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Right to Healthcare
In the last election, a majority of voters in Oregon chose to add a right to affordable healthcare to the state constitution, the first state in the nation to do so. It is short and simple:
SECTION 47. (1) It is the obligation of the state to ensure that every resident of Oregon has access to cost-effective, clinically appropriate and affordable health care as a fundamental right.
(2) The obligation of the state described in subsection (1) of this section must be balanced against the public interest in funding public schools and other essential public services, and any remedy arising from an action brought against the state to enforce the provisions of this section may not interfere with the balance described in this subsection.
It must have been written by trial lawyers. There will be endless litigation. There was already a movement in the state for statewide single-payer health care. This will inevitably lead to it. I predict it will cost the state untold billions of dollars. California can afford expensive, crazy stuff because they get so much money from Silicon Valley billionaires and millionaires. Oregon can’t. The tax burden will fall on the middle class.
I am a fifth-generation Oregonian and I love my state, but I can’t abide the direction it has taken. I stay only to be close to my family (generations six and seven). I can only hope that I die before healthcare goes totally in the toilet.
Published in Healthcare
Bypassing any quibbles about the detailed wording, two major problems with stating that a person has a fundamental right to receive something (such as healthcare or education or food or housing or clean water or whatever):
One is the moral problem RushBabe pointed out in comment #3, that empowers the person with the right to enslave someone to provide it (either the provider directly, or other people to pay the provider).
The other is the practical problem that either the person with the “fundamental right” has the right to unlimited amounts of the thing and at whatever level of quality the person chooses, or there has to be a mechanism to determine what the appropriate amount and quality of the “fundamental right” the person can claim. Which means someone has to decide. Who? On what criteria? In the case of medical care, this is where “death panels” and rationing and long wait times for diagnosis and/or treatment come in.
The potential good news on the practical problem is that many state constitutions already grant to every resident a right to a “sound basic education” and somehow they’ve managed for the most part to avoid too much rancor over that. So maybe Oregon can figure out the scope of what the proper scope of a “fundamental right” to healthcare is. On the other hand, medical care gets really expensive really quickly, and the major expense tends to be incurred by a relatively small portion of the population, so maybe it won’t be so easy to figure out.
I believe the first lawsuit has already been filed against the gun control measure. Several Oregon Sheriffs have already stated that they will not enforce portions of the law. The usual suspects are outraged at these Sheriffs, those that did not enforce the law in Portland during the 2020 Summer of Love come to mind.
The new law will have an impact on crime, just not the one I see. Look for carjackings, gang shootings, home invasion robberies, armed robberies, and homicides to skyrocket in Oregon.
As you say it is a subject for another post.
In my town the local community college’s nursing & medical technician school is so well-equipped that it technically can be repurposed into a (very small) functioning hospital in case of emergency. The only thing it doesn’t keep on site is the pharmaceuticals.
Hmm that might be possible in some places. The main ones I was thinking of in Phoenix were I think an older elementary school, and another place that had been a hospital but it was shut down because the company figured it could run a new building more efficiently. That doesn’t mean the older building was useless though, and the county or the state took it over – maybe the company gave it to them or sold it cheap – and they keep it available and in a state of some readiness. It doesn’t necessarily cost a lot to do that, if you’re not maintaining a full staff.
Another example was Maryvale Hospital. It had been owned by a few different corporations over time, I think the last was Cigna. When Cigna had newer facilities and didn’t want to keep Maryvale any more, rather than tearing it down the county or state turned most of it into a rehab facility for people with various injuries, and they kept open the ER that was on the bottom level. Which was important because otherwise the nearest ER for that area was several miles away.
And again(for the 1,000,006th time), if someone else is responsible to pay for your medical care, they also have to have the right to make all the decisions, medical and otherwise, in your life that might affect your health status.
