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Kitzhaber's second try

By Dylan Matthews

While everyone is busy arguing over whether Republicans won bigger in the House because of health-care reform, arguably the most consequential race in the country for health issues has finally been called. John Kitzhaber (D), who was governor of Oregon from 1994 to 2002, has been elected to a third term in that office.

Kitzhaber, a former ER doctor, was best known during his previous terms as governor and during his time in the state senate for helping create the Oregon Health Plan (OHP), which was among the first state attempts to experiment with federal Medicaid money to provide broader care. Rather than set up a traditional Medicaid program, OHP aimed to provide fewer, higher-value services to more residents. The system worked well at first, cutting the uninsurance rate from 18 percent in 1992 to 11 percent in 1996, but then started to unravel when an expanded version was passed in Kitzhaber's last year in office.

Kitzhaber then spent the next few years touting this model, saying that national health reform shouldn't focus on insurance reforms but on providing a core package of benefits to as many people as possible. He was supportive of health-care reform in 2009 but has been clear this cycle that he doesn't think it goes far enough.

All of which is to say that I'd bet on Kitzhaber applying for a Waiver for State Innovation under health-care reform. He clearly thinks he can do better than the federal model, and the Affordable Care Act gives him the opportunity to take billions in federal money and craft the system he wants with it. Interestingly, the provision allowing state waivers was written by Oregon Sen. Ron Wyden (D), who might have had exactly this situation in mind.

Dylan Matthews is a student at Harvard and a researcher at The Washington Post.

By Dylan Matthews  | November 4, 2010; 12:00 PM ET
 
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Comments

All of this will be a moot point. ObamaCare will either be repealed or, more likely, gutted beyone belief.
At the very least, it will be defunded to where it's impossible to inplement.

Great academic argument, though...

Posted by: WrongfulDeath | November 4, 2010 1:29 PM | Report abuse

you'd think an ER doctor would know who was the driver of costs and how to contain them? Until doctors are seen by the general population as the businessmen and women that they are and not the kindly old doctor that made house calls years ago costs will never be in line.

Other countries realize it, its about time we did too.

Posted by: visionbrkr | November 4, 2010 1:48 PM | Report abuse

An ER doctor like Kitz certainly understands the dilemma of caring for the patient, while the corporation-(aka big money)-backed hospitals and the corporation (aka big money again)-insurance companies interfere for their investors' monetary gain. Kitzhaber is part of the solution and doctors, in general, are not part of the problem.

Posted by: BrazenHussy1 | November 4, 2010 8:51 PM | Report abuse

brazenhussy wrote:

"An ER doctor like Kitz certainly understands the dilemma of caring for the patient, while the corporation-(aka big money)-backed hospitals and the corporation (aka big money again)-insurance companies interfere for their investors' monetary gain"

How many of those jobs are you ready to eliminate? If we went to a single payer plan, governmnet run, what would happen to the tens probably hundreds of thousands of people potentially thrown out of work?

Posted by: 54465446 | November 4, 2010 9:05 PM | Report abuse

54465446 wrote:

"How many of those jobs are you ready to eliminate? If we went to a single payer plan, governmnet run, what would happen to the tens probably hundreds of thousands of people potentially thrown out of work? "

All of them. If private industry no longer had to face the expense of (ever-increasing) insurance premiums, they would have the ability to hire many more workers.

Posted by: karpis | November 4, 2010 10:22 PM | Report abuse

karpis:

I disagree, although thanks for replying. These would mainly be administrative personnel, office types. I believe during the recession large businesses have learned how to do without these type people and improved productivity. Let's hope we don't have to find out.

Posted by: 54465446 | November 4, 2010 11:30 PM | Report abuse

And the "strategy wonk" for the Oregon Health Authority -- the guy who is supposed to be creating a statewide strategy for government-financed health care -- is... Steve Novick, whom you might remember as the guy with the "left hook" and the memorable political ads -- the progressive who ran against Jeff Merkley in the Democratic primary for Senate in 2008. He's a clever and interesting guy.

I voted for Novick in the primary, and hope he is still able to make good use of those brains to help solve our enormous and urgent health care problems.

However, I must add that Merkley is now one of my favorite politicians ever.

Posted by: JulieInPDX | November 7, 2010 2:02 AM | Report abuse

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