The conversation around Oregon's health care system is reaching a critical point, and the implications are alarming. Governor John Kitzhaber rightly identifies the impending crisis in health care, highlighting the stark contrast between an insatiable demand for services and the harsh reality of limited resources. However, it is perplexing that he attributes part of this predicament to a supposed lack of bipartisanship in the political arena.
The reality is that the current leaders in Salem possess the authority to make immediate improvements to our health care delivery framework—those very finite resources that are at risk. For instance, they could choose to revoke certain regulations imposed by the Oregon Health Authority that burden hospitals and physicians during mergers and acquisitions, as well as in their dealings with private equity and setting fees. There is also an opportunity to introduce sensible legislation aimed at capping malpractice claims, which would help mitigate the practice of defensive medicine that drives up costs unnecessarily. Additionally, dismantling the outdated "certificate of need" laws would facilitate the construction of essential new hospitals, while relaxing restrictive licensing reciprocity laws could significantly ease the process for attracting new doctors to the state.
If we fail to implement these crucial reforms promptly, we risk witnessing a gradual but steady exodus of health care investments to neighboring states. Oregon is relatively small and economically challenged; if operating a business here becomes excessively cumbersome, potential investors will simply walk away.
In his remarks, Dr. Kitzhaber references Ernest Hemingway's well-known quote about bankruptcy. Yet, I believe the decline we face won't be abrupt; rather, it will unfold slowly and with increasing urgency. To paraphrase T.S. Eliot, the fate of health care in Oregon may conclude not with a dramatic finale but with a quiet resignation.
Harry Bray, a practicing gastroenterologist in Portland for over 25 years, has previously held a position on the board of directors for The Oregon Clinic.
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