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Health Gap: New Report Links Illness and Poverty

"People may be in the health gap without realizing it. People with health insurance often don't realize that they're underinsured - until deductibles and cost sharing eat up their savings and even force them into bankruptcy." - Mallory Pratt, Oregon Action
June 27, 2005

Oregon Action and Northwest Federation of Community Organizations recently released their study "The Northwest Health Gap." This study reveals an alarming trend away from comprehensive, employer-based health care - and toward a health insurance system where almost everyone is one illness away from poverty.

Between high wage earners who have comprehensive employer health benefits, and the very poor and sick who are covered through public health programs, lies a rapidly growing population with no coverage or inadequate coverage. The health gap is growing as employers are financially forced to cut benefits because of skyrocketing insurance premiums.

The 2005 Health Gap Study builds on the 2004 Northwest Job Gap Study, which estimated the gap between the number of living wage jobs being created in the Northwest and the number of people needing living wage jobs. This report takes a closer look at the impact of health issues on the ability of families to be economically stable.

The Health Gap Study highlights the failures of the current health care system to provide quality, affordable coverage to people in Oregon. It also presents strategies for closing the health gap. These include long-term solutions focused on health care for all, as well as solutions that expand public programs, improve oversight over private insurance carriers, and address the trend in employers dropping health coverage. To read the entire report, click here.

The legislature's lack of attention to health care this session, will only make this gap more pervasive. If you have fallen through the health gap or worry you will, please call Katie 503-655-2793 to share your story.


Educator Insurance Purchasing Pool passes out of committee

Public school and community college employees across the state are facing a growing crisis over health insurance. Squeezed by double-digit increases for health insurance premiums at a time of education budget cuts, school districts and college boards are seeking to transfer the burden of health care cost increases to employees through caps on health insurance premiums, and higher co-pays and deductibles.

SB 639A to create a statewide health insurance savings pool for all school districts passed committee last week and is expected on the Senate floor this week. Its fate in the House is uncertain.

By combining purchasing power, a statewide health insurance purchasing pool will ensure that school districts and taxpayers know exactly how their healthcare dollars for school employees are divided between benefits, administration and profit.

School districts will be able to compare different plans based on benefits and cost. Taxpayers will have accountability on how much local school districts are saving on healthcare for school employees.

The main opposition to this plan is from the Oregon School Boards Association who earn millions from the insurance they sell to school districts.


The Weekly Dose

Health care spending for U.S. residents with private health insurance increased by 8.2% in 2004, about the same as the growth in 2003 and almost four times the growth in wages. -- Health Affairs, June 2005

Oregonians for Health Security
9813 SE Hwy 212 Clackamas, OR 97015
(503) 655-2793 (503) 655-2879 fax
No child uninsured: Cigarette tax would cover 106,000 kids 01.Jul.2005 15:18

A Register-Guard Editorial

www.registerguard.com | The Register-Guard, Eugene, Oregon
July 1, 2005

It sounds too good to be true. A bipartisan team of lawmakers has unveiled a plan that would provide every child in Oregon with health insurance. That's worth repeating: Every child in Oregon - more than 100,000 currently uninsured children in all - would have health insurance.

Not only that, 25,000 more poor people would be added to the Oregon Health Plan, and tens of thousands of uninsured working Oregonians would get help in purchasing health insurance.

So what's the catch? The plan, which depends on voter passage of a 60-cents-per-pack increase in the cigarette tax, requires approval of the Republican-controlled House before it can be referred to voters. Few expect the tax-averse, tobacco-friendly leadership in the House to break a sweat this late in the session pulling the measure onto the floor for a vote.

What a shame that would be. House Bill 3500 marks a return to the kind of visionary legislative leadership on health care that has been lacking in recent years, largely due to chronic revenue shortfalls.

The bill is the result of a productive partnership involving four of the Legislature's best thinkers on health care: Rep. Billy Dalto, R-Salem; Rep. Mitch Greenlick, D-Portland; Sen. Ben Westlund, R-Tumalo; and Sen. Alan Bates, D-Ashland.

The four lawmakers refused to surrender in the face of the enormous hurdles that confront any attempt to address the problem of providing health care to Oregon's 600,000 uninsured residents. Starting with the proposition that health care for children is a right and not a privilege, they began crunching numbers.

Raising the state's cigarette tax from the current $1.18 to $1.78 per pack would generate about $81 million a year. Combined with federal matching funds, the additional reve- nue would more than cover the state's 106,000 uninsured children. It also would double the number of poor Oregonians eligible for Oregon Health Plan coverage and would pump another $5 million a year into tobacco prevention and education programs.

