Governor Kitzhaber says he's angry about the all the mistakes by state officials that resulted in the Cover Oregon health insurance website or "exchange" still not working properly. But that trouble is about insurance and bureaucracy, two words that are almost synonymous. And it is small and temporary compared to what's likely to happen with actual health care in Oregon in the next few years.
The governor held a press conference Thursday after releasing the outside report that detailed the problems in his administration connected with Cover Oregon. (He may have other problems elsewhere, considering that his March 21 press statement online was dated March 30.) Some people are out of a job including Bruce Goldberg, head of the Oregon Health Authority.
Still, the governor said it wasn't all bad. “Despite ongoing technical challenges," he said in his statement, "more than 157,000 Oregonians have enrolled through the exchange, over 49,500 of them into a commercial plan. Combined with our fast track enrollment process, we have enrolled more than 287,000 Oregonians in high-quality and affordable health plans since January... The value of our success in this regard should not be overlooked, even as we work to fix what went wrong.”
Fair enough, but again, that's just insurance, most of it apparently Medicaid paid for by public funds, and how long that money will hold out nobody knows. The real question is whether any of this translates into better health care for everybody, which as the governor pointed out has been his goal for 25 years.
Better heath care means you take care of yourself and when you need care, you can go see a doctor who checks you out and either treats you or gives you some helpful advice. What's the effect of 287,000 new health plan clients, many or even most of them on Medicaid, on the system of doctors and clinics we have? One likely result: Longer waits to see somebody. (I don't know if there's a connection, but I tried this month to line up a doctor because mine is retiring. This evidently requires an appointment, and my appointment is for the middle of June because that's the earliest available.)
The question is whether the medical field in Oregon is prepared for several hundred thousand new clients, even if they don't all immediately become patients. It's one thing to have insurance -- a great thing when you need it. But that's not the same as health care, let alone health. Maybe what we should have done all along is to forget about increasing insurance and the huge amount of paperwork, regulation and costs that this entails. We should have worked on ways of making professional health care less expensive and more readily available instead. (hh)