After several months of delay, the Oregon Health Authority has released an RFP for the study of single payer and other universal healthcare financing systems. With a November deadline for a report to the Legislature, researchers could have a steep deadline.
By Chris Gray
The Lund Report (Portland, Ore.), March 18, 2016
The Oregon Health Authority has finally released a request for proposal to analyze the financing of healthcare in Oregon and provide for a possible state-based universal healthcare system, such as single payer.
Researchers interested in bidding on the project have until April 14. On April 29, the state expects to award the contract, for which the Legislature budgeted $300,000 last July.
The health economists will have a tight timeline to complete the study; a report is intended to be filed with the healthcare committees in November so the Legislature could take action in February.
Dr. Sam Metz, an anesthesiologist and healthcare activist with Physicians for a National Health Program, worries the project will be rushed, since he had believed the study could take 12 to 18 months in order to do a thorough job.
“A complete study, however late, is better than an incomplete study on time,” Metz said. If he’s wrong about the needed timeline, he’s hopeful the state allows the results to be delayed until later in 2017.
The Oregon Health Authority is about four months late in releasing the proposal, a situation that made healthcare activists speculate that the state was balking at touching a study that could prove the value of single-payer healthcare, but the movement’s champion, Sen. Michael Dembrow, D-Portland, ensured The Lund Report that was not the case.
Dembrow said the delays came because of Director Lynn Saxton has been in the process of overhauling the state agency, which resulted in less than adequate staffing the past few months.
“OHA acknowledges the unwanted delay in releasing the RFP. In the winter of 2015, the office leading this important work experienced unexpected staffing constraints due to turnover, which impacted the writing of the RFP. The result was a delay in issuing the RFP by several months. We do apologize, but we do intend to report to the Legislature on the completed project in November,” legislative coordinator Sarah Lochner wrote in an email to the office of Rep. Barbara Smith Warner, D-Portland.
The contract calls for researchers to look specifically at four healthcare concepts: single payer, where the government would provide a program for everyone through taxes; a commercial insurance product for all with the essential health benefits of the Affordable Care Act; adding a public option and basic health plan insurance products to the federal exchange for Oregon; and the default, the current system under the Affordable Care Act.
The researchers must look at both costs and savings. They’ll also have to identify a funding mechanism for the first option, a missing component that has stalled a single-payer system in Oregon.
This could be particularly tricky in Oregon since the state has long rejected a sales tax, and additional payroll or income taxes would come on top of the state’s already very high personal income taxes. But Metz said an economist had already sent an idea to Health Care for All Oregon that would provide adequate funding by relying on a capital gains tax.
Besides a complete overhaul, the study could show the path to smaller improvements, such as opening up a public option or coordinated care to more people, which might be accomplished with waivers from the federal government.
“If everything goes well in the procurement from now on the contractor will have five months to complete a very complicated task,” said Rep. Mitch Greenlick, D-Portland. “I will be delighted if anything useful comes out of the study.”