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Health care guarantee lacks means of delivery

The Eugene Register-Guard

Published on February 28, 2018 4:33PM

A proposal to invite voters to add a guarantee of universal health care to the Oregon Constitution’s Bill of Rights has died in the Senate. Its demise should be unmourned — even welcomed. In the absence of a firm plan for keeping such a promise, a constitutional right to health care would be either meaningless or a cause of litigation.

The state Constitution’s Bill of Rights contains 46 sections, most of them protecting Oregonians’ civil rights. House Joint Resolution 203 would have added Section 47: “It is the obligation of the state to ensure that every resident of Oregon has access to cost-effective, medically appropriate and affordable health care as a fundamental right.” Section 47 would differ from those preceding it in that it would commit the state’s government to providing something, rather than limiting the government’s power over citizens.

If HJR 203 had been approved by the Legislature and signed by the governor, a proposal to amend the Constitution by adding Section 47 would have appeared on the November general election ballot. The resolution’s sponsors were encouraged by voters’ approval of Measure 101 last month, which retained financing mechanisms for the state’s Medicaid program, and by the fact that with an expanded Medicaid program and the increased availability of private insurance under the Affordable Care Act, about 94 percent of Oregonians have health insurance of some kind.

But HJR 203 said nothing about how Oregon will meet the cost of extending health care to that final 6 percent of the population. Nor does it chart a course for continuing to pay the state’s increasing share of the cost of Medicaid. It doesn’t address the Trump administration’s continuing efforts to chip away at the Affordable Care Act, which already are making private insurance more expensive for some people.

Backers of a single-payer health care system, including some supporters of HJR 203, claim that the state could provide health care to everyone at less aggregate cost than the current patchwork of insurance bureaucracies. They may be right, but even if they are, the first step for Oregon would be to put a solid plan in place. The state should make no promise until it is certain the promise can be kept.


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