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Legislation pitched as tonic for ailing health care system.

Byline: David Steves The Register-Guard

SALEM - Lawmakers, unions and health-care advocates Tuesday unveiled a package of bills that includes proposals to expand health care to the uninsured through a payroll tax on businesses.

The bills are part of the Legislature's effort to improve a health care system that many say is failing a growing number of people who don't have adequate insurance to cover prescriptions and other forms of treatment, and who can't afford to pay those costs out of their own pockets.

Currently, 440,000 Oregonians lack health insurance, and about 780,000 Oregon residents lack coverage for prescription drugs, said Maribeth Healey of Oregonians for Health Security, which drew up the package of bills. The group is backed primarily by a coalition of labor unions and health care advocacy organizations.

Among the proposals rolled out by Healey's organization were bills to:

Create a prescription drug purchasing pool that would allow state agencies, local governments and school districts, along with participating private employers and individuals, to negotiate discounted prices from drug companies.

Require drug companies to publicly disclose gifts, fees and other promotions they give to doctors and hospitals.

Expand health insurance through increased taxes. A payroll tax of 1.5 percent would raise about $150 million a year - and attract matching federal Medicaid money. One proposal, House Bill 3285, would use the additional revenue to cover children. Another, House Bill 3286, would provide insurance to working families without insurance.

Business groups said it would be unlikely that they could go along with a payroll-tax increase for health insurance - even if it means bringing in matching federal health-care dollars that can stretch their contributions to provide insurance to workers.

"In view of these economic times, I'm sure we will not be supportive," said Lynn Lundquist, lobbyist for the Oregon Business Association.

But one of the bills' sponsors, Rep. Diane Rosenbaum, D-Portland, said there were good reasons for businesses to support the plan. They included the availability of tax credits for businesses that already provide employees with medical insurance, the cost savings that result from preventive care, and the social value of caring for children, given that one out of every 11 in Oregon lacks health coverage.

"Those children should not have to suffer," she said.

"And they also should not have to be taken to the emergency room when a sore throat turns into a very serious problem like strep throat or bronchitis."

Although expanding health care to the uninsured is a difficult and thorny task, Rep. Alan Bates, D-Ashland, said doing nothing isn't an option.

"We have an explosion of health-care costs that are unacceptable, and which cannot possibly be maintained by our society," said Bates, who is a family-practice physician. "If we do not do this, I believe we'll have a meltdown in our present system, and we'll have an implosion that will affect individuals in ways that we find unacceptable."

Bates also is part of a group of lawmakers working on a plan to dramatically curtail the Oregon Health Plan. A House committee's draft proposal would cut out of the health plan about 110,000 low-income and working-poor adults, about 20,000 of their children and about 9,000 "medically needy" adults.

Such reductions, if enacted by the Legislature, would reduce to 350,000 the number of people covered by the plan and would reduce the state's costs by more than $500 million.

Oregon Health Plan coverage would be limited to those who are eligible for Medicaid, the federal health-care money that is distributed through the states.

To qualify, recipients must be poor and be in one of the following eligible categories: pregnant women, children, blind or disabled adults, and elderly people.

The proposal, which has yet to be drawn up in bill form, includes a number of steps meant to save money through efficiencies without reducing coverage. Among them:

Statewide bulk purchasing of pharmaceutical drugs.

The placement of all OHP enrollees into managed-care, rather than allowing a portion to receive coverage through more traditional fee-for-service insurance.

Requiring doctors to get permission from state regulators before prescribing drugs that aren't on a "formulary" list of lower-cost alternatives such as generics.

Rep. Ben Westlund, R-Bend, said the plan, which was drawn up by a committee he chairs, represented the Legislature's best effort to "save the Oregon Health Plan" from rising costs and falling state revenues. Once the Legislature is able to come up with a scaled-back version of the health plan that it can afford, he said, it will try to find ways to bring back in other categories of uninsured Oregon- ians.

Despite the financial woes that have forced the scaling back of the Oregon Health Plan, Westlund said he and others involved with revamping it aren't trying to harm the growing number of uninsured Oregon- ians.

"I don't think this Legislature would have gotten as far as we've gotten - and we're not finished yet - if it was not for the strong advocacy of people concerned for the well-being of their fellow Oregonians," he said.
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Title Annotation:Health
Publication:The Register-Guard (Eugene, OR)
Geographic Code:1U9OR
Date:Mar 26, 2003
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