OPINION Health Care for All A recently filed initiative goes too far--which is exactly the point. We're not sure whether to applaud Betty Johnson for her moxie or chuckle at the futility of her cause. Whatever the case, Johnson is trying to get Oregonians to address what will surely be a key question for the next decade. Which is the greater evil: the health-insurance industry or big government? Early this week, Johnson, a 77-year-old former director of senior services for Linn, Benton and Lincoln counties, filed the Oregon Comprehensive Health Care Finance Act, an initiative that would create in Oregon a Canadian-style, single-payer system of medical care. No longer could insurance companies deny access. No longer could bean counters make medical decisions. In fact, if this initiative were to pass, the health-insurance industry would become obsolete. Instead, a state agency would collect lots of taxes, offer cradle-to-grave coverage to every Oregonian, and contract with doctors and hospitals to provide care. And Oregonians would never again wonder if they could get the surgery, drugs or long-term care they needed. If health-care reform were weather patterns, John Kitzhaber's Oregon Health Plan would be a thundershower. Johnson's Health Care Finance Act? A tsunami. Which is why it's more likely that Paul Allen will apply for food stamps than that this measure will succeed at the ballot. Several years ago, a similar measure got hammered in California, receiving only 27 percent of the vote. And we all know what happened to Bill and Hillary Clinton's health-care proposal. Yet the desire to expand health care and limit the power of insurance companies is a widely shared goal in Oregon and the rest of the country. The issue is being debated in the presidential primaries. A number of states are addressing the issue in increments; last year, California passed a law that mandated nurse staffing levels at hospitals. And, while Johnson's initiative is doomed, other efforts could succeed here this year. Last month, Jim Davis, an advocate for senior citizens, and Tim Nesbitt, recently elected to run the state AFL-CIO, filed several "Patients Bill of Rights" initiatives that are more narrowly focused than Johnson's effort. In varying ways, the measures would allow patients to appeal denied procedures, sue a managed-care company if a procedure is denied and get wider access to prescription drugs. If the group is too busy fighting Bill Sizemore's anti-tax efforts, it may choose not to proceed with any of these measures. If it does go ahead, however, it will only choose one of the initiatives it has filed, a choice that will be driven by polling and resources. "If the pharmaceutical industry said, 'We will give you $1 million,'" said Davis in a remarkable bit of candor, "we might go ahead with the initiative to allow patients [wider] access to drugs." It's not clear if Oregonians are ready to replace the devil we know (managed care companies) with the devil we don't (increased government interference). But as boomers age, as we hear more stories of the tightfistedness of health insurers and as prices nevertheless continue to skyrocket, people will be more willing to increase governmental control over a health-care bureaucracy in which profits have replaced care as the central mission. Betty Johnson's initiative may not go anywhere, but it helps soften the ground for real reform. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Willamette Week | originally published January 12, 1999