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MailTribune.com
  • Healing a health care system

    While the nation argues, Oregon quietly creates a model that works
  • Mention the words "health care reform" and you're apt to find yourself in a heated argument, or at least an intense conversation. But the heat is turned down to low when it comes to Oregon's efforts at improving health care for low-income people and its costs for taxpayers.
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  • Mention the words "health care reform" and you're apt to find yourself in a heated argument, or at least an intense conversation. But the heat is turned down to low when it comes to Oregon's efforts at improving health care for low-income people and its costs for taxpayers.
    At a luncheon for the Medford-based Community Health Center last week, Dr. Bruce Goldberg, director of the Oregon Health Authority, detailed Oregon's developing success story and urged people to have patience as new systems are put in place.
    While the line could hardly be drawn more distinctly between the pro and con sides of the Affordable Care Act, also known as Obamacare, Oregon pioneering efforts have drawn support from both sides of the aisle and have perhaps laid a foundation that the nation can build on.
    There's no question health care in this country has to change. The United States has the most expensive health care system in the world and one of the least effective when it comes to creating a healthy populace. Sure, we can treat the symptoms, and probably better than anyone else. But the health care system is more like an auto repair shop — we keep fixing the car after it crashes into the ditch over and over, rather than trying to address what's causing those crashes.
    We can keep our car on the road, but the cost is enormous and with every crash, the vehicle's long-term prospects are diminished.
    Oregon has taken a different approach and done so with bipartisan support, which is a bit amazing considering the animosity generated by national health care reform. It has created coordinated care organizations to manage the Oregon Health Plan, this state's version of Medicaid, treating the whole patient and getting to the root of medical issues rather than just fixing the human vehicle over and over again.
    Want an eye-opener on health care costs in this country? Goldberg has one: If, over the past 80 years, the cost of food had risen at the same rate as the cost of health care, a dozen eggs would cost $80 and a dozen oranges would cost $100. We are not heading toward an unsustainable future: We have arrived at an unsustainable present.
    Oregon's plan takes positive steps to end that financial crisis, creating teams of physicians, mental health counselors and others to treat OHP patients, focusing especially on the 20 percent of those patients who are running up 80 percent of the bills.
    Goldberg told the story of a mentally ill man who was admitted 40 times in one year for breathing problems related to anxiety. After being assigned to coordinated care, the man's hospital visits dropped the next year — to zero.
    There are other positive indicators: emergency room visits have dropped by 9 percent among OHP patients, while primary care visits have climbed by 18 percent. Those patients are getting help in dealing with the cause of their problems rather than just the symptoms.
    The goal of Oregon's plan is to cut annual health care cost increases to 3.4 percent. If the program stays on track, it will save Oregon and the feds $4.8 billion over the next 10 years.
    Organizations like the Community Health Center are on the front lines of the effort to provide care for all who need it, while keeping costs under control. They are part of a network of health care providers who truly have created a network that can move us away from our unsustainable present.
    In the midst of all the hue and cry over health care reform, it's a success story that deserves to be told.
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