Setting the Record Straight on Oregon's Healthcare Reforms

A response to an editorial by the Bend Bulletin on an initial proposal related to a single-payer healthcare system.

I am proud to serve as an official public member of the 2019 SB Joint Task Force on Universal Health Care (Task Force). And, I am grateful to Governor Kate Brown for appointing me to the role and to the Senate for confirming my participation. Through my role a community participant, I represent the public's interests.

With that interest in mind, I felt compelled to respond to an editorial published by the Bend Bulletin on August 25, 2021. The editorial addressed the Task Force’s proposed recommendations around new taxes as the source of revenue for its healthcare plan. The recommended tax proposal was part of an interim progress report from June 2020-July 2021 that mirrored the scope outlined in the SB 770 legislation. The report's purpose was to inform the Legislature about the Task Force's incomplete work and its intention to present further recommendations with significant changes to reflect additional community engagement.

Before delving into my reply to that editorial, it is essential to explain the circumstances and perspectives from which my concerns evolved. My purpose for sharing is to help you develop a clear, in-depth understanding of the ongoing health-related issues, challenges, and needs extending over five decades and demanding sincere attention. For example, I directly experienced health impacts originating from lack of access, unaffordable, and low-value quality medical care benefits. My acquired health knowledge, expertise, and understanding are rooted in my shared diverse cultural behaviors, beliefs, and values, including community grassroots organizing and public health engagements.

As a result of my experiences and education, I have a strong understanding of the principles, practices, and policies of public and private health insurers. More explicitly, I know that profit derived from employer-sponsored healthcare plans drive these insurance markets.  Because profit and not the well-being of patients drive these markets, it is reasonable to conclude that our current healthcare delivery system is unsustainable and will continue to deliver unsuccessful outcomes. Reimaging this market to be a single-payer system represents the greatest perceived challenge of the public, the Legislature, and the Task Force members

With that background, it’s possible to analyze the merits of the arguments raised in the op-ed. The Editorial Board mischaracterizes the work of the Task Force by indicating that increased taxes are the Task Force's primary plan for financing this much-needed single payer system. The editorial also mistakenly conflates the Medicare for All plan discussed at the national level with the single-payer system outlined in this proposal for the state. To date, we have not made any conclusive recommendations to the Legislature toward adopting these approaches. I find the editorial’s mistreatment of these important topics to be provocative, inappropriate, misrepresentative, and purposeful, with the potential for unforeseen consequences.

 I am concerned that this misinformation may result in the sort of mental devastation and emotional damage that persists under our current system. Furthermore, I am emotionally impacted by the misrepresentation and implications of this article and what it conveys to the paper’s readers. Overall, this editorial does more to anger residents than to inform them.

Here’s an illustrative portion of the editorial that undermines the work of the Task Force. The Editorial Boards stated:

[T]he plan is for new taxes to pay for [single-payer healthcare]. New payroll tax. New personal income tax. And maybe a new sales tax. Single payer is what some people call in shorthand: Medicare for all. A single government agency takes responsibility for financing health care for all. Everybody would be on the same insurance plan and have access to the same services.

These claims can derail our Task Force efforts before the final recommendations are submitted to the Legislature. I am disturbed by its misinterpreted statements and implications that may influence community stakeholders. I contend that this interpretation could spiral out of control, influencing the public and other stakeholders' understanding and even motivating threatening behaviors resulting in harmful outcomes. The implications of this article can stir up premature unwarranted and violent protests given our current political landscape's adversarial positioning on social issues throughout the nation and within our state.

The possibilities of negative consequences include such public reactions as withdrawing their community advocacy, testimonial engagements, and even their donor support of this matter. The implications are rife with unjust notions of economic uncertainties, indicating that this tax revenue plan finances our single-payer system. It charters a disingenuous course around an already divisive topic and may stimulate heightened concerns and distrust in this necessary model.

In conclusion, the Task Force should set its sights on what is fair, sustainable, practical, efficient, accessible, affordable, of high-value quality, and reasonable for all Oregonians. It is not our obligation to prioritize the care of the wealthy above those of other Oregonians. We will achieve these challenging endeavors with statewide healthcare consumers' input engaging in a collaborative community process. This approach will help us define issues, address root causes, identify motivating factors, implement feasible principles, and evaluate the strategies.

We can then collectively transform our socioeconomic healthcare delivery system with tangential benefits that save lives, and improve quality of life and health status outcomes. In so doing, our final recommendations will ensure public buy-in from diverse stakeholders. To achieve success, we must not become bound by limited thinking around one revenue finance modeling method, including this tax plan.

The Editorial Board concluded their piece by asking three pressing questions:

Would Oregonians be happier and healthier under single-payer? Would quality of care improve? Would it be easier to fight a pandemic?

The Task Force will strive to meet the goals of SB 770. In so doing, we must anticipate the consequences of our recommendations around sensible and innovative approaches per the SB 770 legislative design. We are confident that our hard work and due diligence will yield outcomes such that the answers are yes, yes, and yes.

Photo credit: "visitors - sara, aidan, and tobi meet sequoia - _MG_4341" by sean dreilinger is licensed under CC BY-NC-SA 2.0