Oregon Editorial Rdp

Editorials from Oregon newspapers

The Mail Tribune, May 13, on a new approach bringing health care to the poor:

Oregon has long been a leader in many arenas public beaches, land-use planning, the bottle bill and now, thanks to the hard work of state Sen. Alan Bates, D-Medford, Gov. John Kitzhaber and many others, the state is poised to lead the way on controlling government health care costs.

Kitzhaber made a special trip to Washington, D.C., in the first week of May to pitch a proposal to the Obama administration. He returned with a federal commitment to spend $1.9 billion over the next five years to help Oregon create a new system for administering Medicaid.

If the system works as intended, it will save the federal government and taxpayers $11 billion in the next decade, while improving the quality of care delivered to low-income Oregonians.

How?

Before explaining what the new system is, it's important to understand what it is not. It is not a health care system for everyone. It is a rethinking of Medicaid the federal program that provides medical coverage to the poor. The 600,000 people served by the new system are the same group now covered by the Oregon Health Plan.

The impetus for the new structure was the impending collapse of the old system. Oregon was at least $650 million short of fully funding Medicaid in its two-year budget. The deal with the administration provides an initial infusion of $620 million, which will prevent the catastrophic cuts other states are making in their Medicaid programs.

In return, Oregon has promised to reduce costs by 2 percent in the first two years. As Kitzhaber told The Oregonian, "... at the end of two years if we haven't made that reduction then we don't get any more money."

State leaders are confident they can deliver on that promise.

The system will fund a network of regional Coordinated Care Organizations made up of hospitals, independent physician groups and state agencies. The CCOs will focus especially on patients with chronic health conditions such as diabetes as well as those suffering from mental illness and substance-abuse problems. Some patients are in all three categories.

The current system doesn't cross-reference the various treatment programs, so a mentally ill patient may go to the emergency room for a medical complaint that is actually a result of mental illness, but the ER doctor does not know that. Making those connections should reduce the unnecessary use of costly emergency room care. That's just one example.

Chronically ill clients of the CCOs also will be assigned caseworkers who will help them make appointments and make sure they take medications as directed, again holding down costs.

This is an experiment for the state and for federal officials, but as Bates explained to us, Oregon has tried out this approach in pilot projects. One project in the Bend area saved $600,000 in its first six months by focusing on about 50 patients who were responsible for the bulk of Medicaid expenses.

Federal officials estimate that, if Oregon's approach works and is implemented nationwide, it could save $1.5 trillion.

The first CCOs should begin operating Aug. 1. The administration and other states will be watching closely.

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Ashland Daily Tidings, May 10, on the state's medical marijuana law:

The latest developments in the operation of an Ashland cafe that caters to medical marijuana users underscores the need to clarify Oregon's law regarding medicinal use of pot.

The cafe, Earth Dragon Edibles Restaurant & Lounge, caused a stir and drew nationwide attention when its owner, Michael Shea, announced that it planned to serve marijuana-laced meals to customers who hold medical marijuana cards.

Those plans were quickly derailed by the city, with first Police Chief Terry Holderness and then City Attorney Dave Lohman expressing doubts about the legality of the meal plans. Ultimately, the city declined to give the cafe a business license if it intended to follow through with the pot-infused cuisine.

The restaurant backed off those plans and now says medical marijuana patients can bring their own marijuana to the business and sprinkle it on their food. The restaurant, which briefly closed Monday in part to move drug paraphernalia, also will offer to infuse customers' marijuana into oils used in preparing the meals.

That mollified the city, which has now provided Earth Dragon Edibles with the necessary business license. But Lohman said it's not entirely clear whether the operation meets state law for instance, the law forbids cardholders from consuming the drug in a public place, but does a private restaurant open to the public qualify as a public place?

It also seems unlikely that giving marijuana to a restaurant cook to "infuse" into oil to be used on food meets the requirements of the state law. The law stipulates that only licensed growers, primary caregivers and the cardholders themselves are exempt from laws making possession and distribution of marijuana illegal. So, unless the cook is a cardholder or has been designated as a primary caregiver, it's hard to imagine how he or she would qualify to handle the marijuana.

None of this means that use of medical marijuana in a restaurant setting is a bad thing. But it is more evidence that the law as written falls woefully short of addressing the many questions that accompany the legal use of marijuana in Oregon.

Trying to resolve the discrepancies and unanswered questions in the law seems to immediately provoke a defensive response from anyone with an interest in it. Proponents of medical marijuana howl to high heaven when anyone suggests the existing law should be rewritten for clarity or to curb abuse. Opponents are just as suspicious about any changes, such as the voter-defeated proposal to create state-license dispensaries, fearing it's one step closer to legalization.

We think supporters of medical marijuana are at greater risk of losing the ground they've gained if they don't allow for some common-sense adjustments to the law.

Real medical standards should be applied; anyone who is even remotely neutral on this topic knows that the system has been abused. A wide variety of unanswered questions need to be answered for instance, whether a restaurant is a public or private place.

Even suggesting this raises proponents' hackles. But they should realize that if the law isn't fixed, they could lose it entirely.

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The Oregonian, May 14 on the state historical society:

Thomas Jefferson now gazes from a corner of the Oregon Historical Society's entrance hall. He's part of a lively exhibit of kites inspired by Lewis and Clark.

Not too long ago, the historical society itself seemed buffeted by high winds. Its considerably stronger position now, its reinforced status as one of the ornaments of Oregon and of downtown Portland, owes a great deal to the stewardship of Jerry Hudson, who stepped down Saturday as president of the OHS board of trustees.

At the beginning of 2010, the historical society seemed in desperate circumstances, deeply in debt, staggering to a point where its Park Blocks real estate seemed its main negotiable asset. Hudson, former president of Willamette University, negotiated a Multnomah County levy with county chair Jeff Cogen. Enacted by voters, it not only created a vital revenue stream, it provided free admission to Multnomah County residents, binding the society more closely to its nearest constituency.

Hudson recruited Kerry Tymchuk, former Sen. Gordon Smith's state director, to become executive director, and together they persuaded the 2011 Legislature to grant the society $2.5 million to pay off the mortgage on its Gresham warehouse. Considering that the warehouse is storing a lot of the state's old stuff, it made some sense, as well as stabilizing the society.

Now, the OHS ledgers look better (Jefferson would approve). Attendance is up 29 percent, the library is again open daily, and it has drawn wider philanthropic support, including $2 million from the Fred Fields will. In January and February 2011, the society offered four programs; this year, the total was 24.

The historical society, which should be valued like Oregon's history itself, is in dramatically better condition than when Jerry Hudson took on its leadership two years ago.

You could say it's flying high.