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City cant tackle kids health care

A local physician's attempt to provide all children in Portland Public Schools with at least minimal health insurance is a noble idea loaded with impracticalities.

The loosely defined health-insurance plan advanced over the past several months by Dr. Gregg Coodley raises numerous questions. And it would come with almost-certain drawbacks. But Coodley has managed, through a combination of hard work and accidental political brilliance (as outlined in today's Portland Tribune), to put the Portland City Council in a position where it must seriously entertain some semblance of Coodley's proposal.

We are not sure what Mayor-elect Sam Adams had in mind when he recently committed to study and implement a health insurance plan by September 2009. But we can say for certain that the Portland City Council ought to think hard - very hard - before creating a locally funded health insurance entitlement for every child in Portland.

Good intentions could go awry

Our skepticism about Coodley's proposal has absolutely nothing to do with the good doctor's motives. Coodley is trying to address a real moral issue - that of uninsured children who lack access to regular health care.

We strongly agree that health care for children is a matter of crucial importance, but we don't see how the city can fashion an equitable, efficient and consistently funded program to advance that cause.

Even Coodley's nascent ideas for such a program begin to reveal the complexities that would arise. His original proposal, contained in an initiative petition that he submitted before cutting the recent deal with Adams, called for the city to fund health care for students within Portland Public Schools. But it should go without saying that whatever benefits the city of Portland bestows upon its residents must be made equally available to all.

So if students in Portland Public Schools were to receive a minimal health care program, what about students in the city's other school districts, including David Douglas, Parkrose, Centennial and Reynolds?

Along the same lines, Coodley had suggested that such a health care program would motivate families to move into the Portland district, and thereby reverse recent declines in enrollment. More students would mean more money from the state, and Coodley saw that additional revenue as a way to pay for the health insurance.

One problem: the state determines how its money for basic school support will be spent, and it could object to providing benefits in one district - Portland - that cannot be extended to every student in the state. Another problem: the aforementioned East Portland school districts aren't experiencing declining enrollment. Quite the opposite, they are being flooded with the low-income families that Coodley is understandably trying to assist.

Other governments have responsibility

After considering these complications, it's clear that the issue of children's health care - even when defined in local terms - is too large for the city of Portland to handle alone. The real obligation to protect children's health rests with the state and federal governments. The 2009 Oregon Legislature and Gov. Ted Kulongoski can do their part by reviving and fully funding the Healthy Kids Plan, which fell victim last year to voter rejection of increased tobacco taxes.

But if Adams is serious about taking action locally on this issue, he must do it hand in hand with county government. The county already provides health care through its clinics, school-based and otherwise. If the city of Portland has money to spare for health care, it ought to use it where it would be most effective. And that would require a partnership with Multnomah County, which likely would welcome any additional health care funding the city is able to offer.