Oregon Department of Human Services Director's Message
March 26, 2010 DHS Director's messages on the Web
To: All DHS employees
From: Bruce Goldberg, M.D., director

A big move forward on health reform

"I look to the future because that's where I'm going to spend the rest of my life."
~George Burns

When the Oregon Health Authority and Oregon Health Policy Board were created last year, the Legislature gave us some very specific direction:

  1. Improve the health of all Oregonians.
  2. Lower the cost of health care so it is affordable to everyone.
  3. Improve the way health care is delivered in our state so everyone receives extraordinary patient care.

The first thing that must be done to improve the health of all Oregonians is for everyone to have health care coverage. We had started that work with the Healthy Kids program and expansion of the Oregon Health Plan, but we still had a long way to go before we could cover everyone in need.

As of last Sunday, though, with passage of the federal health reform legislation, we can now see the day when about 85 percent of Oregon's uninsured — some 500,000 people — will have coverage when the federal plan is fully implemented.

So now our charge in Oregon is clear: We must focus on the additional ways to improve health, on lowering costs, and on improving the way health care is delivered. Here are just a few ways that work is moving forward through OHA and the Health Policy Board:

Improve the health of all Oregonians. We cannot improve the health of everyone unless we put more emphasis on the root causes of ill health. That means everything from chronic disease prevention to public health strategies that reduce obesity. It also means including mental health and addictions treatment as part of the conversation. And we must address the racial, ethnic and geographic disparities in health and reduce barriers to getting care. Sadly, the quality and availability of health care in Oregon often depends on where you live, how much you earn and your ethnic background. We need a system that is equitable for all. The federal reform bill provides some much needed investments in all these arenas.

Lower the cost of health care so it is affordable to everyone. Adding more people into health care in 2014 as laid out in the federal legislation will ultimately help slow the staggering annual increases in medical inflation. Investing in prevention will also — over time — help lower the cost of care. But costs are rising so much and so quickly, we also have to take action at the state level to tackle the problem from every possible angle.

There is no single answer and to lower health care costs. We must change the way we pay for and deliver health care. That means everything from reducing administrative costs and making our health care system simpler for everyone. It also means coordinating the purchasing of health care by creating common high standards for quality, contracting and payment with providers. That will not only get the best value for the public dollar but will lower costs for everyone who buys health care in Oregon.

Improve the way health care is delivered in our state so it provides extraordinary patient care. For decades our health care system has been focused on quantity, not quality. Today it can be easier for a patient to get an expensive but unnecessary test than an extra five minutes of face time with a doctor or nurse. This has to change.

The Health Authority is working on plans to stimulate and implement important innovations in how health care is delivered, such as "primary care home." That means your doctor or health care provider would be given the incentives and tools to provide what we all want: more patient-centered care. That means focusing on wellness and prevention and coordinating care in a way that looks at the entire person and not just the symptom or disease.

When I was a practicing family physician, I saw firsthand the effects of not having health care on patients. They would wait too long because they couldn't afford care, then come through the door with serious conditions. I have seen families facing bankruptcy and met small business owners who live daily with the anxiety of not being able to afford health care for their employees. I have seen too many people unable to afford vital health care for themselves and their loved ones.

I am really happy that, with the passage of the federal legislation, we have begun the work to put those days behind us. I am also proud that Oregon is poised to move forward quickly to tackle the problems with health care that remain. There is a lot of work to do.

To learn more, go to www.oregon.gov/OHA.

DHS on the web