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Health care measure will be cost-effective.

Byline: MARC SHAPIRO For The Register-Guard

THE OREGON COMPREHENSIVE Health Care Finance Plan, which we hope will appear on the Nov. 6 ballot, will be the most significant issue to ever come before Oregon voters.

This plan, which was described in a May 4 Register-Guard article, will have a major impact on the availability and delivery of health care in Oregon. It will create a single paying agency to finance medically necessary health care for all Oregon residents. There will be no exclusions for pre-existing conditions. There will be no deductibles or co-payments. Coverage will not be dependent upon employment or economic status. Services may be provided by any Oregon licensed, registered or certified practitioner.

The benefits available under the plan will be comprehensive. No referrals will be required, and the determination of necessary services will be made by patient and practitioner.

Care that is provided is actually less costly than care that is denied! The costs of denied health care are varied and sometimes subtle. Countless people are trapped in jobs they don't want because changing jobs or becoming self-employed would leave them without health care. Many small businesses cannot employ the talent they need or lose the talent they have because they cannot afford to provide medical insurance.

People with existing health conditions are unable to get needed insurance coverage and are frequently forced into poverty by the cost of health care. Forty-five percent of bankruptcies in Oregon are due to the cost of health care.

Those on Medicare and many others who do not have effective insurance for pharmaceuticals are forced to choose between life-saving drugs and the other necessities of life. They frequently wind up needing emergency care, the cost of which is shifted to others who are fortunate enough to have either insurance or personal resources to pay for both their own care and the health care of those who cannot pay.

Consider the cost of treating, for example, pneumonia, diabetes, glaucoma and high blood pressure. Early, relatively inexpensive treatment can prevent costly, debilitating and possibly lethal conditions. Early treatment is far less costly than its denial.

The plan derives its finances from several sources. Government funding that currently provides health care would be redirected to the plan, together with progressive personal income and payroll taxes. The income tax rates will range from 0 percent for taxpayers with incomes of up to 150 percent of the federal poverty level, to 8 percent of taxable income (which is generally about 60 percent of gross income), with a cap of $25,000. The payroll tax will range from 3 percent to 11.5 percent based on the size of payroll. These taxes are deductible on federal returns.

The typical combined administrative overhead in our current insurance-based system, shared by insurance companies and providers, runs between 25 and 50 percent. Some 60 insurance companies provide health coverage in Oregon. Each has its own facility, each with a staff of claims processors, sales personnel and managers, as well as personnel who increasingly make treatment decisions that health care professionals are far better qualified to make. Each has to advertise its product and pay sales commissions. Their CEOs frequently receive unconscionable levels of compensation, and if they are for-profit corporations, they must also provide a return to their shareholders.

Each insurance provider or health maintenance organization has its own set of rules that force hospitals, doctors and other practitioners to supply workers and space - expenditures that provide no health care services, but are needed just to process claims and make referrals to insurance companies.

The administrative cost of the Medicare system is less than 3 percent, and that of the proposed plan is capped at 5 percent after three years and then tied to nonmedical inflation.

Based on these concepts, the Oregon Comprehensive Health Care Finance Plan will provide comprehensive health care for all Oregon residents for the same money that supports the rapidly disintegrating "system" we presently have.

Marc Shapiro is the Lane County chair of Health Care For All Oregon ( and helped draft the initiative to create the Oregon Comprehensive Health Care Finance Plan.
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Title Annotation:Columns
Publication:The Register-Guard (Eugene, OR)
Article Type:Column
Date:May 13, 2002
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