Wanna go skiing, rock climbing? Sorry pal, too dangerous. Wanna eat whatever you want? Uh uh uh, calories! Obesity is expensive my friend . . . here, eat this. And whatever else we tell you. You like to drink beer? Hahahaha! Not a chance.
Hey, you decided that you were effectively still a child living with your parents when you demanded that the government supply you with your basic needs. The government are now your mommy and daddy. Now, go to bed!
When Minnesota tried to do this with a single payer system hilarity ensued. They came up with a document that created some committee that had dictator powers, violated the Minnesota constitution, I think probably the United States Constitution, and was literally not accountable to the legislature. They were going to control all of the capital, labor, and capital assets. It was a joke.
Recently they tried to revive something like this. I couldn’t believe it.
So-called positive rights are created at gunpoint.
Vermont literally passed single payer and I think it went down in flames in about 12 months.
You can’t do anything like this unless you lock people in a sovereign entity at gun point. You have to do it at the federal level.
There is so much evidence that this is idiocy at the state level and they keep trying it, apparently.
That’s because the left continues to believe that communism/socialism only fails because it’s not done BIG ENOUGH.
That and because of the “wreckers” etc.
Which is one big reason why the name “progessive” is such a bad joke.
The health care crisis that America has that America has and which was caused by progressive policies can only be fixed by more progressive policies.
The failure was programmed in. It’s a feature and not a bug. The political pitch when “critical mass” is reached will be that national single payer is the only answer.
That’s what I think. The GOP is being so irresponsible in dealing with it.
What is happening as far as the millionaires and billionaires in California supposedly supporting the state is this: Elon Musk has left the building and he and his enterprises are now in Texas.
The millionaires are often keeping a home or two here in Calif, but buying new places in Nevada where there is no state tax.
This group doesn’t actually move there – they are too busy going to the French Riviera for the Cannes film festival, Italian Alps for winter skiing, Tahiti just to cheer up etc.
The reports are that these huge multi million dollar homes in Nevada will sit empty as places that can serve as the official residences for Mr or Ms Big Bucks. They can’t be rented out, as if the houses are, then the Calif Tax Assessors might realize the Californians haven’t really moved there.
Some have formed RE companies that serve as The Nevada Company which front for the money exchanging hands from their old Calif homes, which now can be rented out or sold. (Rents on a modest 1.5 million dollar dwelling can range from $ 3500 to 6500, depending on location.)
We are bleeding out our tax revenues. Even normal middle class people get fed up. We pay 12% on everything except food and meds. This is an extremely regressive form of taxation.
By the way, the access to care that we have in Calif is wonderful if you are dirt poor, or have a disability putting you permanently on “MediCal” which is sort of MediCare for the indigent. (Except unlike MediCare Part B, you pay nothing.)
A normal person has to “guesstimate” how much they will make for the coming year. Then they are insured under The ACA “Affordable Care” umbrella. People of moderate means find it is too expensive to pay for anything but the plan with a huge deductible. People of better than moderate means might find all their “disposable” income will now go off to the Calif ObamaCare insurance policy, but at least their deductible is sensible.
This saves the individual from having that headache of deciding about what to do with the extra $2200 to 3600 they had gained by finally getting into management. (These amounts exclude rent, utilities, car payments car ins – just purely fun monies or for the kids’ college fund. But those monies now belong to Big Insurers.)
Plus if you guesstimate badly, you now owe a penalty!
Before I was eligible for MediCare, the only way I could have afforded a decent ACA policy was if I worked an extra 15 to 20 hours a week. But then that would have nudged me into a higher income bracket so I would have had to pay for the health insurance at an increased rate. (!!!)
Plus if you inadvertently make more money that you initially stated, there is a significant penalty.
But it was sold as “Single Payer” without any “Buyer Beware” precautions mentioned.
#44 is excellent analysis.
Our politicians, be they of the “D” brand or “R” brand, quickly learn that once inside the Beltway, their first responsibility is to their donors.
