Going to extremes over health care Two out of three initiatives could help; the third is a pipe dream
Health-care reform efforts tend to fall into one of two categories: the incremental, or let's raise this tax over here to provide specific benefits to that group of people over there; and the universal, or let's wave our magic wand and decree that there shall be affordable health coverage for all. Two proposed initiatives for the November 2006 ballot reflect those two extremes. A third falls somewhere in the middle.
We've already said that the first initiative, which would raise cigarette taxes again to provide health insurance coverage for every Oregon child under 19, is worth putting up to a vote.
A second, filed last month, is of the magic-wand variety. It would direct the 2007 Oregon Legislature to create a framework for universal health coverage, and require that such a plan be in place by November 2008.
The initiative provides no funding mechanism for such a mammoth undertaking, and precious little direction for lawmakers. The direction it does provide is murky at best.
For instance, it says the plan must incorporate affordable health care for all Oregonians, but never defines affordable, and it limits administrative overhead to no more than 6 percent of total costs, with no indication that this is either achievable or desirable. The initiative further requires cost management strategies and regulatory or administrative authority to keep total plan costs sustainable, rising at a rate not greater than Oregon real Gross State Product.
If wishing could make it so, we would already have such a plan. Presumably, if these lofty goals are simply impossible to achieve, the Legislature would be off the hook on meeting the 2008 deadline. We can only guess, because the initiative does not say.
— And so to the third initiative, which takes the middle road.
This one, sponsored by three lawmakers including Sen. Alan Bates, D-Ashland, at least acknowledges the harsh realities of the broken health care system. It would establish access to health care as a basic right of all Oregonians, and direct the Legislature to increase access to health care by 2009, but it stops short of requiring anything like universal coverage. It gives some general guidelines, but leaves the details up to the Legislature.
Of course, the very real danger is that all three of these initiatives could appear on the ballot at the same time. That could confuse voters, and raise the possibility that conflicting measures might pass.
We understand the frustration of the sponsors of all of these measures. Health care reform is desperately needed, and the Legislature has so far shown no willingness to seriously address the problem.
Let the voters decide whether to tax smokers to provide health coverage for children. Let them also decide whether to prod the Legislature to increase access to health care for all state residents.
But let's not delude anyone into believing that universal health care can simply be voted into existence.
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