And only sick people have resisted the OHP's offers to pay for assisted suicide prescriptions rather than for anti-cancer treatments.

We're a model alright. What is this State's "death panel" really called?

Yep. Laugh, but "Death panel" is a great meme. There is a death panel in every health care system where price is an object, even the unreformed one we have now.

Call it a "Physician Review Board" or "Fiscal Accountability Unit" or an "Utilization Committee," but whether it is an ad hoc meeting between consulting physicians, formally located in a department of the hospital, or on the org chart of an insurer, even a governmental insurer, they exist and exist to tell people "No, sorry but you (or a loved one) have exhausted your effective __(treatments, coverage, limits of our patience)."

Nice post Kari. Do you happen to have the name of the website where people can sign up their kids/learn more? Thanks, and nice party Fri. Thank you for allowing us to attend.

A quick correction: The legislature's health reform package is expected to expand coverage to 80,000 more children and 35,000 more adults, which adds up to 115,000 newly covered. The 200,000 figure Kari cites was a goal of the Oregon Health Fund Board, but the number was lowered in order to increase Medicaid reimbursements to the same levels of Medicare. It is this change that engendered support for the package among health care providers.

It is an excellent and much needed incremental reform, but there will still be around half a million uninsured adults in Oregon, so we still have work to do!

If you don't like what Boats has to say, then ignore his posts. It is really easy you know. One of the reasons we are so F'd up now is that we isolate ourselves from anyone who might disagree with our POV. The reason the few remaining members of the Republican Party are so radicalized is that they only listen to Rush and Fixed Noise. Any media that goes against their pov is part of the 'liberal elitist media.'

When did we become so damned scared of words. If you think they are lies, REFUTE THEM. It shouldn't be that hard.

Boats:"And only sick people have resisted the OHP's offers to pay for assisted suicide prescriptions rather than for anti-cancer treatments."

That "panel" is the "patient and their doctors". It's quite a concept! It gives the patient "choice" and forces the doctor to go over all other options, like palliative care and helps ensure the patient's last days are not spent in agony, even if they don't choose the "death with dignity" option (most patients don't).

Families can learn more about Healthy Kids and even fill out an application online at www.oregonhealthykids.gov. Find more information or have an application mailed to you by calling 1-877-314-5678.

Thanks Cathy!!

I believe it is time to bite the bullet and admit that any rational health care plan has limits on care available and if that causes your 99 year old granny to be ineligible for a heart/lung/liver combination transplant, so be it. Anybody else recall ten or twenty years ago when an attractive young teenage woman was dying of something or other and she and her parents wanted the Oregon Health Plan to pay for a combination heart and lung transplant which the OHP denied because the believed it would not save her life? Ultimately the Republican guy that owns Shilo Inns volunteered to pay for it but I think she died before they found a donor. Anyway, we don't have unlimited resources to pay toward health care and somebody needs to admit that so we can move on. Decisions need to be made on a cost-benefit basis. If you or your loved one is on the losing end of the cost-benefit equation it will be painful and tragic and horrible, but whatever happened to making decisions based upon what is best for society as a whole and not for each individual?

Thanks, Greg. That was a big debate even inside the Democratic Party. The 1988 election for national Platform Comm. member included someone who had served in the position before and talked about his experience, and a legislator who said "We should always pay for transplants", not much else, and sat down.

Of course, the man who had held the position before won that election.

MP, "ignore it and it will go away" has not proven a good strategy to challenge incorrect information.

Or maybe 8 years ago when people said Gore won the election, you just ignored them? As many incl. McCain have said, people are entitled to their own opinions, but not to their own facts.

In fact what Kari has carefully done here is avoid presenting the real truth of that Kulongoski, Kaufman, Courtney, Hunt, and Nolan have actually continued to take us down the road to the system the right wing crazies we are seeing at these town hall meeting, and that Republicans and Democrats working on behalf of the private insurance industry want: To the extent they accept that publicly-assisted health care coverage exists at all, they are fighting to make sure it is built purely on private health insurance with the relatively high and accelerating costs that necessarily entails without unacceptable government controls on benefits. And, as they insist, it is paid for. But it is paid for by making our private health insurance-based system even more unaffordable to more people by taxing the private health insurance benefits of those working people fortunate enough to have them.

