Lane County seeks seat at the table as Oregon researches universal health care

Eve Gray (Lane County Health and Human Services, director): The health care system in the United States today in many places is on the verge of collapse and we’ve seen this in rural areas for years. It’s now starting to hit us in metro areas as well.

[00:00:14] Presenter: That’s Health and Human Services Director Eve Gray speaking Nov. 5. Lane County residents shared their frustrations with local health care and asked commissioners to support the Universal Health Plan Governance Board. During public comment Nov. 5:

Amy Fellows: My name is Amy Fellows. I am one of the nine members of Oregon’s Health Plan Governance Board appointed by our governor that began meeting in April of this year.

[00:00:41] The Universal Health Plan Governance Board was created from Senate Bill 1089 sponsored by our state Sen. James Manning. Our deliverables by September 2026 are to design a comprehensive plan to finance and administer a universal health plan that is responsive to the needs and expectations of the residents of the state.

[00:01:01] I am the co-chair of the Community Engagement and Communications Committee.

[00:01:05] I applied to be a part of the Universal Health Plan Governance Board as someone with a masters of public health with over 25 years in the field, seeing the devastating health disparities and financial burden our current for-profit system puts on all of us and impacts our most vulnerable family, friends, and neighbors most.

[00:01:23] UnitedHealthCare, Optum’s acquisition of Oregon Medical Group, and the fallout of over 3,000 patients losing their primary care providers is just one example of our current system with incentives to make profits over providing health care.

I am a disability justice advocate and want to make sure our systems support and do not sacrifice our most vulnerable. I encourage you all to endorse the remitting of the resolution as presented to support our work towards a healthier Oregon.

[00:01:52] Jensina Hawkins: I’m Jensina Hawkins and I’ve worked in health care beginning right here in Eugene since 2006. I’ve worked in reception, scheduling, surgery scheduling, practice operations, billing, practice management, and compliance. I’ve also been council vice president for the Community Health Centers of Lane County. I’m currently a medical software consultant training over a hundred practices in 30 states on utilizing and optimizing their electronic medical record system.

[00:02:19] Over the years I’ve had a front-row seat to the all -consuming financial struggles of medical providers who want to render equal care to all patients, but the reimbursement they receive from various payers is wildly unequal.

[00:02:31] I’ve had the heart-wrenching task of building schedules to allow only one or two low-paying Medicaid patients per week in an effort to accommodate more high-paying Blue Cross and commercial PacificSource patients.

[00:02:44] One evening about a decade ago, I was in the RiverBend ER with a sick child, and the frantic mother next to me repeatedly told the desk clerk, ‘We have PacificSource. We should get to move ahead on the line because our insurance will actually pay you.’ I don’t condone her request for favorable treatment based on financial status but the tragedy of the story was that she was not entirely inaccurate.

[00:03:07] A couple of months ago a couple of you generously helped support the first citywide health care forum, which I organized and moderated. That evening culminated in a total of 77 questions received from community members for our panel of elected and appointed officials. One of the most recurring themes in those questions was folks asking how to find a provider who accepts their insurance.

[00:03:29] There were many harrowing, heartbreaking tales of senior citizens who purchased a Medicare Advantage Plan based on slick promises that nearly everybody accepts this plan and yet they discovered that in fact nearly nobody accepted their plan.

[00:03:43] It’s my honor to be on the Community Engagement and Communications Committee for the Universal Health Plan Governance Board and I’m here to request your support for the amazing work being done to ensure every Oregonian has equitable access to quality health care.

[00:03:57] Commissioner Laurie Trieger: Next up is Jay Brown.

[00:04:00] Jay Brown: I want to take a moment to express my strong support for the resolution backing the Universal Plan Governance Board.

[00:04:06] As a single-income mother, former foster mother, youth advocate, and social worker of 16 years, I witnessed firsthand how vital it is for everyone to have access to quality health care. This access isn’t just about individual health, it’s about the well-being for our entire community.

