Media Feature Oregon Universal Health Ballot Measure

Several newspapers this week examined Measure 23, an initiative on the upcoming November ballot in Oregon that would institute a universal care system. The Eugene Register-Guard reports that if the measure is approved, the state would be required to implement a universal care system that covers all "medically necessary health services," including preventive care, prescription drugs, long-term care and alternative care, by 2005. A new state agency, called the Oregon Comprehensive Health Care Finance Board, made up of two members from each congressional district and five members appointed by the governor, would oversee the system (Christie, Eugene Register-Guard, 10/15). The measure would "end the system of private health insurance" and make the state government responsible for residents' medical bills and collecting the taxes necessary to run the system, the Hartford Courant reports. Participants in the new system would contribute no deductibles or copayments for services, but would pay increased income taxes. Businesses would pay a new payroll tax of up to 11.5%, and personal income tax rates would increase from 9% to as much as 17%. The new system is expected to cost the state $19 billion per year (MacDonald, Hartford Courant, 10/17). A recent poll by the Oregonian found that 47% of residents are opposed to the measure, with 40% in favor and 13% undecided, the Register-Guard reports. With 470,000 uninsured Oregon residents, or 13% of the state's population, Measure 23 supporters say that the current health insurance system is "basically falling apart." But opponents say the state will be unable to cover the cost of the "expansive, expensive plan." Supporters counter that the system's costs will be controlled by negotiating "hard bargains" with pharmaceutical companies and health providers and by providing preventive care that will keep future costs down. Marc Shapiro, Lane County chair of Health Care for All Oregon, which is sponsoring the measure, said, "Insurance companies have tried to control costs by restricting care. Our premise is, care provided is less costly than care denied" (Eugene Register-Guard, 10/15). About 10 state legislatures have proposed universal coverage systems this year, but all failed in part because of budget restrictions (Hartford Courant, 10/17).

'Full of Holes'
Oregon's universal care measure is "full of holes" and is "not a proposal we'd endorse for Nebraska," an Omaha World-Herald editorial states. The editorial notes that opponents of the measure have said it will lead to "runaway spending" and could "invite seriously ill people without insurance to move to Oregon to take advantage of the program." However, the World-Herald gives "Oregon residents credit ... for putting forward a plan that gets debate out of the usual rut of prescription drug plans and Medicare funding formulas." While addressing prescription drugs and Medicare reform is important, action on those "symptoms won't fix the underlying disease plaguing the nation's health care system," the editorial says. The editorial concludes that while the universal care system proposal "is not the best laid-plan," supporters have at least "succeeded in getting ... some Americans to think outside the box on health care issues. That's the kind of ingenuity needed in this increasingly important debate" (Omaha World-Herald, 10/16).