That's right, this is NOT the progressive health care program that Kari, Kaufman, Kulogonski, Courtney, Hunt, Nolan and the Democratic majority who passed this desperately try to spin it. What has happened here in Oregon is a bad, regressive, example for the nation. We have not created or expanded a system that taxes private health insurance companies and providers to expand a public system of health insurance.

This is not even a system in which the net financial cost ultimately falls on private insurance companies. All of the tax money raised from citizens and businesses who buy private health insurance policies goes right into the pockets of private insurance companies for which the OHP in reality simply acts as a sales agent. This is no more or less than further expansion of the control of the private insurance industry over our health care system. It is exactly the kind of "reform" that the right wing crazies at the town halls, Blue Dogs, and other Democrats like Wyden who are acting on behalf the industry are demanding.

Be very clear about several facts as representations are made to you: 1) Kari is a paid political operative who works Wyden and other Democrats who have drug their feet on behalf of the private health insurance at the state and federal level. 2) Kaufman and her organization savagely demonized people who opposed the tobacco tax scheme as nothing more than pawns of the corporate tobacco industry, and yet she and her organization in this last campaign were, at the bottom line, nothing more than lobbyists for the corporate private health insurance industry. And 3) On July 8th, Kulogonski rewarded Kaufman with a state job heading leading the new office of Healthy Kids in the DHS to direct this program funneling tax money to the private health insurance industry.

Also, be very clear that in sum and substance, Kari's post is not about providing health care coverage for children or adults who need our help. Only sociopaths oppose that. Health care is a right. Because it is a right it is our responsibility as the government to create a system that doesn't hemorrhage dollars for which we get nothing in return to a private insurance industry which has no business being between us and our doctors. No, the only material point of Kari's post, which also happens to politically support the national pro-industry agenda of many of his Democratic clients, is this approach of further converting our entire publicly-assisted medical coverage system into an insurance agent for the costly private health insurance industry should be a model for the nation.

Remember too that the OHP is nothing more than entity that administers the Medicaid system in Oregon. In fact, Wyden's bill proposes abolishing Medicaid and making every state convert to exactly this model of the state acting as an agent for the private insurance industry.

Finally, be absolutely clear on the truth of this: Ultimately in this system it is still private insurers making the daily decisions about what level of benefits will be paid for what medical care . Chisholm, Kaufman, Kulongoski, Courtney, Hunt, and Nolan have NOT started us down the road towards a system in which we determine through our public process what we want for ourselves, as we would with a single payer system or a public plan. All the talk about "cost-benefit" and "physician review panels" and such misses the point that those roles are in fact about the state acting to shield private insurance companies from public accountability for subordinating health care decisions to their business interests in this system.

Of course Disney-ABC thinks this further expansion of the total control of the private health insurance industry over our health care is what the rest of the nation needs. What does that actually tell you?

It's time to speak the truth.

Health care is a right? I'm curious about where that right is located in our social compact and what its scope is.

Posted by: Boats | Aug 11, 2009 6:11:27 AM:

Health care is a right? I'm curious about where that right is located in our social compact and what its scope is.

IN CONGRESS, JULY 4, 1776 The unanimous Declaration of the thirteen united States of America ... We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. -John Hancock and 55 other American partriots

Only someone who denies reality can claim we can exercise any of our unalienable rights to LIfe, Liberty or the pursue Happiness when we face life-threatening or debilitating illness without health care to overcome it. Or that our unalienable right health care is no more than being reduced, or even compelled, to buying insurance for ourselves or others (i.e. through the OHP/FHIP) from the private health insurance companies.

