Rovner Reviews Oregon Governor’s Address on Health Care Inequities

In her Jan. 24 "Health Matters" column, CongressDaily/AM reporter Julie Rovner discusses the "beyond-the-Beltway dressing down" that Oregon Gov. John Kitzhaber (D) last week delivered to the National Health Policy Conference, in which he asserted that the current health reform measures being debated by Congress would not solve the inherent inequities in the U.S. health care system. Kitzhaber, a former emergency room physician, introduced a mock bill to conference attendees, called the "Health Care Equity and Empowerment Act of 2002," that contained such clauses as: "Categories shall be established to differentiate between the 'deserving poor' and the 'undeserving poor,'" and "all those over 65 years old shall be entitled to publicly financed health care, regardless of income," while "employed citizens under the age of 65, regardless of whether they can afford health care for themselves and their families, shall be required to pay a portion of their taxes to purchase health care for wealthy citizens over the age of 65." Kitzhaber said, "I doubt that anyone in this room -- or in the United States Congress -- could openly support [the bill]. Yet these are exactly the policies which underlie the U.S. healthcare system. Reforming our health care system is also not about passing a prescription drug benefit for those on Medicare" or a "'bill of rights' for people who are already enrolled in managed care plans. It is about ensuring a floor of basic primary and preventive care for the over 40 million Americans who have no health insurance coverage at all. It is about basing eligibility for a public subsidy on financial need, not on categories." Rovner writes that "few have as much standing" to make these criticisms of the U.S. health care system as Kitzhaber, who has advocated that Oregon provide fewer benefits to Medicaid beneficiaries in an effort to expand coverage to more people. Despite Kitzhaber's proposals, Rovner writes that the chances for national action to help the uninsured are not good. According to conference participants Celinda Lake, a Democratic pollster, and Bill McInturff, a Republican pollster, because most voters are already insured, Congress is only likely to take steps that benefit the insured, such as patients' rights and a Medicare prescription drug benefit. "That is," Rovner concludes, "unless Kitzhaber -- who last fall declined the entreaties of national Democratic leaders to run for the Senate in 2002 -- changes his mind about coming to Washington" (Rovner, CongressDaily/AM, 1/24).