How a city works...

[Lamplighter]

NY Times
ANNIE LOWREY
5/22/12

Oregon Study Shows Benefits, and Price, for Newly Insured

But in 2008, Oregon opened its Medicaid rolls to some working-age adults living in poverty,
like Ms. Parris. Lacking the money to cover everyone, the state established a lottery,
and Ms. Parris was one of the 89,824 residents who entered in the hope of winning insurance.

With that lottery, Oregon became a laboratory for studying the effects
of extending health insurance to people who previously did not have it.
Health economists say the state has become the single best place to study
a question at the center of debate in Washington as the Supreme Court prepares to rule,
likely next week, on the constitutionality of President Obama’s health care law:
What are the costs and benefits of coverage?<snip>

For the nation, the lesson appears to be mixed.
Expanded coverage brings large benefits to many people,
but it is also more likely to increase a stretched federal government’s long-term budget responsibilities.

The newly insured were more likely to describe their health as good,
and to say that their health was getting better, according to self-reported data
that researchers are now combining with objective measurements for a deeper follow-up study.
The uninsured reported being in worse physical and mental shape and were less likely to describe themselves as happy.

Getting insurance also had powerful financial effects, the study showed.
The insured were 25 percent less likely to have an unpaid medical bill
sent to a collection agency and 40 percent less likely to borrow money
or skip paying other bills in order to cover their medical costs.
<snip>

[Glinda]

Here's something else Portland/Oregon can be proud of...


In Vancouver, Washington, this costs $39.65



Three miles away, in Portland, Oregon, it costs $19.45 (Still too expensive, but better than a poke in the eye with a sharp stick). Ciggies cost twice as much in Washington, too. Fuckers.

[Lamplighter]

Three miles away, in Portland, Oregon, it costs $19.45 (Still too expensive, but better than a poke in the eye with a sharp stick). Ciggies cost twice as much in Washington, too. Fuckers.

Why Glinda, how can you be so critical of capitalism ?

Washington just did away with their "state-owned" liquor stores.
Oregon is still that bastion of socialism with hard liquor sold only in the state-operated liquor stores.

[classicman]

Also from that article ... located immediately after the (snip)

The insured also spend more on health care, dashing some hopes of preventive-medicine advocates
who have argued that coverage can save money — by keeping people out of emergency rooms, for instance.
In Oregon, the newly insured spent an average of $778 a year, or 25 percent, more on health care than those
who did not win insurance.

hmmm...

[classicman]

and furthermore ...
“The study put to rest two incorrect arguments that persisted because of an absence of evidence,”

“The first is that Medicaid doesn’t do anything for people, because it’s bad insurance or
because the uninsured have other ways of getting care,” Ms. Baicker said. “The second is that
Medicaid coverage saves money” by increasing preventive care, for instance.

[Lamplighter]

Dwellars should read the entire article.
Below are the entire paragraphs of Classic's quotes...

In a continuing study, an all-star group of researchers
following Ms. Parris and tens of thousands of other Oregonians has found
that gaining insurance makes people feel healthier, happier and more financially stable.
The insured also spend more on health care, dashing some hopes of preventive-medicine advocates
who have argued that coverage can save money — by keeping people out of emergency rooms, for instance.
In Oregon, the newly insured spent an average of $778 a year, or 25 percent, more on health care than those
who did not win insurance.

“The study put to rest two incorrect arguments
that persisted because of an absence of evidence,”said Katherine Baicker,
a Harvard economist who worked on the study and served as an economic adviser to President George W. Bush.
“The first is that Medicaid doesn’t do anything for people, because it’s bad insurance or
because the uninsured have other ways of getting care,” Ms. Baicker said. “The second is that
Medicaid coverage saves money” by increasing preventive care, for instance.
“It’s up to society to determine whether it’s worth the cost,” she added.

If you are an economist, $ is unfortunately your only unit of measure.
To say that the uninsured have other ways of getting care is discussed in this same article...

Most of the uninsured described their lack of coverage as a profound problem.
<snip>
Interviews with study participants showed that the insured and the uninsured
got health care in significantly different ways. Lottery winners tended to have
a primary care physician who saw them regularly and helped them navigate the health care system.
In contrast, few of the uninsured saw doctors regularly, and none said that they had regular health examinations.
<snip>
The uninsured described borrowing medication from family members and friends,
taking it every other day, and asking doctors to diagnose multiple conditions
and write multiple prescriptions on a single visit.

The insured said they had largely abandoned such strategies.

Certainly, health care costs more than no health care at all. But better health,
being happier, and financial stability are just some of the basic outcomes of health care
... regardless of how it is financed.

[classicman]

Originally Posted by Lamplighter

Dwellars should read the entire article.
Below are the entire paragraphs of Classic's quotes...

Thanks, I don't think I missed anything of relevance, I certainly didn't cherrypick.

Certainly, health care costs more than no health care at all. But better health, being happier, and financial stability are just some of the basic outcomes of health care ... regardless of how it is financed.

Agreed. BUT we were sold on this saving money and being LESS expensive. That has been undeniable proven false.
Even the latest CBO study has shown that. AND it could get FAR WORSE as described by the insurance death spiral which many are predicting will happen.