For people struggling to understand what is really going on with OHP and FHIAP, and perhaps you can approach feeling about it. The OHP and FHIAP have virtually nothing in common in fact or in principle with the Medicare Part A and Part B public health insurance programs wherein tax dollars are used to directly purchase health care coverage in a cost effective way, and that we tend to think of as the social compact of Medicare.

The OHP, and the Family Health Insurance Assistance Program (FHIAP) are actually akin to the Medicare Advantage system (formerly Medicare Part C), wherein tax dollars raised for health care are turned over to the private health insurance industry. In practice, they operate essentially identical to Medicare Part C in many cases. Medicare Part C/Advantage was and has been promoted by those Republicans and Democrats who agree with the private health industry in their desire to weaken our Medicare system. During this whole health care debate it's been repeatedly noted that the much higher costs of Medicare Part C for the effective medical services actually rendered are one of the significant contributer to the financial instability of our Medicare system.

So Boat, I'll bet many readers are curious to have you state your real purpose behind your question and your beliefs. Why don't you just come out and state your opinion where the right to health care is (or isn't) located in our social compact and what its scope is? Do you support turning over our publicly-assisted health care coverage to the private health insurance industry or not? Do you even support publicly-assisted health care coverage at all or not?

Yeah but what about having to wait 6 months for an MRI .. does America really want this?

I think Boats' questions/comments liven up the discussion. If challenging the author is "trolling", then we all might as well just flip on Fox News and forget it. Steve Maurer needs to suck it up and be a man--come on, Steve, stand up when you pee! John Doe does and excellent job of answering Boats' questions/comments. Good job John Doe.

And del, I know many people who would be thrilled to wait six months to get an MRI! If you don't have insurance or $450 to $3500 dollars handy under our current system you will wait till you drop dead for an MRI.

A friend of mine began having seizures but couldn't get a diagnosis of her condition and therefore medication because she couldn't afford an MRI. She went to the ER a dozen times and they wouldn't do one there because by the time she got there the seizure would be over, so it wasn't an 'emergency' anymore. It ended up being cheaper for her to go to Mexico to get an MRI and a visit with a neurologist to get a diagnosis.

Now, Boats and del, that is how our current system works. Please explain why our current system is better than 'socialized' medicine, i.e. Medicare for all. I'm waiting with baited breath to see what you come up with.

Why talk about health care? People don't care about health care! What Americans are worried about is whether or not the President is legally President and why Obama has no birth certificate! What is he hiding? God bless the Republicans who are holding BO's feet to the fire on this! THE TRUTH WILL COME OUT!

Excellent points LVR. As well there would be literally millions of people who would be ecstatically grateful to have as much healthcare available to them as they might get under the systems existing at the VA or in Canada, Great Britain or France.

I work in an Emergency Department in a hospital in the Willamette Valley. What I see, especially among the working poor whose employers don't offer health insurance and who can't afford it and don't qualify for OHP, is what I call, "Primary Care by Emergency Department and/or Urgent Care." They literally come to see us for the barest of care because it's all they can afford.

Needless to say, it often doesn't work out well. Small problems are put off and ignored because of the cost factor and then one day......boom! It's a major health event. Example: Hypertension or high blood pressure. It can't be treated relatively cheaply by medication. But without insurance ? Those doctor appointments and prescriptions add up.

Untreated it can lead to a stroke and an increased risk of heart attack. Two very catastrophic and extremely expensive medical problems.

As the old commercial stated, "You can pay me now, or pay me later."

Better to pay for prevention than to try and fix the unfixable.

To answer Boats: Health care is a "right" if We The People decide it is.

I sure don't understand a country where people want the right to parade around with threatening signs and a pistol outside a spot where the President is speaking, but think health care is optional. But then that guy with the pistol is probably also denouncing "government run health care" while helping his mama fill out her Medicare forms.

I am still not convinced that this is the best for this country.

So after all of the blather, health care is not in fact a right.

So after all of the blather, health care is not in fact a right.

Of course, we know that you know you can't demonstrate that conclusion on the basis of a sound argument, Boats, because you haven't presented one here. You have made a fool of yourself because you made statements you couldn't backup or prove. And you know it.

