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Janet Firshein or Joe Sutherland at 301/652-1558

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FRIDAY, JANUARY 30, 2004

NATIONAL REPORT WARNS THAT OREGON’S

HEALTH CARE REFORMS ARE IN PERIL

WASHINGTON, D.C. (January 30, 2004) – An assessment of health care in the 50 states, released here today, finds that although Oregon has pioneered innovative approaches to health care, its efforts are on the critical list. The report indicates that a bold plan to expand access to health care by prioritizing benefits has been waylaid by the federal government, which has often refused to permit the state to cut low-priority benefits when budgets are tight. The report appears in the February 2004 issue of Governing magazine.

“The idea certainly had promise,” says Katherine Barrett, the report’s co-author. “The state wanted to make sure that far more people had access to health care for vital treatments such as heart surgery even if that meant that fewer people had access to treatments for things like back pain. All states ration health care in one way or another. Oregon was just being somewhat more honest about the way it was doing it than many of the rest.”

But, the authors write, reluctance by the Centers for Medicare and Medicaid Services to allow the state to eliminate benefits it could no longer afford unraveled the plan. Oregon is awaiting word now on its request to drop 30 lines of coverage and if that is refused, the underlying structure of the state’s approach will be further compromised. The pressure on the state is compounded by the fact that it is facing one of the tightest budgets in the country. It recently cut the number of adults covered by Medicaid by one-third for their failure to make relatively small premium payments.

The report also has some positive news about the state. It points to the fact that “the state boasts the nation’s lowest percentage of elderly people in nursing facilities. Its long-term care program provides incentives to the nursing home industry to develop home-care programs and diverts savings in institutional care to community and home care.” In addition, the report praises the state for its leadership in implementing “evidence-based practices,” which require rigorous documentation on treatment results as a condition for increased funding in mental health.

Governing’s analysis of state-funded health care is part of the Government Performance Project, a six-year-old effort, funded by the Pew Charitable Trusts, to evaluate a wide range of state government management and policy functions. This year’s special report focuses on six critical health care problems facing states: long-term care, public health, mental health, prescription drugs, access to care for the uninsured, and care for children.

The Government Performance Project found and documented the inability of the 50 states’ health care system to deliver improvements in medicine fairly and consistently to many of their citizens. Health care in most states is not just inadequate, the study concluded--it’s deteriorating. “After exhaustive analysis and hundreds of interviews,” says Peter Harkness, Governing’s publisher and editor, “it became clear that there is a health care crisis in America. But it is in no way a medical crisis. It is a fiscal crisis.”

Governing is a policy and management magazine aimed at high-level state and local government officials. An online version of this report will be available at http://www.governing.com/gpp/2004/intro.htm as of January 29. Press releases for each of the 50 states can be found at http://www.governing.com/gpp/2004/press.htm.

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