Personally, I don't believe letting the insurance lobbyists have so much control over this was the right solution.
Healthcare for all, NOT insurance insurance for all, is the only viable solution. The only way I see that happening and costing less is to not have insurance companies as they now exist, and even more so - to NOT allow the providers and suppliers to name whatever price they want.

[Lamplighter]

Thanks, I don't think I missed anything of relevance, I certainly didn't cherrypick.

Obviously, I feel you did.

Personally, I don't believe letting the insurance lobbyists
have so much control over this was the right solution.
Healthcare for all, NOT insurance insurance for all, is the only viable solution.
The only way I see that happening and costing less is to not have
insurance companies as they now exist, and even more so
- to NOT allow the providers and suppliers to name whatever price they want.

Wouldn't that be an attack on capitalism and physicians' way of life ?
I thought I was the only closeted socialist on this forum

It's funny... but not really... that for some it's never quite good enough,
or it was not done the right way, or it is not the right time to do it.
The only governmental program that I know of that even
comes close to meeting such criteria is the "Do Not Call" list.

More seriously, the main reason I posted this article is that Oregon
has progressively amended this State's Medicare funding to cover
heterogeneous populations, to bring about better physical and mental health outcomes.

Health insurance coverage for all children was the first step.
Unfortunately there are not sufficient funds in the State's Medicare pot
to cover everyone, so the lottery was implemented.
It now serves yet another purpose of research studies

The warm and fuzzy social outcomes, such as families not having bills
turned over to collection agencies or not being evicted for non-payment of rent
have hidden costs that do not get into the spread sheets, but they are real for the families.
With time and research, I believe these benefits will become part of the "economic equation"

[classicman]

[quote=Lamplighter;816574]Obviously, I feel you did.
Oh really? Which part specifically?

Wouldn't that be an attack on capitalism and physicians' way of life ?

I don't think healthcare belongs in the business sector.

The warm and fuzzy social outcomes, such as families not having bills turned over to collection agencies
or not being evicted for non-payment of rent have hidden costs that do not get into the spread sheets,
but they are real for the families.
With time and research, I believe these benefits will become part of the "economic equation"

So will all the added costs associated.
I do not think we are that far apart in our views and our desired end results are even closer.

[xoxoxoBruce]

While I support the notion of universal health care for American citizens, I have no obligation to be concerned if everyone is happy.

[Lamplighter]

Maybe it would be one of those "unintended consequences" people talk about...

[xoxoxoBruce]

Probably so, but not sufficient reason to implement a health system. Makes too easy a target for the naysayers to scoff. The numerous benefits to the community and country are the legitimate points that should be hammered repeatedly. The touchy feely shit will get nowhere.

[Lamplighter]

Without the Willamette Falls locks, commercial shipping and recreational boating
is severely restricted to the south of Portland for the remainder of the Willamette River.

The locks were closed "for repairs" during George W.'s administration,
and since then only a few recreational boats can make it through the locks.
This affects federal funding because $ is based on commercial tonnage.



Portland Tribune
Raymond Rendleman
June 27, 2012

Corps may give up Willamette Locks

A large, multijurisdictional meeting last week launched new partnerships to usurp the U.S. Army Corps of Engineers'
control over the shuttered Willamette Falls Locks between Oregon City and West Linn.

As a rare, intact piece of America's canal-building era, the locks are unique in Oregon as the first significant
navigational construction on the Willamette River and in the greater Columbia River drainage basin.

The locks joined eight other unique Oregon places in gaining the dubious "Most Endangered Places" distinction,
a label that attracts preservation-league resources. The National Trust for Historic Preservation simultaneously
named the locks one of its new "National Treasures."

Local officials are fed up with what they see as the Corps' neglect of the historic, manmade waterway.
Citing public safety concerns in November, the Corps moved the 138-year-old locks into a "non-operational" status,
thereby cutting the navigational potential of the Willamette River in half.<snip>

Corps Project Manager Patrick Duyck offered several excuses in response to the community outcry.
Finding seven gates and anchors that were more than 50 years old and experiencing excessive corrosion,
the Corps determined that the distressed condition of three anchors in particular increases potential for failure.
With the locks "non-operational," as Duyck explained federal law, private partners
can no longer contribute to what he estimates will be a $3- to $5-million repair job.
He acknowledged, however, that the Corps has "no idea" of the actual condition of buried anchors.

Then the crowd turned what had been a simmering frustration into outright revolt.
During the June 20 meeting at the Ainsworth House in Oregon City,
Lehan was among the more than 50 people raising their hands when
a facilitator asked whether the Corps should give up the locks.
<snip>
The One Willamette River Coalition, whose members have been working for six years
to keep the 1873 locks operating, picked up some powerful new friends May 22
with a joint public announcement by the National Trust for Historic Preservation
and the Historic Preservation League of Oregon.

[classicman]

Originally Posted by Lamplighter

Without the Willamette Falls locks, commercial shipping and recreational boating is severely restricted to the south of Portland for the remainder of the Willamette River.

The locks have been primarily used for recreational purposes, meaning a low funding priority,
since the 1970s when log rafts became a rarity.

[Lamplighter]

Yes, primarily recreational now.

But until the locks were closed for longer "repair" periods,
there was still some commercial traffic to Salem and even Albany
... reduced, and not as much as while logging was still going strong,
but commercial tugs did not cease completely.
Also, one large ship/barge-builder in PDX required use of the locks,
but then moved away when the periods of lock operations became erratic.