Actually does anybody notice Boats almost seems to be an alter-ego for Kari?

Same kind of snarky comments, and same resort to not really too snappy one-liners when she or he can't make an argument.

More importantly, the counter-reality belief that health care is not a right necessarily underlies the position of Democratics and Republicans like Wyden and Kulongoski that our only "right" is to be forced to do business with private health insurance companies, not actual access to health care.

No, you all start from the faulty premise that everyone owes you health care paid from their pockets just because you exist.

Kari, thanks for the insightful post. Yes, OHP as originally envisioned could well be a model for HEalth Care Reform. Remember, the original did have some procedures and practices that were not covered because they were not viable and were not shown efficable.

Kari, would you do us a favor and clear something up? Many people, myself included believe that the health insurance tax is not levied on the insurance companies, but rather on the employers, unions and individuals purchasing the health insurance. Please let us know. According to the statute, who pays? Thanks.

John Doe speaks for me. Kari has said essentially the same thing as "Boats" re health care not being a right. When will progressive Democrats wake up from their secular mystical devotion?

Kari, thanks for the non answer. While looking it up I was able to understand what the bill considers health insurance. HB 2116 section4(2) (a-k) includes the following as being taxed at 1%: 1. Health insurance 2. Dental insurance 3. Vision insurance 4. Medicare Part D 5. Medicare Advantage plans 6. Long Term care insurance 7. Health insurance issued to federal employees and dependents 8. catastrophic Stop Loss coverage 9. Self insurance and health insurance union trusts 10. Supplemental Liability insurance 11. Automobile and motorcycle medical coverage 12. Re-insurance 13. Workers Compensation insurance 14. Disability Insurance

Kari, further thanks for your non-answer. Later on in HB 2116 the Insurers are granted the ability to PASS ON the entire 1% tax to their insureds as a premium rate increase.

SECTION 8. (1) Sections 5 and 6 of this 2009 Act apply to premiums earned by an insurer during the period from October 1, 2009, through September 30, 2013. (2) Notwithstanding any provision of contract or statute, including ORS 743.737 and 743.767, beginning October 1, 2009, insurers may include in their rates an additional one percent of the existing rate.

I'm certain Oregonians will be happy to know that the dems in Salem passed a sheep in wolve's clothing and efffectively upped almost 100% of the insurance premiums paid by insurers in the state in the middle of the worst recession in decades.

Kari, health care is a right, its just that saying that the insurers have been taxed is misleading at best. The consumer is being taxed. And it is a heck of a lot more than what is normally considered as health care insurance that was thrown into HB 2116.

I would question the constititionality of taxing mandated coverage such as the uninsured motorist medical portion of auto insurance as well as workers compensation.

Funny. I am public health to the cockles of my pasty little heart. ANd I have indulged in that hc is a right business all my life. I actually will be changing this as a result of what Kari has said.

His logic is sound. And born out by the fundamental realities of life.

No - in nature it is not a right. However: is it good policy? Yes. AND - if we are going to dash around touting ourselves as the species that has morality AND the opposable thumb for differentiation from the rest... well, practice that morality. How moral is it that the children of the rich are well-cared for and have better health, life expectancies all of that... while the stats of the demographically impoverished are otherwise?

Not so moral. Not such great policy.

And, rich guys: in the end you might find it better for your almight wallets if a different, transparent way is found to pay for those who have-not. For now you bitch about the secret ways it hits your precious wallet... so why not opt into sunlight on the setup? We may all sleep better at night and even solve some class warfare along the way.

rw. you ruin an otherwise brilliant piece by slipping into the mantra of, Only Rich Folks Will Disagree With This. You couldn't be more wrong on this account. I cold support a more open manner of subsidizing this type of healthcare and I'm in no way 'Rich'. You breed the very class warfare you rail against.

<h2>The dems buried the fact that the subsidy comes from a wide range of sources. They should be called on it. I can't wait for the unions to start raising hell when they realize they get to pay as well.</h2>