Oregon Health Authority Director's Message
June 3, 2011 OHA Director's messages on the web
To: All OHA employees
From: Bruce Goldberg, M.D., Director

We can't afford business as usual

"Once we rid ourselves of traditional thinking we can get on with creating the future." ~James Bertrand

No one would design the health care system we have today as a model of health or efficiency. Costs are too high and quality isn't high enough. Providers are paid for sickness, but not health. Too many families can't afford coverage and those that can are seeing their out-of-pocket costs increase every year.

But what if we could start over? What kind of system of care would we build?

In New Orleans, after the public hospitals were leveled by hurricane Katrina in 2005, the community decided to go a different direction for health care. Primary-care health homes were established in the neighborhoods to help treat low-income people with chronic conditions rather than rebuilding the old emergency room-based care. The clinics are open evening hours and they have caseworkers or community health workers on staff to ensure that patients take their medicines, make their appointments, and do the treatments providers recommend.

Today, according to recent news reports, patients are healthier and are able to avoid expensive hospital care.

New Orleans didn't let itself get stuck in the old model of care that lets people get sicker than they need to be and drives dollars to expensive hospital care. It looked at innovations in other communities and built a new health care system that delivers better health at lower cost.

In Oregon, I believe we have a similar opportunity -- in fact, an imperative. We can no longer afford our current health care system. Too much of our health care spending goes to pay for expensive care for conditions that could have been prevented if our system was designed for real health.

Sadly every single dollar we spend treating something we could prevent is a dollar taken from our children's public schools, our neighbors' long-term care, and from the well-being of our communities.

We have created a vision for health care in our state that delivers the right care at the right time in the right place. We need to ensure that we have emergency care, highly trained specialists able to treat complex problems, and hospitals there when we need them. We also want to ensure that no one goes without robust primary care and preventive services for so long that they find themselves in the hospital when they could have avoided it. Both they -- and we -- pay the price for that.

OHA on the web