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Health care plan: Is Oregon a model for Minnesota?
by Tom Scheck, Minnesota Public Radio
April 4, 2003

Sen. Linda Berglin says she didn't know how much the state would save by enacting the Oregon program. (MPR Photo/Tom Scheck)

The Senate Health and Human Services Policy Committee approved a bill on Friday that would dramatically change how the state provides health coverage to lower income Minnesotans. On a 4-2 vote, the committee approved a portion of the Senate health and human service budget proposal that would reduce services available rather than limit eligibility for state coverage. The bill is modelled after a program in Oregon.

St. Paul, Minn. — Sen. Linda Berglin says she's concerned that Gov. Pawlenty's health and human services budget proposal would cut health insurance for 68,000 Minnesotans by 2007. Pawlenty says the state's health care costs are increasing dramatically and need to be scaled back to help balance the state's $4.2 billion deficit. Berglin says her bill wouldn't cut anyone from coverage, but would provide a limited amount of coverage for an unspecified number of Minnesotans.

"We're looking at best practices and we're finding that some of the health care services that are provided are not particularly cost effective so we're saying we think eliminating those services should be the first thing that we should do in order to reduce our costs," she said.

	Too much change, too soon

Berglin says she didn't know how much the state would save by enacting the program. Last month she said it could save between $50 and $100 million over the next two years. That's when she brought in representatives from Oregon to talk about their experience with such a system.

Bob DiPrete, the director of the Oregon Health Council, says the Oregon model has a list of over 650 procedures and ailments that the state will cover. For example, Oregon covers prenatal care but won't pay for treatment for the common cold. He says Oregon adopted the program to address rising health care costs.

"We would not come to you and say this is some kind of magic bullet. We do believe, however, that this is a tool in a toolkit that can be useful in constructing public policies that have a better impact on the health of the population you're trying to serve than other options," DiPrete said.

erglin has listed 214 effective treatments in her bill.

Critics say the program isn't worthwhile. Sen. Brian LeClair, R-Woodbury, says he supports Gov. Pawlenty's budget proposal even though it cuts health insurance to thousands of people. He says the Oregon model is problematic because it rations health care so that enrollees won't get the kind of full coverage available to other Minnesotans. LeClair, who's also a health insurance executive, says lawmakers should pass Pawlenty's proposal and then work to fix the problems in the private health care market.

	Not a fan of the Oregon model

"We've got a good model here in the state of Minnesota where we provide a full safety net. A full range of benefits and services for those people that are on the lowest end of the ladder. And we acknowledge that those people who are higher up on the income ladder have to look for other solutions other than relying on state government," LeClair said.

Michael Garland, professor emeritus of health care policy at Oregon Health Sciences University in Portland, says the Oregon model is providing the necessary services for enrollees. He says the program provides enough coverage for over 100,000 people. He also says the state saved millions since enacted in 1994.

"It gives them access to the most useful kinds of health care. And for those who are eligible, it serves them very well. They have a very good health benefit plan that's suited to the needs of people who are of very low income and are struggling at the economic level," Garland said.

Garland says the program has experienced some problems. He says Oregon expanded coverage in the late '90s, which added to the state's budget deficit. He says several lawmakers want to scrap the program to save money. The state would then offer traditional services to the poor.

Sen. Sheila Kiscaden, I-Rochester, says she doesn't know if she supports or opposes the bill that would adopt Oregon's program. But she says there are enough outstanding questions that the state shouldn't rush to adopt such a major health care reform.

"Why should we approve major policy changes without any witnesses, without any information, without any advanced notice? There may be good ideas in there, but we don't do a wholesale in our policy direction without debate," Kiscaden said.

House Republicans say they support most of Gov. Pawlenty's budget proposal.

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