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Kitzhaber wants his reforms to continue

PORTLAND TRIBUNE: JAIME VALDEZ - Former Gov. John Kitzhaber spoke Monday at a panel on health care reform, continuing his emergence into public life despite an ongoing federal criminal investigation.In his most prominent public appearance since he resigned from office, former Gov. John Kitzhaber said Monday that Oregon should expand the health care reforms he started.

Kitzhaber resigned in February 2015 while he was the subject of a federal criminal probe. The investigation focused on his partner Cylvia Hayes’ role as a top adviser in his office while accepting outside payments from advocacy groups seeking to influence state policy.

Nearly 18 months after the federal probe went public, no charges have been filed. And on a sunny afternoon in Portland, Kitzhaber continued his reentry into public life by speaking on a health care reform panel before hundreds of people at First Congregational Church in downtown Portland.

Kitzhaber drew frequent applause, including when Don Berwick, former top administrator for the federal Center for Medicare and Medicaid Services, called him a longtime friend and mentor.

“He’s done a lot for America,” Berwick said.

Cautioned to keep to the topic at hand, questioners did not ask about the legal cloud that led to Kitzhaber’s departure. Nor did they highlight the warts on his own health care record as governor — such as the $300 million Cover Oregon debacle that Kitzhaber has admitted was partly due to his administration’s mismanagement.

The talk was called “Healthcare in the U.S. — Are we ready for more reform?” and was organized by advocates for universal health care working with the City Club of Portland.

Other speakers included Alisha Moreland-Capuia, executive director of the Avel Gordly Center for Healing at OHSU; and Dr. Paul Gorman, an OHSU professor who served as moderator.

Kitzhaber’s fellow panelists, and some audience members, indicated Oregon should pursue a waste-cutting, universal health care program similar to those in place in Europe or Canada, though they didn’t get into specifics.

Kitzhaber, for the most part, advocated for the state to continue on the path he’d been charting until he left. His remarks relied on much of the same technocratic health care jargon he was known for as governor.

“We need a publicly financed (minimum health care) floor and a defined set of effective health services,” he said, adding that the idea is similar to that of public education. “Every child regardless of income gets a public education. You can argue whether it’s a good education or not, but everyone is covered. And parents who want to give their kids more can use their after-tax dollars to get a tutor or (pay for) private school.”

Kitzhaber hammered on the theme of extending the reach of the coordinated care organizations (CCOs) that were the centerpiece of his Oregon Health Plan reforms of 2011 and 2012 — the same agenda he had as governor.

The CCOs are essentially beefed-up HMO-like managed care organizations, deputized to ration services in order to meet a defined budget while focusing on prevention.

Kitzhaber said that Oregon should “prove out” the reforms and show private-sector employers they could save money by using a similar model. Oregon should do so by mandating that state employees and teachers join the CCOs, then offer the resulting insurance product on the market.

Kitzhaber called the profits in the pharmaceutical industry “obscene.” Asked if competition in health care is healthy, Kitzhaber criticized the proliferation of urgent-care clinics in the Portland area as an example of the waste in health care. “It’s about competing for market share ... I think we are competing for the wrong things.”

Berwick, the former federal official, ran for governor in Massachussetts in 2013, and later in the campaign came out for a single-payer, or “Medicare for all,” national health program.

Though Berwick wasn’t elected, he said he still thinks that “there should be some states that try single-payer out ... It would be far more efficient administratively ... I’d really like to see that somewhere. How about here?”

State Sen. Michael Dembrow, who watched the talk, said afterward he found it heartening. He hopes to introduce legislation after a state study examining possible reforms is completed in December.

Kitzhaber has become more public of late. In March he released a video on Facebook and, in an interview with Oregon Public Broadcasting, expressed confidence the federal probe would clear him. On Facebook, he admitted to having had “second thoughts” about his resignation.

He told OPB reentering public life is part of his plan to become a consultant, saying, “If you’re going to do some consulting, people need to know you’re alive and well.”

By Nick Budnick
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