Access problems to health care for Oregon Health Plan clients might be less about the plan than other factors, a Brookings doctor told legislators and state officials this week.
I think it is time to stop apologizing for our plan and Oregons attempt at equitable health care for all, Dr. Larry Witt said. There are some other insurance programs that are at the bottom of the barrel.
Witt has been working with State Rep. Wayne Krieger, R-Gold Beach, and state health plan officials to review access problems.
Based on reviews, Witt said there is little difference in reimbursement to providers, either between Portland and rural areas, or between Oregon Health Plan and private insurance companies. The presumption of differences has been blamed for health care providers not accepting new state plan patients in the Brookings area.
I was surprised to find out that OHP in Curry County pays more than the insurance that the Pelican Bay prison guards have really! Witt said in a letter to Krieger and State Sen. Ken Messerle, R-Coos Bay. He said reimbursement is also better than CHAMPUS for federal retirees.
If I were in charge, I would put some of those other insurance programs on the spot, Witt wrote.
As for differences between Portland and rural areas, Witt said statistics skew the reports. Metropolitan providers tend to have managed care reimbursement, which rural providers are paid fee for service. In the rural areas, more is spent by the state on helping patients get to care, including babysitting, taxi fees and motel rooms when they must travel out of the area.
Actually, I do not have a large complaint with OHP, now that I have examined the entire health care picture, Witt said.
He blames access problems on providers refusing to care for some types of state plan clients.
They dont want to take care of the disabled, retarded, drunks on OHP, he wrote. They use the lack of dollars to cover discrimination and bigotry.
Messerle said he would use Witts assessment to argue solutions with lobbyists for the insurance companies and health care providers.
How are we going to solve the problem? Messerle said he asked five insurance company lobbyists at a gathering this week. Do you want the legislature to solve it, or are you as an industry going to do it?
A proposal he wants to review, Messerle said, would require insurance companies to offer coverage statewide, rather than choosing areas of coverage. One firm, he said, told him they would be cutting off coverage in Curry County soon.
Krieger and Messerle participate in a weekly telephone conference call with Brookings area leaders, hosted by the Curry Coastal Pilot.
In other topics this week, Brookings officials expressed concern about a proposed statewide motel/hotel room tax, which would also limit local room taxes. This would directly affect the ability of areas to raise funds to promote their own attractions, said Les Cohen, executive director of the Brookings-Harbor Chamber of Commerce.
Krieger and Messerle both said they will oppose HB 2680, proposed by the telecommunications industry to limit local governments involvement in providing such services. Messerle noted it was local governments that often spread electricity and phone service to rural areas.
Both legislators expressed continuing concern about state revenues for programs. The most current projections have dropped $113 million since the legislative session opened.
Were going to held off on school funding, health and public safety funding until after the May projections, Messerle said. but were expecting May to be down as well.