[00:04:26] When all of us have proper health care we can see fewer illnesses spreading, and our children, peers, friends, and family are successful in pursuing and living healthy lives. This benefits not only the families but our entire community.

[00:04:40] The current health care system can feel overwhelming and very costly, not to mention overly exhausting to navigate, often leaving our health department strained. By moving towards a public- funded universal health plan, we can shift our focus from complicated billing to providing real care for our community, one that focuses solely on the well-being and outcome of health over the dollar amount, codes, and paperwork process.

[00:05:05] Every individual, every heartbeat, every brain, everybody deserves quality care. A mother should not have to choose between a doctor visit for their sick child and putting food on their dinner table. A couple shouldn’t fear bringing a child into the world due to the costs associated with the birth of a child. It’s more expensive the entire first year, three years of the child’s life than it is to just have the child at a hospital.

[00:05:30] This change would help us spend more time helping people and less time on navigating paperwork that appears to be never enough anyways, depending on your CCO.

[00:05:38] It’s a top priority to address the social factors that affects health as well. Investing in these areas can lead to better outcomes, especially for communities that have faced historical inequalities, biases, or blunt disregard as if they do not have the right to live a healthy life.

[00:05:53] The steps already taken in SB 770 and SJR 12 shows that Oregon is committed to making a health care right for all, and I really appreciate that, right? Supporting the governance board is a key part to making that vision a reality. We have already set the bar really high in Oregon. Again, appreciate that. But let’s continue that.

[00:06:14] It’s a place where people seek safety and community-focused environments. Let’s continue that trend, continue to build a state that is affirming the commitment that you matter and we care about you.

[00:06:23] Due to the CCO, service providers and strict guidelines, even if someone does have insurance, the access is very limited depending on their provider. A good example was the Trillium / PacificSource situation. This is unacceptable. We’re seeing an increase in preventative health care concerns filing out of control due to the insurance hinders.

[00:06:40] I strongly encourage the commission to really push the governance board. We really have a great plan. I think we can really do some great work out here. So I appreciate you.

[00:06:51] Tom Peck: My name is Tom Peck. I would like to talk to you this morning about the corporatization of our health care. Thirty years ago, physicians for the most part were self-employed, but today, 80% of our physicians are employed by large health care, corporate health care systems, private equity firms, and insurance companies. Eugene and Oregon are a prime target for the purchase of our health care systems. The corporate acquisition of Oregon’s health care clinics has increased 100,000 % in the last 10 years.

Corporate executives are making decisions about our patient care, but remember, corporate executives have a fiduciary responsibility to their shareholders to make a profit.

[00:07:47] Physicians, however, are held to the Hippocratic Oath, which obligates them to their patients. This conflict of corporate versus physicians’ interest is the cause of the Oregon Medical Group’s meltdown. We are losing primary care, community-based health care clinics, pushing more and more patients into extreme long waiting lines at our two emergency rooms in Springfield.

[00:08:19] It has been proven that basic primary care keeps patients out of the hospital and increases their likelihood of recovery. I think the closure of the University District ED PeaceHealth shows that we are moving in the wrong direction.

[00:08:40] I have an example, a personal quick story that I had a medical emergency recently. I was transported to PeaceHealth RiverBend ED. I was discharged in three days with a long list of medications with no explanation of the side effects and I was told I’ll talk to my doctor in three weeks.

[00:09:02] However, I am a patient of Lane County Medical and Public Health. The two days after I got home, I got several calls from Lane County staff saying, “Do you need food? Do you need care? Do you need to make an appointment with your primary care physician?’ That’s the kind of care that we get from community-based.

[00:09:26] Terry Parker: My name is Terry Parker and I’m here as the president of the League of Women Voters of Lane County. The League of Women Voters stands on the belief that the U.S. health care system should provide all U.S. residents with a basic level of health care.

[00:09:39] Basic care includes disease prevention, primary care, including prenatal and reproductive health, acute and long-term care, mental health care, and health promotion and education. Health care policy goals should include the equitable distribution of services and delivery of care advancement of medical research and technology and a reasonable total cost.

