Health

Oregon A National Leader In Health Care

OPB | Nov. 29, 2007 7:12 a.m. | Updated: July 17, 2012 1:18 a.m. | Portland, OR

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By Ethan Lindsey

Republican Senator Gordon Smith Friday again called on Congress to pass the children's health care measure known as SCHIP. Smith says the measure could still become law, even though the president vetoed an earlier version of the bill in October.

Gordon Smith: "But let's not quit, because this is too important. Let's get it done in Washington and Salem."

Smith faces a tough reelection fight next year. And his position on the issue breaks with most of his fellow Republicans. But maverick positions on health care aren't unusual to Oregon politics, as Ethan Lindsey reports.


You'll have to forgive some Oregon politicians if they  sound a bit prideful right now.

After years of being dismissed like an eccentric uncle who talks too much about his back problems, the state may finally have the ear of the country when it comes to health care.

Health care reform ideas spawned in Oregon are coming out of the mouths of presidential candidates Rudy Giuliani, Barack Obama … and even Ron Paul, says Oregon Democratic Senator Ron Wyden.

Ron Wyden: “My sense in terms of the presidential race is that the overriding issues are the war in Iraq and fixing health care.”

Wyden was at a hospital in Bend recently talking with doctors and nurses about his new health care plan.

Along with Utah Republican Senator Bob Bennett, Wyden wrote the 'Healthy Americans Act', which now has nine Senate sponsors from both sides of the aisle.

And Wyden says his legislation could be the model for national health care reform.

That is when a new president takes the oath of office in January of '09.

Ron Wyden: "Oregon clearly has been a leader. And when you look at the states, what we really oughta be saying is that they, particulary Oregon, are doing a great job given the fact they got no bandwidth."

Bandwidth. Sort of an interesting choice of words.

Wyden is implying that a smaller state like Oregon doesn't have the resources of  a state like say, California.

Bruce McLellan, a heart surgeon in Bend, says that's exactly why Oregon plays a national role.

Bruce McLellan: “As a matter of fact I think it's a very good lesson for Washington to understand. Rather than trying to implement a new health care program for 300 million people at once, it makes sense to start on a smaller scale. Those of us in medicine started out as scientists we know that's the best way to find out if something works or doesn't.”

But Oklahoma, for example, has almost exactly the same number of people as Oregon. So why hasn't the Sooner State taken a similar responsibility?

McLellan, and others, point out the people.

There are the advocates who championed the state's maverick 'Death With Dignity' law.

And, McLellan also credits politicians like Senator Ron Wyden and former Governor John Kitzhaber.

Bruce McLellan: “I think they are definitely seen as visionaries. The Oregon Health Plan was seen as a visionary program.”

The Oregon Health Plan is what really put the state on the map, in terms of the health care debate.

Kitzhaber, a former emergency room doctor, was the president of the Oregon senate in 1993. He was also the architect of the Oregon Health Plan.

John Kitzhaber: “Its just really a maverick state. But I also think there were some circumstances that really aligned. I think the initiative process is what really allowed the Death With Dignity Act to be created. I think we've had the stars lined up, and being a physician didn't hurt at the particular point in time.”

In effect, the state let Medicaid support more people with the same amount of money - but stopped paying for some medical procedures deemed to costly or too risky.

And the Oregon health plan influences almost every health care proposal being offered by the candidates today.

Steve Buckstein is a senior policy analyst at the Cascade Policy Institute, a libertarian think tank in Portland.

He says the Oregon Health Plan isn't as progressive as it seemed at the time.

Steve Buckstein: “People outside of the state, who haven't taken a close look, look at the intentions of the Oregon Health Plan, it was obviously an innovative approach. I don't think its succeeded, and that's why it hasn't been emulated. But we are seen as innovators for having tried it.”

Buckstein says the state is still playing its role of health care pioneer.

He says the rest of the country is influenced by the state, even when the state doesn't do anything.

Steve Buckstein: “Just the very fact that Measure 50, for whatever reason, failed by a very significant margin, set back the efforts nationally to expand the SCHIP program. I don't the intention was to influence the national debate, but I think that's the effect.”

Wyden says he is not unhappy with the power the state continues to wield.

Ron Wyden: “The fact however is, no state can fix health care because the driving forces, the biggest problems, were created by the federal government.”

He says it's no longer about just three-and-a-half-million Oregonians.

The state's policies could now affect 300 million Americans.

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