A much debated public option that died amid the creation of a new national health care plan could be brought back to life in Oregon.

A much debated public option that died amid the creation of a new national health care plan could be brought back to life in Oregon.

Oregon Sen. Alan Bates, D-Ashland, is spearheading an effort to create a state-run health care plan that would provide a public option, paving the way for universal coverage within three to four years.

An amendment to the federal health care plan by U.S. Sen. Ron Wyden, D-Ore., created a provision that allows states to enact their own health care program, including the creation of a public option. The provision allows states to apply for a waiver from the federal law as long as the state health plan has provisions for cost containment and improving delivery of services.

After studying Wyden's provision, Bates, a physician who practices in Medford, said he believed the amendment would allow Oregon to expand its progressive health care program, called the Oregon Health Plan.

"We really have a good chance of setting up a public option here," said Bates, who was involved in the creation of the Oregon Health Plan while serving on the state's Health Services Commission, which he chaired for three years. He began serving on the commission in 1989 and continued until resigning to run for public office in 2000.

Bates said he has had meetings with Wyden and state officials to lay the groundwork for universal health care coverage.

Universal coverage would feature a controversial mandate requiring everyone to pay for health care coverage, either through an insurance company or through some kind of state insurance pool.

Bates said he plans to meet again with Wyden and other state officials in the next two weeks to determine whether Oregon could forge its own plan and what steps would be needed to make it work.

"We are not asking to eliminate insurance companies, but we just want to look at a public option," Bates said.

Oregon would have to receive federal waivers to set up a state-run health care plan, Bates said. The state was successful in getting similar waivers to establish the Oregon Health Plan.

Jackson County Commissioner Dave Gilmour, a Central Point doctor, supports a public option, saying it would provide less-expensive insurance than is available through insurance companies.

Roma Sprung, a Phoenix general practitioner, said Oregon has a progressive history in providing health insurance to many of its citizens and the creation of a public option would expand on that philosophy.

"I don't know why we didn't get it before," she said.

Both Sprung and Gilmour are general practitioners, who would be in greater demand under a universal health care system that relies less on specialists.

Bates said that current health care plans steer patients to specialists when the diagnosis and treatment often could be better handled through primary care.

Bates said nurse practitioners who work with specialists and current emergency room doctors could be freed up to take on more responsibility for primary care.

Bates doesn't see any significant cost impacts to the state through a universal plan, other than for increased administration.

He said the big stumbling blocks could be in receiving the approval for the federal waivers and the political climate. If Republicans win over the Oregon House this fall, it would make it far more difficult to pass a public option, he said.

Oregon Rep. Dennis Richardson, R-Central Point, said he would remain open minded about Bates' proposal, but worries about how it would be funded.

"I know there is a need to have access to health care," Richardson said.

Too often, he said, people rely on emergency rooms for primary care, which drives up the cost of insurance for everyone, he said. Families are often overwhelmed by out-of-pocket expenses under health plans, sometimes getting stuck with bills of $20,000 or $30,000, Richardson said.

The problem, Richardson says, is not the public option as much as the government's failure in controlling costs.

"Reform is often discussed, but rarely implemented," Richardson said.

Richardson also noted the state anticipates a $2 billion shortfall going into its next biennial budget. If a public option were created, low-income residents would receive subsidies for coverage, which would have budget consequences.

Richardson said Oregon already has the legislative framework set up that could allow for universal health care coverage by 2015, if a workable plan can be developed.

Richardson said he didn't think Republicans would necessarily discount the public option idea, but would like the chance to sit at the table to help form the legislation.

"I think it could be worked out, but it will only be possible if the Republicans are involved in the crafting of the bill, rather than be ignored as often takes place," he said.

Reach reporter Damian Mann at 776-4476, or e-mail dmann@mailtribune.com.