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OHSU and the American Health Care Act

Joe Robertson, M.D., M.B.A.
Joe Robertson, M.D., M.B.A.

As Oregon’s academic health center, OHSU provides leadership in health policy when the health and well-being of Oregonians are at stake. As a public institution and a statewide resource, we strive to be thoughtful and constructive in how we do this. We work hard to find solutions. It is therefore disappointing to have to oppose a piece of federal legislation, but the American Health Care Act leaves us no choice. We do not take this step lightly. We will not be partisan, but we won’t be silent, either – not when there are risks for our mission and the health of the communities we serve.

Under the American Health Care Act, hundreds of thousands of Oregonians who have health care coverage today will lose that coverage. If this bill were to become law, it would reverse progress made over the last four years to expand access to preventive care and increase the pool of insured with the goal of improving the overall health of Oregonians and managing costs.

The Affordable Care Act (ACA) has worked to great effect covering many millions of Americans, a critical factor for improved health. But the ACA is not perfect. The insurance exchange, while improving access, has not proven to be as affordable or comprehensive as originally conceived. As a major system change, however, it is still early in the life cycle of the ACA – or it should be. One of the most important lessons of the ACA is that change is hard. It may not be politically realistic but I believe we need a longer period of implementation and observation of the ACA, and likely some additional modification and refinement – such as in the insurance exchange – before we contemplate another significant shift.

Good health care policy takes time and deliberation. No one knows that better than Oregonians who have labored thoughtfully over many years to create first the innovative Oregon Health Plan (OHP) and now Health Care Transformation. The OHP pioneered the prioritized list and remains a landmark achievement in health care policy. Under Transformation, coordinated care organizations have improved health outcomes for the people they serve, and they have done so while cutting the rate at which Medicaid costs are growing.

Oregonians have tremendous history, expertise and resources to bring to bear in the debate happening in Washington, D.C., right now – but only if there is time for a conversation about these issues rather than a headlong dash to the finish line. The process is moving with a velocity that does not allow for a thorough exploration of unresolved issues in health care policy. These are tremendously complex matters with huge implications for our country. What’s the rush?

Joe Robertson, M.D., M.B.A., President, Oregon Health & Science University. 



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