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If wishes were health care, all would be well

In a perfect world, everyone would have access to health care at a reasonable cost that did not require people to set up fundraising accounts on the internet to pay for treatment. And someday, some kind of universal health care system likely will become reality. But that day is not today, and amending the Oregon Constitution to make it the state's responsibility to provide it won't make it happen.

The Oregon House on Tuesday passed a bill that would ask voters to amend the state Constitution to say, “It is the obligation of the state to ensure that every resident of Oregon has access to cost-effective, medically appropriate and affordable health care as a fundamental right.”

Those are powerful words, and if the Senate also passes HJR 203 and the voters agree in November, Oregon would become the first state in the country to enshrine such a right as a matter of law.

Whether access to health care should be considered a right on a par with the freedom of speech, religion or assembly is worthy of debate. One could argue that health care is inextricably intertwined with the God-given rights to life, liberty and the pursuit of happiness enshrined in the Declaration of Independence.

But simply declaring health care a fundamental right is one thing. Obligating the state to "ensure that every resident of Oregon" receives it is something else entirely.

If we had the slightest confidence that such a move would provide health care to every Oregonian, we might be inclined to support it. But the measure contains no funding and no delivery system. It does not define what "cost-effective, medically appropriate and affordable" health care is.

As it stands now, Oregon's health care system provides some level of health insurance coverage to 95 percent of state residents. But that is thanks to massive federal subsidies under the Affordable Care Act, a law the Trump administration and congressional Republicans have vowed to dismantle. And it's far from certain that every one of those Oregonians is receiving care that is "cost-effective, medically appropriate and affordable."

Other states have tried and failed to enact single-payer health care, including California, which dropped the effort because of its astronomical cost, and Vermont, where the governor scrapped a plan because of the steep tax hikes that would be needed to pay for it.

Now some Oregon lawmakers want to declare health care a right without any plan whatsoever. That raises the very real possibility of lawsuits against the state for failing to fulfill its new constitutional obligation.

House Speaker Tina Kotek says that's not her problem.

“Somewhere down the line that will be someone else’s conversation,” she said.

Kotek described the amendment as "primarily aspirational," saying the details would be worked out later.

We're all for aspirations. But it's one thing to write hopes and dreams into the state Constitution. It's something else again to do the hard work of figuring out how to make them come true.