“Glass half full” at Cover Oregon | DOJ on mental health: “Woefully inadequate” | SEIU 49 files initiatives

With the legislative session underway, and the campaign season just around the corner, it’s sometimes easy to get distracted by the more strategic questions facing Oregon health care.

Our “5 Things” this month aren’t so much strategic questions as they are events with strategic implications.  Each of the five have the potential to fundamentally alter the direction of health care in Oregon.  We don’t know how they will turn out, so we’re keeping an eye on them all.

DJ 5 things updated

1. The Cover Oregon investigations  

When I listen to folks talk about the investigations lining up of Cover Oregon, I can distill almost all of the commentary into a few key lines:  “It’s too bad.”  “The politics don’t matter anymore.”  “What happened to the money?

That seems to be the crux of it:  few are excited to see this happen to what was once such a promising, national-attention-grabbing enterprise.  But the questions, like those raised by US Rep Greg Walden in his call for a GAO investigation, seem entirely reasonable, regardless of your politics.  We’ve got a ‘crib sheet’ of all of the investigations – pending and underway – at our site.

2. A “glass half full” CEO for Cover Oregon 

The Cover Oregon board announced it is taking resumes for the CEO position formerly held by Rocky King.

Dennis Karras, the consultant leading the national search to fill the position, is one of the best recruiters in the Pacific Northwest.  He’ll find a great candidate if anyone can.  So, we talked with him about the position to get his take on the job.  “In truth, it is unlikely that things can get much worse.”


3. Wyden to chair US Senate Finance committee 

With the ascension of US Senator Ron Wyden to the prestigious chairmanship of the Senate Finance Committee, Senator Wyden must now be listed as among the most powerful members of the body.   His characteristic humility should serve Oregon and the nation well.

On the list of his priorities:  Medicare, set to become insolvent in 2026 without action.  Finance has also has oversight of the federal insurance exchanges, where some of the most informed – and biting – criticism of exchanges took place a year ago.

Like Senator Bob Packwood, himself a former chairman of the Senate Finance Committee, Wyden may face “tough odds.”

4. SEIU 49 files ground-shaking initiatives with Sec. of State

We’ve been watching SEIU 49 and their thinking regarding running initiatives to the voters to regulate hospitals closely.  One hospital executive told us last fall that the talk was just saber-rattling for purposes of negotiations, and that nothing would come of it.

Well, SEIU 49 has now filed two initiatives with the Secretary of State – a step beyond mere positioning.  One of the proposed initiatives to voters would cap the compensation of executives to no more than 15 times the earnings of the lowest paid system employee.   The other would cap rates hospitals could charge health plans and individuals to no more than “30% above sum of hospital’s per patient cost.”

Let’s be honest: if these go to the ballot (signatures must still be collected), these are probably going to pass.  And, if they pass in Oregon, they are probably going to pass in other states.  To paraphrase VP Biden upon the passage of the ACA, this is a big deal.

5.    DOJ report on mental health: ‘Woefully inadequate’    

In a recently completed three-year study by the US Dept. of Justice, it found Oregon’s mental health system continues to over-rely on institutional settings versus community based mental health treatment.

The report says “Multnomah County ACT (a community-based care model) team serves only 25 of the roughly 13,173 estimated adults with a serious and persistent mental illness in the county. By any measure, this is woefully inadequate.”  Also that “the data suggests that the high quantity of services… in some parts of the state do not meet evidence-based models for quality.”

It is relatively gentle in both tone and content.  However, when it comes to regulating states, the federal government doesn’t care to repeat itself.  This report  is a shot across the bow of the mental health system:  “limited progress” is not enough.