Peeling all this money out of the wallets of the 22.4 percent of Oregonians who smoke may seem unfair, but that argument cuts both ways. Smokers take more than their fair share of health care dollars from the state. Westlund says that every pack smoked in Oregon comes with a hidden bill for more than $8 in lost productivity and unreimbursed medical costs resulting from tobacco use.

Higher cigarette taxes offer another incentive for smokers to quit or cut back. That could help reduce tobacco-related illnesses for the 43 percent of adult Oregon Health Plan clients who smoke.

There's another huge benefit of HB 3500 to the state's economy: The additional insurance coverage would cut into the increasingly burdensome cost shift that occurs when uninsured people can't pay for the emergency room or hospital care they require. These expenses don't disappear. They're shifted to paying patients, and they can add as much as $1,000 to the annual cost of a health insurance policy.

When the economic multiplier effects of new health care jobs and lower insurance premiums are added to the equation, HB 3500 becomes the kind of win-win deal that House leaders shouldn't pass up. The bill would pump more than $382 million in federal and state funds into Oregon's economy, creating up to 4,500 jobs.

Remember, HB 3500 isn't a tax increase. It's a legislative referral of the proposal to voters. If Oregonians don't like the idea of giving every child health care coverage by hiking the price of cigarettes, they can just say no. But first, they need for House leaders to give them the choice.

Let's Face Up to Health Care Needs 01.Jul.2005 16:29

HCAO email list

North Adams Transcript May 26, 2005
By Charles Joffe-Halpern

Americans are consistently inconsistent when it comes to their attitudes
toward health care. This observation, from a report written by the St.
Luke's Health Initiative of Arizona, is one of the reasons why Americans are
stalemated when it comes to deciding how to expand health coverage to the
uninsured. St. Luke's observes that:

* Most Americans favor providing health coverage to the uninsured, financed
by taxes.

* Most Americans don't want to pay increased taxes themselves.

* Most Americans think the health care system is badly in need of reform.

* Most Americans express satisfaction with their personal use of the health
care system.

* Most Americans don't trust the government to do the right thing.

* Most Americans expect the government to do something. What will it take
to breakthrough the stalemate that has allowed 45 million Americans to go
without health insurance?

Uwe Reinhardt, professor of political economy at Princeton, suggests the
nation needs to rethink its claim that our national objective is to provide
equal opportunity to all, noting that people in poor health and lacking
health insurance do not have equal opportunities. He adds: "There is
something deeply troubling about the thought that a family should suffer
foreclosure on a house or fail to send a capable youngster to college just
because a member of the family had been stricken by, say, cancer or another
serious illness."

And this is where our internal contradictions surface. Americans don't like
seeing people suffer unnecessarily, or go without fundamental security,
especially if they play by the rules. But we also don't like giving things
away. With this in mind we should note that 80 percent of the uninsured are
in families who work hard, pay taxes, and indeed play by the rules, but
still they can't afford decent health care.

Part of the struggle with expanding health coverage to more uninsured
Americans, is a consequence of the way Medicare and Medicaid, our major
public health programs, were implemented in 1965. We agreed that Medicare
should cover all Americans over age 65, regardless of income. To be eligible
for Medicaid though, one had to be very poor and we linked eligibility to
welfare. Others were expected to get health coverage through the workplace.

With the steadily increasing costs of health care we can no longer depend
on employers to provide affordable health care to those who work. In the
mid-1970s there were approximately 23 million uninsured, now there are 45

Shockingly, of all the countries in the industrialized world, Americans now
have the lowest life expectancy, and the high numbers of uninsured is
considered a major factor.

Without government intervention the numbers of uninsured will continue to
rise. When I discuss health care with those who consider themselves
political moderates, most agree that no one in this country should have to
go without health coverage, but consistent with the national surveys many
get stuck on the tax issue.

Indeed, over the past 20 years political conservatives have been effective
in demonizing tax revenue. George Lakoff, the influential thinker in the
field of political linguistics, observes that Americans have lost sight that
tax revenues enable us to live in a civilized country. It is what we pay to
have democracy and opportunity, to have essential services that none of us
could live without.

Health care is not a giveaway, and it is not cash assistance. Relief from
pain and being able to seek medical care when sick or injured, without fear
of crippling financial debt, should not be considered a luxury.

Health care is a basic necessity that allows people to get on with their
lives. America was founded on the principle that we should be a country of
equal opportunity, where those who work hard would be able to thrive and
pursue the American dream. Perhaps when our country accepts that health care
is essential to pursuing that dream will we break the stalemate and finally
find a way to bring health care to the millions of Americans who are not in
a position to afford it. Until that happens we will not be able to call
America the land of equal opportunity.

Charles Joffe-Halpern is the executive director of Ecu-Heath Care and the
president of the Board of Directors of Health Care for All in Boston. He can
be contacted at  cjoffehalpern@nbhealth.org