By 2033, the Oregon Legislature is poised to declare, we will live in a state where, among other things:<\/p>\n
House Concurrent Resolution 202<\/a> heralds Oregon\u2019s achievements\u2014for example, the state\u2019s high health insurance rate\u2014while describing a grim state of affairs: for example, skyrocketing health costs. It sets some central goals that describe what transcending those circumstances would look like. <\/p>\n \u201cThis is just more useless legislation,\u201d wrote a Bend man in opposition, noting, not inaccurately, that the resolution doesn\u2019t technically do anything at all. <\/p>\n But mostly all are on board with a concept that former Gov. John Kitzhaber and his health care sustainability work group drafted as a kind of lodestar for policymakers and other leaders as they steer Oregon\u2019s health care system through one of the most uncertain periods in memory. <\/p>\n \u201cI\u2019m reminded of one of my favorite passages from Ernest Hemingway\u2019s novel The Sun Also Rises, where Bill Gordon is asking Mike Campbell how he went bankrupt, and Mike says, \u2018Two ways, gradually, then suddenly,\u2019\u201d Kitzhaber told lawmakers recently. \u201cThat\u2019s our health care system. We\u2019re past the gradual part, and things are about to get sudden.\u201d<\/p>\n Betsy Boyd-Flynn, executive director of the Oregon Academy of Family Medicine, tells WW the health system has been in \u201creaction mode\u201d for some time now, and that the budget pressure will only grow in the coming years. Thus, she sees the resolution as a genuinely useful document. <\/p>\n \u201cIf we can articulate a shared vision, a shared goal\u2014that this is what we want our health care system to look like, this is what we\u2019re shooting for\u2014then we can evaluate all the difficult choices we\u2019ve got between now and then against that goal,\u201d she says.<\/p>\n She adds, \u201cWe\u2019re going to have to undo some stuff and it\u2019s going to be really painful,\u201d but a clear sense of purpose will make this effort more tolerable.<\/p>\n As she noted in testimony to lawmakers, Boyd-Flynn experienced the effects of a straining health system personally when her longtime Northeast Portland family medicine clinic announced<\/a> in recent weeks it would close. <\/p>\n With news like this trickling out, concerns that Oregonians could be losing access to health care only grow. <\/p>\n Only a few days ago, Providence Medical Group restricted<\/a> parts of its network to members of the largest Medicaid plan in the Portland area. The state\u2019s largest employer\u2014its parent organization, Providence Oregon\u2014has lately announced multiple rounds of layoffs<\/a>, posted massive financial losses<\/a>, and shuttered<\/a> several medical facilities.<\/p>\n Providence Oregon CEO Jennifer Burrows is one of the many system leaders who have been taking part in Kitzhaber\u2019s health care sustainability committee. Asked in a phone interview with WW where her system feels the most acute strain, she pointed to changing revenue streams. Government insurance programs pay less than commercial ones, and \u201cas more people have aged onto Medicare, we\u2019ve not found ways to live within the rate that Medicare gives us as health care organizations,\u201d she said. <\/p>\n