Oregon can pave the way for a single-payer system

Patient-centered, high-quality health care accessible to all is a realistic vision, says Dr. Paul Gorman

By Paul Gorman, M.D.
Portland (Ore.) Business Journal, Sept. 15, 2016

Every person in Oregon should have access to quality health care when they need it. We can achieve this vision without compromising on the quality of care, crippling the economy, or excluding hundreds of thousands of people from receiving care until it becomes an emergency.

The solution is a single payer health care system.

Working as an Oregon physician for over 30 years, in small town primary care and big city academic medical centers, I have become convinced that this is the only way to achieve the health care system we need and deserve.

Imagine a future in which our children and their children receive care in a system that ensures access, choice, patient-centeredness, accountability and affordability.

Access means universal access, cradle to grave. If you are in school, want to start a small business, or are laid off — no matter what happens — you and your family can get the health care you need. Choice means free choice — you choose any doctor or hospital, not just those in the company plan. All of them are included in the plan because there is one plan for everyone.

Patient-centered means that you and your doctors make decisions together, based on your situation and values, not based on bewildering rules in hundreds of different insurance plans. There’s just one set of rules for everyone, so your doctor can spend time caring for you instead of filling out paperwork.

Accountable means that decisions about health care coverage and costs are made by a publicly accountable group, guaranteeing citizen input, ensuring that the plan covers services that are evidence-based and cost-effective.

Affordable means affordable. None of us should go bankrupt because of medical costs: not patients, not businesses, not governments. None of us should have to do without needed care because of copayment and deductible schemes meant to reduce our access to services and ensure company profits. We should not all be one serious illness away from bankruptcy and ruin.

What we’re talking about here is simple: publicly funded, privately delivered, affordable and accountable health care for everyone in Oregon. We all chip in on the cost and we all have a say in the coverage.

Some will say that this vision is not realistic, that to call for health care for everyone in our country is to appear ridiculous.

Of course, we’ve heard this before. Elizabeth Cady Stanton heard it at Seneca Falls in 1848, when she insisted on demanding voting rights for women: “Why Lizzie, thee will make us ridiculous,” she was told.

We hear this argument whenever the status quo is threatened by the movements for equity and social justice. But we know better.

Every person in America should have access to quality health care when they need it. Oregon can lead the way.

Dr. Paul Gorman is a member of Physicians for a National Health Program and a professor of Medical Informatics and Clinical Epidemiology at Oregon Health & Science University. The views expressed here are his own.

Reprinted with permission.