Politics and Health Care Reform

Republicans used an infographic to make their point about the need for tort reform to complete the picture of health care reform.Politics is never a stranger in legislative proceedings, as reflected this week by moves in both the Oregon House and Senate to slow down or hijack elements of Governor Kitzhaber's health care reform package.

The governor's provisions dealing with coordinated care organizations and a health care insurance exchange are likely to survive the short Oregon legislative session, now in its third week, but it may cause lawmakers to hang around Salem a few more days than expected.

At issue is whether the health care reform package will include tort reform to shield coordinated care organizations from expensive malpractice lawsuits. Republicans want it in while Democrats, including Kitzhaber, want to wait to consider it until the 2013 legislative session.

The first political twist occurred early in the weekend when House Republicans convinced Democratic Rep. Mike Schauffler to join them in voting to send the health care insurance exchange measure (House Bill 3164) back to committee. Observers watching health care legislation interpreted the unexpected move as a way to create trading stock with the Governor over tort reform.

Later in the week, Senate Republicans tried the unusual — and usually unsuccessful — tactic of trying to amend the health transformation measure (Senate Bill 1580) on the Senate floor. It failed. So did a subsequent effort to send SB 1580 back to committee, largely because Senator Betsy Johnson, D-Scappoose, stuck with her Democratic caucus in voting for the bill, despite earlier pledges to vote for tort reform

Johnson possibly was kept in the fold by a promise made, confirmed during Senate floor debate by Senator Alan Bates, D-Ashland, to bring some kind of tort reform proposal to the 2013 session. Kitzhaber has made a similar pledge. On the Senate floor, she attributed her change of position to questions raised by the Department of Justice about the constitutionality of tort reform provisions. Rumors also circulated in the Capitol that Johnson shifted position in return for increased money for the Vernonia School District. Johnson denied any such deal.

Bates gave an impassioned speech in favor of SB 1580, calling on medical providers in service areas to coordinate care that benefits patients.

Senator Frank Morse, R-Albany, was equally passionate in calling for tort reform, which he called an unfulfilled promise to protect doctors who provide services to low-income Oregonians under Medicaid. Morse has served many years on the board of directors for Samaritan Health Services based in Corvallis.

Senator Fred Girod, R-Stayton, who is a dentist, stood up near the end of the debate, to urge defeat of the health care transformation bill, which he said would wind up costing more money than it purports to save.

SB 1580 initially passed on a party-line 16-14 vote. Later, two Republicans changed their votes, so the final count was 18-12.

Presumably the issue — and its attendant politics — now will center squarely in the House, which is split 30-30 between Republicans and Democrats. It is a perfect playground for politics to run wild.