Oregon Health Fund Board is Making a Move!

Funded by the Northwest Health Foundation, fifteen community meetings were convened across Oregon during the months of May and June 2008 to solicit input on health reform in advance of the Oregon Health Fund Board preparing its draft report for the 2009 Oregon Legislative Session.

Oregon Health Fund Board members invite you, the glorious public at large, to a community town hall forum to share the plan for improving health care in Oregon. You are invited to hear details, ask questions and give feedback before the plan is finalized. Your participation is important in this vital effort.

The town hall forum will be from 6:30 - 9 PM, Monday, September 8 at the PORTLAND Oregon Convention Center.

Below is a summary of the key recommendations. The full 40 page draft document for the Oregon Health Fund Board recommendations with detailed information will be available in early September.

From: Your Oregon, Your Health Summary Report …

Responsibility

It is important to encourage people to exercise personal responsibility for their own health and for their role as participants in a health care system shared by all.

The Community Meeting participants described ways to build the value of responsibility into the policy recommendations the OHFB will produce, including:

• Include educational components that promote understanding of personal responsibility for one’s own health—beginning in childhood. This includes helping individuals understand how to prevent disease, how to achieve and maintain health, how to manage chronic disease effectively, and how to use the health system resources appropriately and effectively.

• Frame health care financing recommendations as a joint responsibility where we all play roles (i.e., taxpayers, patients, employers, employees, government) that must work together to produce a functioning system.

• Assure that everyone participates in financing the system with reasonable, equitable adjustments for various income levels (both for individuals and employers).

• Design clear lines of accountability into the system. Include transparency that will support informed consumer behavior and promote appropriate understanding of policy issues.

• Frame reform recommendations in terms of investment – in community well-being and social justice—even when it involves making personal sacrifices.

• Include multiple ways to foster the sense of community participation and contribution, such as volunteering to provide health-related community services in lieu of financial contributions.

• Consider a single payer strategy as an optimum way to achieve inclusiveness, participation, and efficiency.

Universal Access

It is important for a community to include all its members in a system of access to needed health care.

The Community Meeting participants described several ways to build the value of universal access into the policy recommendations the OHFB will produce, including:

Participants used multiple concepts to explain their belief that all members of the community should have access to health care, describing it as:

1. “A human right.”
2. “The proper response to human dignity and human needs.”
3. “A matter of social justice and common good.”
4. “A means to good health.”

Participants expressed several concepts about aspects of the benefit and delivery system, including:

1. Design system with seamless coverage across time and life circumstances
2. Guarantee access to a core group of health services emphasizing prevention and promoting healthier communities
3. Require services to meet standards of quality and affordability
4. Include educational efforts and financial incentives to support healthy behaviors
5. Be transparent and explicit about decisions to prioritize services, ration services or to use waiting lists
6. Specify a clear rationale for the role of government in securing universal access
7. Address current problems of workforce and resource distribution
8. Take advantage of strengths of current system and opportunities for innovation
9. Pay attention to regional differences
10. Consider a single payer strategy as an optimum way to achieve inclusiveness, participation, and efficiency.

Fair Financing

It is important to design financing mechanisms that serve the goal of universal access to affordable care focused on health and emphasizing prevention.

The Community Meeting participants described several ways to build the value of fair financing into the policy recommendations the OHFB will produce, including:

1. Base recommendations on an assumption that everyone will participate in sharing the costs of financing a system with universal access.
2. Select financing strategies that produce an equitable distribution of the financial burden among households with differing levels of wealth and differing needs for health care.
3. Consider a single payer strategy as an optimum way to achieve inclusiveness, participation, and efficiency.
4. Consider innovative ways to moderate the financial impact of health insurance and health services on households.
5. Consider various taxing strategies to raise adequate funds for public components.
6. Include strategies for coordination among public and private entities.
7. Reallocate existing health resources for improved efficiency and expanded access.
8. Build financing recommendations that focus on outcomes and effectiveness.
9. Frame cost control and efficiency strategies in relation to the social function of health care—to express compassion and respect human dignity.
10. Identify the role and focus of public leadership in transition to new system.
11. Explore tradeoffs among various public sector activities, not just among components of the health care system.
12. Target issues of excess profits, duplication of services, and the need for local flexibility.
13. Include fair compensation of providers and support for provider education among cost considerations.
14. Look for ways to use financial incentives to affect both consumer and provider behavior.
15. Support the function of informed consumers by respecting choice and assuring access to needed information.

Stability, Sustainability

It is important for members of the community to trust that there will be continuity of both function and funding in health care during and after transition to the reformed system.

The Community Meeting participants described several ways to build the values of stability and sustainability into the policy recommendations the OHFB will produce, including:

1. Identify clearly articulated process steps for transition from the present to the new system.
2. Account for regional differences and include opportunities for regional innovation when defining problems and developing solutions.
3. Include support for health care provider education in designing sustainability solutions.
4. Consider the role of incentives, payment levels, and malpractice reform in maintaining adequate access to services.
5. Consider the single payer strategy as an optimum strategy for stable and sustainable funding and functioning.
6. Focus on prevention, primary care and chronic disease management in order to achieve improvements in overall population health.
7. Improve education about health, healthy behaviors and the most appropriate way to use the health system, beginning with education during youth and continuing into adulthood.