The one-issue ballot that arrived in your mailbox earlier this week, and the complicated question therein, is proof that something is rotten in the state of Oregon.
It’s a confusing, complicated decision that asks a lot — too much, we’d argue — of voters. The voters’ pamphlet (again, all that for just one question) includes arguments in favor and in opposition that are often too thick to penetrate.
In short, Oregonians are asked to decide the fate of a two-year, 0.7 percent tax on some hospitals that was approved by the Legislature in the last session. A 1.5 percent tax also extends to insurers, the Public Employees Benefits Board and coordinated care organizations.
Voting “yes” keeps the taxes; voting “no” repeals them.
If the tax is repealed, the state would lose anywhere from $210 million to $330 million in revenue, in addition to $630 million to more than $1 billion in federal Medicaid matching funds. Proponents say as many as 350,000 low-income residents could lose health insurance, while opponents say the state could find other ways to cover them (though they haven’t been able to clearly identify any).
There is a lot at stake, but voters have a right to feel like legislators — and initiative proponents — have put them in a vise.
One jaw of the vise is the fact that we know access to health care for people who cannot afford their own insurance comes at a cost. The cost is on those who can afford it — they pay a little extra to cover those who cannot.
Supporting the sick and suffering is something that many believe is a moral and financial obligation. And the fiscal conservatives among us also understand that the obligation is lessened if we pay a little bit up front (in the form of insurance) instead of a lot more in the end (loss of societal production, emergency room visits, delayed care, and avoidable suffering and deaths).
Yet there is pressure from the other side of the vise, too.
Measure 101 isn’t fair — not everyone in the state pays equally. People covered by self-insured medical plans through their employer (the East Oregonian, for one) and unions are exempt, among others. Small businesses, school districts, nonprofits and college students aren’t. Shouldn’t everyone bear the burden of supporting the neediest in our society? The insurers and hospitals are likely to push their costs onto customers, many of whom count the high cost of health care as one of the biggest challenges in their lives.
Fiscal conservatives are also justified in feeling that the Legislature is holding the state’s most vulnerable residents hostage in its thirst for ever-increasing taxes. Who is going to argue against medical coverage for sick kids? But why weren’t deeper cuts made in other programs to offset this expense?
That’s the pattern of the Legislature. As long as powerful interests — such as the public sector employee unions — carve out their pieces of the pie, solutions to complex problems such as health care will continue to be unevenly applied. And applied poorly, like a two-year Band-Aid over an open wound.
And this is a Band-Aid — a temporary solution that does real good. It will make many Oregonians healthier and less financially stressed. But it does mask the deeper issues beneath.
Yet at the same time, we’re not comfortable with complex legislation being picked apart by the initiative process. We live in a representative democracy, and we elected our representatives to run our state — to make laws, make sure the bills are paid and the right investments made.
The initiative process is an excellent way to decide on easily understood social issues like same-sex marriage or marijuana legalization. But complicated tax policy should not be nit-picked this way, and repealing these taxes would set a bad precedent. Business and the government both need stability in revenue and expenditure in order to make decisions and plan for the future — the rug cannot be pulled out from underneath either at a moment’s notice.
We sent our legislators to Salem to do a job and this is the job they did. If we don’t like it (and we don’t), then we should vote them out. Until such time, voters should approve Measure 101.
In recent years, we’ve seen the number of insured Oregonians increase dramatically in the state. And with the help of coordinated care organizations, we’ve seen health outcomes improve, too. The opioid epidemic is lapping at these gains, however, and we cannot be complacent.
Assessing that situation, a Band-Aid is better than pushing a still recovering patient back into the street.