A conversation with Dr. Kitzhaber and Rep. Reynolds, January 2022
In our East Washington County Dems meeting on January 6 we talked with former governor, Dr. John Kitzhaber and state rep, Dr Lisa Reynolds about innovative ways to make our healthcare system more responsive, effective, affordable, and equitable.
One of the biggest issues raised by Dr. Kitzhaber was how we can create a healthcare system that focuses as much on value as it does on coverage. To cover pediatric visits for a child who goes home to a chaotic environment or one without enough food doesn't advance the cause of good health sufficiently. As Dr. Kitzhaber said in his address to Families USA:
This is not an either-or choice—it is not a zero-sum proposition. It is a matter of demanding value for each and every public dollar we spend on health care; it is a matter of holding the delivery system accountable for quality and outcomes; it is about putting downward fiscal pressure on a delivery system and cost structure that has become obsessed with the delivery of medical care as an economic commodity at the expense of the health of the American people; it is about rooting out those aspects of the system that are focused solely on maximizing revenue, increasingly financed with limited public resources. (https://www.apg.org/news/former-oregon-governor-dr-john-kitzhaber-focuses-on-value-in-speech-to-families-usa/)
How we achieve this dual goal of universal coverage and attention to the social determinants of health is challenging. In the recording of our program below, you can see the suggestion that we use federal Medicaid waivers to reconfigure how we fund portions of healthcare funding, including capitation (paying a set amount for each person) rather than fee for service as a way to strengthen attention to the societal factors that deeply affect health of Oregonians.
It may be up to Oregon to make these changes. The gridlock in Washington means that we probably will not have an effective change in our healthcare systems coming from there in the near future. Oregon has been a leader in the past in creating ways to provide healthcare coverage to all Oregonians. 95.3% had some coverage as of 2020, including a new initiative to cover all Oregonians regardless of immigration status. We need to continue that leadership. That is how we Build Back Better.
For those wanting to dive deeper, Dr. Kitzhaber shared a useful document with us to help further understand this complex challenge.
Dr. Lisa Reynolds, a practicing pediatrician, agreed that it is the time for Oregon to take the lead once again on healthcare innovation. As a member of the legislative Behavioral Health Committee, she emphasized the problem of a fractured behavioral health system where there is not parity (equal funding for BH and physical health). Investing in the health of our children and focusing on Social Determinants of Health, such as good dental habits, is a powerful way to drive down long term healthcare costs. For years she has talked about how effective it would be for insurance to provide air conditioners to some people. This year's heat dome made that a stark reality.
Dr. Reynolds emphasized that we have to begin to have courageous conversations, challenging such things as resorting to surgery when physical therapy might be equally effective. Too many of our healthcare decisions are determined by who can afford to buy the best lobbyist.
Lisa is running for representative in the newly constituted House District 34, which serves Bethany, Oak Hills, Bonnie Slope, Cedar Mill and Terra Linda. Please consider donating or working to bring her back to the Oregon legislature with her important perspective on these issues. You can learn more here: www.lisafororegon.com
To hear all of this and the question and answer session in more depth you can watch the recording here:
Topic: EWCDems January 6, 2022 Date: Jan 6, 2022 06:20 PM Pacific Time (US and Canada)