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Entries in Health care transformation (4)

Tuesday
Jun252013

"They Are Here;" Now What Will We Do?

As the Oregon legislature appears headed for adjournment, possibly without a grand budget deal, The Oregonian is publishing a multi-part series by investigative reporter Les Zaitz revealing deep inroads into Oregon's drug scene by Mexican cartels.

Too bad legislative attention couldn't have been given this session to the underlying facts Zaitz has uncovered — bombings and shootings linked to the cartels, our own state drug lords, drug dealers in our neighborhoods, deaths from drug overdoses and challenges to law enforcement to bring perpetrators to justice.

"They Are Here," the headline on the lead story of the series published Sunday, is a scary reminder that we could see — or maybe already have seen — first-hand the kind of violence we usually associate with U.S.-Mexico border towns. It also hints at the long, grasping coils of criminal organizations that pursue drug trafficking like a business, hooking customers, bribing local officials and terrifying anyone who gets in their way.

Zaitz has won plaudits for his eye-opening reporting, which come ironically as The Oregonian scales back its profile as a print publication in pursuit of becoming a digital enterprise. Questions arise about whether stories like this will continue to be chased and reported in the new, emerging journalistic landscape.

While that is an important question, the more immediate issue is what response will Oregon law enforcement leaders give to Zaitz's story?

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Friday
Feb222013

Kitzhaber Makes National Waves

Governor Kitzhaber went from a face in the crowd in the First Lady's State of the Union box to a news media headliner talking about Oregon's bold venture into transforming the health care delivery system to deliver better quality at less cost.

The former emergency room physician told national audiences this week he couldn't accept budget cuts that forced low-income and working poor families to access their health care in the ER. He told The Washington Post he still vividly recalls an elderly man who was culled for budgetary reasons from the state's Medicaid rolls, but who showed up at his emergency room after suffering a stroke. "These people don't disappear," Kitzhaber said.

Appearing on NPR's Here and Now show, Oregon's third-term governor explained the approach the state is pioneering to "bend the cost curve" of health care by creating incentives to keep people healthy rather than just treat them when they are sick. 

Kitzhaber focused on the care of patients with chronic illnesses who can avoid hospital admissions and additional prescription drugs through more personalized care, often in the form of a Registered Nurse. He said helping to manage chronic illnesses can result in better outcomes for patients and drastic reductions in medical costs. Another cost driver is untreated mental illness, which can result in frequent, costly medical incidents that are treated, but without getting to their root cause.

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Monday
Mar192012

Huge Issues Loom in 2013 Session

The short 2012 session just ended and there are nine months until the 2013 legislature convenes, but it is still timely to look ahead at the issues that need resolution or are just ripening for action.

At the top of the list is how Governor Kitzhaber's health care transformation strategy will work and whether newly forming coordinated care organizations can squeeze out cost savings in serving Oregon's Medicaid population. The health insurance exchange will get up and running, just as the federal health care reform measure lands in the U.S. Supreme Court, which could toss some or all of the controversial reform legislation.

Despite a slow economic recovery, many parts of Oregon still feel the after-effects of recession and could benefit from state efforts to boost employment. Strong differences exist between Republicans and Democrats on how to stimulate job growth, especially in rural Oregon.

As a result of education reform measures pushed by Kitzhaber, K-12 school districts are signing achievement compacts to promote improved student learning. A question remains whether this reform will under-perform or have unintended consequences as have previous reforms such as No Child Left Behind and Race to the Top.

Lawmakers in February approved a measure that deals with home foreclosures. However, consumer advocates felt it didn't go far enough, while bank and title company officials said it might not work as expected.

Kitzhaber, who will be entering the last two years of his third term, has vowed to give tax reform another shot. This has proven to be as elusive as the pot of gold under the rainbow. While a majority of Oregonians feel the state's current tax system isn't sustainable, there is no clear consensus on how to refine or replace it. A state sales tax is certain to make another stage appearance, with a few clapping and others throwing big red tomatoes. 

Local governments are pressing for expanded access to property tax revenues. They are looking for authority to exceed property tax rate limitations for voter-approved levies. The temporary state hospital tax expires and hospital interests may be less willing to go along with an extension after proceeds were diverted from their original purpose.

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Friday
Feb172012

Politics and 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

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