Gov. John Kitzhaber is correct that Oregon faces an imminent health care implosion and correct to note the “growing disparity between unlimited demand and the reality of finite resources,” (“Oregon is ambling toward a health care implosion,” Jan. 25). But it is odd that he seems to blame, among other things, a lack of bipartisanship for such a state of affairs. The current political leadership in Salem has the power to improve the outlook for the health care delivery system (those finite resources) right now. It could repeal Oregon Health Authority rules that expensively constrain hospitals and doctors in mergers and acquisitions, in private equity capitalization and in fees. The state could enact reasonable laws to limit malpractice payouts and reduce defensive medicine. It could end “certificate of need” rules that discourage much needed hospital building. It could ease licensing reciprocity restrictions that make Oregon one of the hardest states into which to import doctors.
If those changes are not made now, we will see an increasing withdrawal of health care related capital to other states. We are small and relatively poor. If it becomes too hard to do business here, people simply won’t bother.
Dr. Kitzhaber quotes Hemingway’s famous aphorism about bankruptcy. But I don’t think anything will be sudden. It will be a slow and accelerating decline. If I may paraphrase T.S. Eliot: This is the way health care ends in Oregon … not with a bang but a whimper.
Harry Bray, Portland
Bray, a physician specializing in gastroenterology, has practiced medicine in the Portland area for more than 25 years. He previously served on the board of directors for The Oregon Clinic.