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Measure creates health care plan
By MIKE FERGUSON
Of the Baker City Herald
Last year, nurses at the Baker County Health Department saw an average of 300 patients each month. Services, which will cost state and county taxpayers a little more than $1 million this year, ranged from well-child exams to immunizations to family planning to flu shots.
Nurses saw people with full or partial insurance coverage, both private and Medicare. They saw many of the 23 percent of Baker County residents (about 3,850 people) who qualify for the Oregon Health Plan. And they saw many hundreds of people including scores of children who have no insurance at all.
The 2000 U.S. Census does not indicate how many Baker County children are uninsured, but the "Kids Count" survey done for the group Children First For Oregon determined that nine percent of Oregon children more than 70,000 in all are not medically insured. Nine percent of the 4,427 children in Baker County age 19 and under would translate into 398 uninsured children.
"We see many, many families with no insurance for themselves or their children," Health Department Office Manager Sandy Cross said. "We see any client, regardless of their ability to pay."
But if voters approve Measure 23 on the Nov. 5 ballot, every Oregonian would have health coverage for medically necessary health services after Jan. 1, 2005.
The Oregon Comprehensive Health Care Finance Plan would be funded by an increase in income taxes, a new payroll tax on employers and a one percent payroll tax on employees beginning Jan. 1, 2003.
The increase in income taxes to pay for the plan would range from 0 percent for people who make 150 percent or less of the federal poverty level ($26,475 for a family of four in 2001) to eight percent, with nobody paying more than $25,000 in additional taxes.
For wage-earners, a temporary payroll tax of one percent will begin Jan. 1, 2003, and end Jan. 1, 2005.
Employers, too, must pay more taxes under the plan: a minimum of three percent, and a maximum of 11.5 percent.
The plan, which would cover all Oregonians, covers the following services: prescription medications, dental and eye services, preventative services, inpatient and outpatient services, treatment for work and auto accident injuries, mental health and long-term care services.
Pre-existing conditions will not be excluded, and participants can choose any state-licensed practitioner.
Cost of the plan will be at least $1.7 billion per year to implement and could rise as high as $12 billion annually when it's fully implemented.
That cost is the rub for many of the groups that have come out against the plan, including Associated Oregon Industries and the Oregon Association of Health Underwriters. Businesses considering moving to or expanding in Oregon may reconsider if the payroll tax is added.
Opponents claim that working people would pay more for health care under the plan, even if a portion of their current coverage is paid by their employer.
They also worry that out-of-state residents will move to Oregon to take advantage of the plan, and that the plan does nothing to control rapidly-increasing medical costs. They say the plan goes far beyond essential health care to include services from music therapists to marriage counselors.
Proponents argue that the U.S. is the last industrialized nation without universal health care. Health care coverage cannot be removed if an employee changes jobs or retires, and Oregonians will be able to select their own doctor or other provider, not one approved by a health maintenance organization.
They say the plan will ease over-crowding in the state's emergency rooms, since those are the places to which people without insurance often must turn for their medical care.
They also believe the plan will reduce overhead costs in the current system, which account for up to one-fourth of health care expenditures.