's population and 20% of our children were uninsured through no fault of their own. As a result, these populations were without sufficient access to critical medical services. These circumstances led too many underserved individuals to their untimely fate.
These challenges have persisted into the 21st century. Before implementing the 2010 Affordable Care Act (ACA), and Patient Protection Clause (PPC), Oregon struggled with providing adequate healthcare coverage resulting in 1 out of 5 individuals being without insurance. Even with the ACA, too many individuals lack the healthcare they require to thrive. This result is despite Oregon's existing Medicaid healthcare coverage expansion effort insuring 95% of its population since the implementation of the 2010 ACA-PPC. According to the US Census Bureau, Oregon's current uninsured rate remains at eight percent (8%) of its entire population—roughly 4 million Oregonians, it’s as if the entire city of Wilsonville lacked insurance.
In response to the persistent health and healthcare system challenges in providing adequate and equitable healthcare coverage today, Oregon's State Legislature proposed, approved, and adopted the 2019 Healthcare for ALL Oregon Senate Bill (SB) 770. This proposal was signed into law by Governor Kate Brown on July 23, 2019, and implemented on August 8, 2019. The Bill required establishing a special Joint Task Force (JTF) on Universal Health Care, leading to designing a universal healthcare system plan model with a completion date by January 2022. I’m honored to be a member of the JTF.
However, because of the coronavirus (COVID-19) pandemic outbreak taking priority, our tasks have been delayed. The deadline for the JTF’s work has been extended through new amendment legislation, SB 428, allowing for a one-year sunset timeline ending January 2023.
The purpose of establishing the JTF is to recommend to the legislature a practical design model of the Health Care for All Oregon Plan to be implemented. This implementation will be a significant achievement because it will help lower healthcare costs, insure all Oregonians, and improve the health of our state's economy, citizens, and communities. It will provide equitable and quality healthcare coverage benefits and services. We will achieve this outcome by developing a transformational comprehensive Single-payer Universal Healthcare Delivery System Planning model.
To provide you with a better understanding of our important work, it is necessary to highlight a few details. We seek to be transparent in our approach and aim, as this will increase the public’s knowledge and therefore buy-in. The expectation is that the state will publicly fund the Health Care for ALL Oregon Plan, as required by the 2019 SB 770 enactment. The model will be equitable, affordable, comprehensive, and high-quality; these principles will guide our focus in achieving our goals and objectives toward addressing the diverse and important healthcare needs of all Oregonians.
With these goals and SB 770’s design standards in mind, the JTF must examine and explore in detail the extent to which our focused equity objectives will reflect broad socio-economic realities. Analyzing and incorporating these concepts will help influence our thinking, methods, goals, procedural strategies, and objective outcomes. For example, we must discern the sources to generate sufficient revenues required to fund the plan.
In so doing, the JTF will engage in a collaborative effort with expert healthcare policy analysts, healthcare administrators, community members, activists, and advocates to identify and develop comprehensive strategies to reflect areas of provisional coverage in the benefits package plan. This sort of outreach is essential to reducing the partisan rancor that’s been associated with healthcare reform. This plan isn’t about a party, or profits, but you and me – the people of Oregon.
The intended model plan will be holistic in developing its objective tasks of specified covered services constructed to be equitable, maintainable, doable, and sustainable. These objectives will include provisional services that will begin at conception and end at death. These services will incorporate a socio-economic framework to address potential healthcare consumers' unmet health and healthcare needs while providing patient-centered care.
Currently, the provision of services to address unmet needs face a number of barriers. Such restrictions are consistent with unmanaged health conditions, limited healthcare coverage, remote locations, untimely care, out-of-pocket costs, and healthcare providers' implicit racial bias impacts. These elements often result in unequal access and disproportionate health disparities related to diseases, injuries, job losses, inadequate nutrition, domestic violence, and other socially denied opportunities, resulting in poor health outcomes and unsustained quality of life disruptions. Observed circumstances of this magnitude often occur among the rural, low-income, abject poor, LGBTQIA, the disabled, elderly, and minority populations.
Beyond our plan reflecting these circumstances, it must reflect budgeting and financing issues, and public and private contractual partnerships, as well. The financial aspect of the plan will also focus on healthcare providers' interests, location of facilities, donors and philanthropists, racism, health differences, and economic barriers such as premiums, co-pays, deductibles, wages, and incomes.
These aspects are relevant to consider because they are contributors resulting in treatment inequalities and inequities. These areas of focus and outcome are significant when considering comprehensive coverage and the impacts of inappropriate care. When healthcare plans are compromised for profitable gains through decreased medical services, it lessens healthcare costs. This behavior creates the potential for less expansion of access and care delivery toward ensuring quality assurance; Oregonians lose out on accessible, affordable, equitable, and quality healthcare as a result of this dynamic.
In conclusion, the SB770 design will include sufficient financing to assist low-income and rural residents with social determinants of health needs, including those residing in high-risk environmental areas of increased exposures to toxins, waste, and other harmful chemical agents. Application and incorporation of these issues will help address exclusionary practices and unfair policies by dismantling ageism, classism, gender orientation, sexual preferences, transgender populations, cultural diversity, and linguistic differences. These embedded socialized components exist within our societal norms with devastating health impacts on our minority communities, our state's economy, and the entire population. These impacts result from a lack of actionable strategies thwarting preventable illnesses, health disparities, medical bankruptcy, and premature death outcomes.
Therefore, the JTF needs to consider these components as unhealthy and unchallenged issues and barriers that impede quality of care and adequate healthcare services access. Ensuring an all-inclusive health design model encompassing SB 770's principled concepts requires its identifiable strategies to be measurable, sustainable, specific, achievable, reasonable, timely, serviceable, and feasible. These elements will help the JTF identify the crucial unmet health and healthcare plan objectives.
This effort will lend itself to a holistic care approach making its services, practices, and coverage care plans available to every resident living in Oregon. This effort will reflect the undertaking of the Healthcare for ALL Oregon (HCAO) organization. We will honor their hard work on initiating the SB 770 proposal by acknowledging and incorporating their eligibility, enrollment, affordability, and benefit mantra: Everybody in and nobody out.
In short, healthcare is a human right. You can find out more about this work at hcao.org
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Glendora Claybrooks has laid out a clear history of healthcare in Oregon and the challenges facing her Joint Task Force in providing for the needs of all who live in our state. I will be interested in seeing how we can deal with the economic challenges that have served as false barriers, keeping the public from understanding how inadequate the current system is and has been for so many years. The clarity of intention and the commitment expressed assures me that the battle ahead will require our support. Count me in!