Twenty-nine years ago, Oregon showed how health care planning should be done

Many years ago, twenty-nine of them, I was the lead staff person for an Oregon Health Priorities for the 1990s project. In 1988 it culminated in a Citizen's Health Care Parliament organized by Oregon Health Decisions, which is still in existence (I was the first executive director of Oregon Health Decisions). 

In May 2009 I wrote a blog post just before the Affordable Care Act became law that focused on a paper I wrote for the Citizens Health Care Parliament, "Quality of Life in Allocating Health Care Resources." In the post I said:

Like most Americans, I'm hoping that a viable national health care plan is going to emerge from Congress and the Obama administration soon -- looks like it could be this year. Whatever that plan looks like, it is going to have to deal with quality of life and resource allocation issues.

I'm proud that Oregon helped lead the way in finding solutions to our health care problems. And pleased that I was able to contribute to that effort.

Well, I still am.

But this week the GOP-controlled Senate came very close to dismantling the Affordable Care Act ("Obamacare"). Even though a Senate vote has been put off for a few weeks, there's still a good chance that Republicans will do the wrong thing and take our country several big steps backward, health-care-wise. 

So I figured this would be another good time to dust off the PDF file I made of "Quality of Life in Allocating Health Care Resources" to remind myself, and others, of what real health planning looks like. 

Because whatever Senate Majority Leader Mitch McConnell and his cronies have been doing behind closed doors in crafting their super-shitty "repeal and replace" Obamacare bill, it sure isn't any sort of rational, fair, compassionate, reasoned effort to improve the United States health care system.

What Oregon did back in the 1980s was far superior. We involved ordinary citizens in setting health care priorities and discussing difficult bioethical issues. We openly tackled thorny topics like health care rationing and death with dignity. 

When I re-read what I wrote in 1988, I was reminded of a couple of things: (1) our country hasn't made a heck of a lot of progress in coming to a consensus on the questions Oregon's Citizen Health Care Parliament debated 29 years ago, and (2) Oregon was on the right track back then, especially compared to the disastrous debacle of current GOP "repeal and replace" efforts -- which go against every principle of good health planning.

Here's a few pages from the document that struck me as particularly relevant to what's going on in Washington, D.C. today. First, the title page. 

Next, three short pages about setting health care priorities. 

Lastly, the Acknowledgements page -- to show how much support there was for the Oregon Health Priorities for the 1990s project. Which ends with my name, something I remain proud of, notwithstanding how little progress our nation has made in coming to grips with the perennial health care issues we debated almost 30 years ago, and continue to grapple with today.

(When telling someone about my professional past, I like to say, "I used to be one of the top health planners in Oregon back in the 80's; obviously I did a terrific job, since now our health care system is functioning perfectly!" The irony is so obvious, I can say this with a straight face and still get my humorous message across.)

Comments

[Jim Scheppke]

I am right in the middle of reading the new book, An American Sickness: How Healthcare Became Big Business and How You Can Take it Back by Elisabeth Rosenthal. Wow, what a great expose! I haven't gotten to the "you can take it back" part yet. So far Rosenthal demonstrates again and again how our US health care system is ALL ABOUT GREED and not about health (not at all). It's about making people rich: doctors, hospital administrators, insurance executives, pharmaceutical executives, device makers, the list goes on. The best thing to do might be to blow it up and start over. We could do that in our state, I'd bet.

[Mike Hughes]

I'm reading a similar book which was recommended by Chuck Marohn, titled Catastrophic Care: How American Health Care Killed My Father--and How We Can Fix It written by David Goldhill. It's been a real eye-opener for me to find out how much our system is really costing and why we get so little in return.