As state officials and legislators struggle to deal with Oregon's ailing budget, there's little doubt that the Oregon Health Plan will be on everyone's list as a place to trim. That's expected and necessary. But how that trimming takes place makes all the difference in the world to rural hospitals throughout the state - and especially right here in northeast Oregon.

Without trying to explain the unbelievably complicated health payment disbursement formula and the possible cuts, it boils down to either people or services being cut. The other element is the desire by some at the state level to further reduce health plan payments to hospitals, which has a much more drastic effect on small, rural hospitals. Clearly it's in all Oregonians' best interest to keep as many people as possible on the plan, trim some of the services and keep reimbursement to hospitals at a fair level.

As explained to the East Oregonian, one thought out there is to basically cut 100,000 people from the health plan. This is a bad idea because it's not as if these people are suddenly going to be more healthy and not need health care. They will need it, and without health insurance, will go to emergency rooms for the most expensive treatment available. We'll pay much more money in the long run through increased insurance premiums and more expensive hospital bills.

If reimbursement rates are cut and hospitals must go to insurance companies for increased costs, that in turn will force insurance companies to raise rates, which causes employers to either cut health care benefits altogether or make it more expensive for people. So no matter how this issue is looked at, we will pay in some form or another.

Unfortunately, the best way to cut costs on the Oregon Health Plan is to prioritize the services, such as medical, dental, vision, mental health, etc. All of these things are important and it is our hope that none of it must be cut, but if cuts must be made, it has to be to items such as vision and dental insurance. Having medical coverage obviously has the most value to the most people.

Any of these cuts are excruciating and carry with them all kinds of complications that will be felt. What we cannot do, however, is throw our rural hospitals into the red financially. Besides supplying the health care we require, these facilities also provide some of the best jobs our communities have. Hospitals and clinics are critical economic engines in our communities.

Let's hope the people making the tough decisions about the Oregon Health Plan keep an eye on what their actions will do to rural areas. As it stands, we could lose a lot.

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