And most Congress critters receive donations from Big Insurers and Big Pharma.
On top of that, with the SuperPac situation such that a vast majority of donated monies now comes to the candidates from non-identifiable entities, unless we somehow figure our way out of the SCOTUS Citizens United decision, the citizenry now has only the smallest of voices reaching those we elect.
Ask the IRS.
This reads more like giving the state unlimited control of access to healthcare, not ensuring it’s available.
I’d ask this: What current resident of Oregon is prevented from accessing healthcare? Any remedy should only apply to a situation where access has been removed.
Which doesn’t exist. Because anyone can see a doctor, in some way, shape, or form.
It’s basically to ensure hospitals aren’t expanding beyond what’s historically assumed to be needed. It can also be used to approve capital projects at hospitals, like building a new wing with more modern equipment (including basics like HVAC, data, etc).
Hospitals turn a buck when their beds are full to some determined amount, like in the 90% range, on average. This will vary by cost center, or department, meaning a surgical “bed” generates a lot more revenue than just a generic bed that gets consumed by someone who stubbed a toe.
When complaints about hospital overheads arise, think about how much financial and regulatory work is involved simply in the filing of a CON. Which gets reviewed by “experts” at the state level, then voted on/approved (I’m assuming via different apparatus by state).
https://en.wikipedia.org/wiki/Certificate_of_need
An example of a state waiving the CON requirement for pandemic needs.
https://gmcboard.vermont.gov/sites/gmcb/files/CON/Certificate%20of%20Need%20Bulletin%20003.pdf#:~:text=Mountain%20Care%20Board%20%28GMCB%29%20approved%20Certificate%20of%20Need,of%20new%20health%20care%20projects%20related%20to%20COVID-19.
One of many reasons I left VT.
There is no single-payer. Not with Medicare and Medicaid, a slew of private insurance companies, military insurance, you name it. Which is why they’re moving to a “value-based” model, not fee for service. This is just another way to try to wrap insurers into a warm, loving, state-controlled blanket of allocated health care spending for you, in your best interest, as determined by 5 loads sitting at a desk somewhere in Montpelier.
https://gmcboard.vermont.gov/content/APM/AboutTheAPM
This is a massive disaster. It creates insane incentives for individuals, all negative ones (earn less money to stay in an insurance plan).
Accurate. Their incentives are not ours, the citizens, they are not the same. It honestly doesn’t matter the D or the R, it is a self-serving leviathan. The public interest is no longer being served.
And can someone be compelled to receive “health care”?
We have botched this thing so, so badly.
Cost effective means you’ll get the needle once an assessment team decides the expense of your care exceeds your value to the public.
Brown v. Board of Education
Oberfell
Or the State could say it meets the requirement by offering subsidized tele-health provided by physicians located in India.
Certificates of need came in to being after the advent of Medicare. The reason was that Medicare had no financial controls: Any bill that was submitted was paid, no questions asked. Medical cost inflation tripled and there was a massive expansion in the number of hospitals, clinics, imaging centers, medical schools. It was the golden financial age of Medicine. Because everyone and their brother wanted to build a hospital and get in on the action, which was like having direct access to an ATM with unlimited funds. So ironically the State interest in providing medical care led to limitation of access. But the advent of Medicare was due to the prior existence of employer provided health insurance that been driving up medical costs for 37 years and had priced the elderly, disabled, retired, eg those that did not have employer provided insurance, out of the market.
I would that Oregon would require all doctors to accept Medicaid under the threat of loss of licensure if the State has not already done so, then expand Medicaid and mandate Medicaid rates for all. Or something of the sort. Then of course single payer only.
Obamacare and Arizona’s Legendary Maverick.
There is nothing in this life that makes me more insane than that and everything around it.
No thinking ahead even though they had eight years + three months + another 365 days if they weren’t ready. It’s just vile behavior. Vile abuse of power. Good God why can’t you guys help Trump put a stake in this thing.