[00:10:04] So I want to make this short because you’ve got other people that want to say, do what Tom said, you know, I’m had it, right? Pursuing this dream for Oregonians is vital for the overall health of our communities. We asked at the board endorse the resolution in front of you presented by your Department of Health and Human Services.

[00:10:21] We’ve seen in our own community the negative impact of the trend of consolidating health care markets with insurance companies and private equity funds making acquisitions in many health care arenas that result in spiraling prices, diminished access, and declining quality, including unnecessarily illness, injury, and death.

[00:10:43] The United States already trails peer nations in the quality and outcomes produced by its health care system, while simultaneously leading the world in the cost of its care. We should be hyper-focused on moving in a different direction.

[00:10:57] Raudel Perezchica: My name is Raudel Perezchica. I am with Health Care For All Oregon. I hope you will adopt the resolution in support of publicly-financed universal health care. A universal health care system will help essential workers, like the farm workers, which help harvest our crops in Lake County.

This will go a long way in helping farm workers and their families stay healthy and productive. This will also help other minimum wage workers to keep more of their hard-earned money and will go toward other expenses. It is in our interest that essential workers stay healthy as they contribute to the local economy.

[00:11:43] Dr. Henry Elder: Hello, I am Dr. Henry Elder. I am a retired psychiatrist and practiced for 45 years in family medicine and psychiatry, ending in Eugene two years ago. During the time I practiced, it was clear that medicine was becoming more and more pressured by the presence and action of insurance companies, and it has been progressively worse.

[00:12:11] I am here to ask for your support of the resolution in front of you because I believe that removing the insurance companies from impediment to medical care will vastly improve the services in Lane County, especially to mental health patients.

[00:12:29] Because mental health patients have much more difficulty adjusting to the demands of insurance and because doctors do not enjoy the battles that are imposed upon them by insurance companies. The removal of those battles would vastly improve care to everyone.

[00:12:51] And that includes my partner. She’s an internist who shares my beliefs that medicine is deteriorating and has a difficulty that she wants to attend to, and we discussed it this morning. She said, “Oh, I’m not going to be able to see the doctor for a month. Even though she’s quite capable of understanding what is urgent and what is not, she is unable to get medical care for a month.

[00:13:17] And this is outrageous, it’s widespread that people who do not have the training of the physicians, who do not have the experience, the practical experience become gatekeepers to determine whether people get care or not.

[00:13:30] I ask you please to consider the advantages to the people of Lane County of supporting this measure, and the major efforts that Oregon has to become the forefront and the promoter of better care for everyone.

[00:13:47] Commissioner Laurie Trieger: Next up is Hap Ponedel.

[00:13:51] Hap Ponedel: We have all had a universal health care moment and that was when the federal government offered the opportunity to get the COVID vaccine, which was delivered literally through the windows of our cars. That made the entire population of the county, those who took part, a much healthier population and we know that a healthier population is more productive and gets more work done in our country.

[00:14:12] I want to just encourage you to adopt or support the resolution for presentation to the Oregon Universal Health Governance Board. I think this would be a good move for our society and certainly the voters of Oregon have indicated that they are interested in having health care be a human right. So it sort of means we all have to work on that together.

[00:14:32] Charlie Swanson: Hello, I’m Charlie Swanson. I’m here to support the resolution in favor of the governance board, or support the governance board. I am a member of the Finance and Revenue Committee of that governance board. And one of the things I want to emphasize is the last couple of clauses in the resolution about Lane County helping the governance board so that as the plan develops, it will meet the needs of Lane County and Lane County residents.

[00:15:01] Lou Sinniger: My name is Lou Sinniger and I live out in Elmira. So I’m a rural resident. However, most of my life, my career, was as a union rep. In fact, I worked 20 years for AFSCME, and one of the locals that I was responsible for was Local 2831. And so I have kind of an inside view of how health insurance has become kind of the elephant in the middle of the bargaining table.

