A Policy analysis: The Oregon Health Plan
Introduction and definition of the issue--why is it important to analyze?
The Oregon Health Plan (OHP) is a public and private partnership to ensure access to health care for Oregonians. The major components are: Medicaid reform, insurance for small businesses, and a high risk medical insurance pool. “In addition, OHP includes provisions for oversight, research, and analysis to achieve the best use of health care funding” (Department of human services; Oregon health plan a historical overview (2006, p 2). According to the DHS (Department of Human Services, p 1), their current goals are a complex set of ideas that affect every Oregonian, resulting in the need for a closer, more structured analysis. They include: ➢ All citizens should have universal access to a basic level of care. ➢ Society is responsible for financing care for poor people. ➢ There must be a process to defining a “basic” level of care. ➢ The process must be based on criteria that are publicly debated, reflect a
consensus of social values, and consider the good of society as a whole. ➢ The health care delivery system must encourage use of services and procedures
that are effective and appropriate, and discourage over-treatment. ➢ Health care is one important factor affecting health; funding for health care
must be balanced with other programs that also affect health. ➢ Funding must be explicit and economically sustainable.
➢ There must be clear accountability for allocating resources and for the human
consequences of funding decisions (2006, p 1).
Therefore, looking at a the OHP with respect to its relative history, what policy options are available, including trade-offs, a clearer view of what Oregon residents can expect form the plan should emerge from this analysis. Background information, including a historical context and the major stakeholders
The major stakeholders include: “OHP recipients, hospitals and care centers, taxpayers and the federal government” (Health policy monitor, 2004).
In 1987, the state of Oregon was growing increasingly concerned about the cost of Medicaid, and the Oregon Legislature decided to no longer fund soft tissue transplants for Medicaid clients, prompting a debate over what to cover. “That year, Governor Neil Goldschmidt appointed a workgroup of representative health care providers and consumers, businesses, labor, insurers, and lawmakers. This group developed a political strategy to answer three main questions about Oregon’s health plan: (1) who is covered, (2) what is covered, and (3) how is it financed and delivered” (Oregon health plan a historical overview, 2006, p 1).
In 1987 they established the Insurance Pool Governing Board (IPGB) to offer uninsured self-employed and small businesses (1-25 employees) the opportunity to purchase affordable small group health insurance from private companies (HB 2594). They also created the Oregon Medical Insurance Pool (OMIP), to offer health benefits to people who can’t buy individual health insurance because of a health condition. The bill establishes Oregon Medical Insurance Pool (OMIP) as a quasi-public (a type of corporation in the private sector that is backed by a branch of government that has a public mandate to provide a given service) agency with no state funding (SB 583) (Oregon health plan a historical overview, 2006, p 3). In 1988, Senate President John Kitzhaber initiates the Oregon Medicaid Priority Setting Project, which laid the groundwork for the Prioritized List of Health Services. In 1989 John Kitzhaber completed the following: ➢ IPGB makes insurance available to uninsured small businesses and offers a tax credit. ➢ The Legislature...