[00:15:40] What I saw during my years of experience was that the insurance, the cost of it always went up every year and the benefits were somewhat reduced. So, what this does is create a burden. It’s a burden for Lane County as an organization, and it’s a burden on the employees.

[00:16:06] Stop to think about the number of people that you have working just to administer health insurance, and stop and think how much it costs the Health and Human Services Department, just to administer the care through the health insurance companies. So I got to thinking, there’s got to be a better way.

[00:16:30] And it started with the passage of Senate Bill 1089, which creates the Universal Health Plan Governance Board. It’s a big step forward to try to find a better way. So I ask you to support the resolution in front of you. And I think by seeking a better way, we will all get better soon, OK.

[00:17:02] Eve Gray (Lane County Health and Human Services, director): So what we’re talking about today is a resolution in support of the work of the universal Health Plan Governance Board. This is purposefully, distinctly not resolution in support of a universal health plan for the state of Oregon, and that is because we don’t yet have a proposal on the table for a universal health plan and what all would be included within that.

[00:17:26] So we’re really talking conceptually right now, that we are asking for support of the work to create a universal health plan as an option to consider for the state of Oregon in order to improve the many challenges that we recognize exist within our health care system today.

[00:17:50] And also for Lane County and Health and Human Services in particular to be a voice at the table.

[00:17:59] So what are we really trying to solve here: The health care system in the United States today in many places is on the verge of collapse and we’ve seen this in rural areas for years. It’s now starting to hit us in metro areas as well. So for individuals, health care is incredibly costly…

[00:18:25] When you are most with a serious illness, I think many of us have experienced the thought, of course the thought of ourselves and our health and our future, but, ‘Oh my gosh, how much is this going to cost? What’s the impact going to be on my family when we have to pay for my health care bills instead of paying for rent or instead of paying to put food on the table?’

[00:18:52] The proposal that is being put forward would be that a universal health plan is financed through replacement of what employers pay today for health insurance,,,, so those dollars would be reallocated to a universal health plan, and then likely some form of a payroll tax. There is a finance committee that would figure out all the details of how this would come into play.

[00:19:20] Beyond that, though, beyond what you pay ongoing that you know is coming out of your paycheck, there would be no deductibles, no co-pays, no coinsurance, no additional out-of-pocket expenses. So in a year when you are diagnosed with cancer, you don’t have to be worried about how your family is going to afford that expense. You can be focused on how you’re going to get better or at times how your family is going to transition to life without you, which is really what people should be focused on in this point of their lives when they have these major health care events that occur…

[00:19:57] The health care system isn’t working for individuals, the health care system isn’t working for employers, the health care system also isn’t working for providers. We have an incredibly, incredibly complicated system where every single health care provider needs to contract individually with every single insurance company. They have to submit documentation for every single one of their doctors, nurse practitioners, physician associates, to every insurance company who has to independently verify every time that that provider is licensed to practice in the state and is able to be contracted under their plan. All of the plans are different…

[00:20:39] An independent actuarial firm looked at the idea of a universal health plan and what would that mean financially if we’re not asking for out-of-pocket costs beyond our general funding of this system and we’re paying providers a living wage… An independent actuarial firm said that the implementation of this plan would save the state of Oregon $1 billion a year. And where are those savings coming from? It’s coming from getting rid of all of that really complicated administrative burden that’s about getting reimbursed for the service you provide, not about the care that we provide to patients in the state of Oregon…

[00:21:23] So that’s the premise here. That is what the Universal Health Plan Governance Board has been asked to figure out. And we know that the devil’s in the details, which is absolutely why today we’re looking very high level at the promise of the plan and not at endorsing this as the solution to Oregon’s health care challenges until we see what does that actual plan look like and what’s all the feedback that’s provided on it.

Presenter: Lane County commissioners support research and design of a state-funded universal healthcare system.

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This story was produced by John Q. for Whole Community News, KEPW 97.3 Eugene PeaceWorks community radio.