VOICES FROM THE COMMUNITY:
The visionPDX Input Report

HEALTH:
Access to Healthcare

  


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Every Portlander should have access to healthcare.

Section Summary

In this section, Portlanders discuss access to healthcare, which they generally see as resulting from a combination of three factors: availability, proximity and affordability. On the whole, Portlanders are thrilled that there are so many healthcare options available in Portland. They like the many choices for both western and alternative healthcare services and they like the size of our city, saying that it feels like healthcare opportunities are relatively close by. They also value the mix of healthy lifestyle choices available, including the availability of healthy food, outdoor recreational opportunities and walkable, bikeable, mixed-use neighborhoods.

However, many people acknowledge that while excellent medical care and healthy lifestyle choices are available in Portland, not all Portlanders have access to these services or the ability to afford them. They point to the rising costs of healthcare and difficulties in obtaining insurance as two of the biggest barriers to receiving needed health services. Overwhelmingly, Portlanders want to see all people have access to healthcare, either by expanding insurance programs to cover everyone or by creating a local system of universal care. They also want to see a more equitable distribution of “healthy infrastructure” throughout all of Portland’s neighborhoods, so that all people can benefit from prevention and healthy living.

Note: Issues of access inevitably overlap with issues of cost and issues related to insurance. To gain a fuller perspective on healthcare accessibility in Portland, see Health: Cost of Healthcare and Health: Health Insurance.

Summary of Main Ideas

  1. In Portland, many excellent healthcare options are available.
  2. Many people lack access to healthcare and healthy living options.
  3. High costs and lack of insurance represent the largest barriers to access.

MAIN IDEAS

  1. In Portland, many excellent healthcare options are available.
  • Portlanders value the wealth of healthcare options available in Portland.
  • They speak highly of the city’s mainstream medical establishment, including:
    • The well-trained, caring doctors, dentists, nurses and other healthcare professionals;
    • “World class” hospitals and conventional medical treatment; and
    • The presence of OHSU as a research, teaching and medical facility.
  • They also value the availability of a wide variety of alternative healthcare options in the city and region, including:
    • Naturopathy and the naturopathic college;
    • Chiropractic and the Western States Chiropractic School;
    • Acupuncture and the various acupuncture schools;
    • The abundance of massage therapists, chiropractors and other alternative health practitioners in the area;
    • The acceptance of alternative healthcare practices by a larger portion of the city’s population; and
    • The ability to locate and purchase alternative healthcare medicines and remedies.
"Portland has culture, beauty, good schools, good shopping, good hospitals, and other health care centers, choice of churches, recreation, and Tri-Met provides an excellent service.”

“I also value our diverse health care practitioners because there is so much to learn about health and better, more affordable ways to healthier living.”

"Portland attracts people and businesses which value healthy lifestyles including natural organic food stores, alternative health practitioners like Naturopaths, Chiropractors, Acupuncturists, and Massage Therapists.”

  1. Many people lack access to healthcare and healthy living options.
  • Despite a vast array of healthcare options that are located in Portland, many people lack access because they cannot afford to take advantage of these options.
  • Portlanders are specifically concerned about the ability of certain groups to access the health amenities in our region, including:
    • Low-income families;
    • Children living in poverty;
    • Elders;
    • Homeless individuals and youth; and
    • Artists, small business owners and self-employed people, many of whom cannot afford their own healthcare.
  • Portlanders want to see neighborhood health amenities (free clinics, farmers markets, walking trails, etc…) distributed fairly and equitably throughout our city.
  • In particular, people want to see access expanded to the following:
    • Health insurance;
    • Medicines (prescription, natural or other);
    • Quality preventative care;
    • Alternative care and therapies (including massage, acupuncture and chiropractic);
    • Dental care;
    • Safe, clean environments (gang-free, pollution-free, smoke-free, toxin-free, etc.);
    • Opportunities for exercise and physical activity; and
    • Healthy food (although it exists in abundance, many cannot afford it);
  • Portlanders believe that everyone deserves access to health amenities and envision a future in which affordable, quality healthcare is available for all.
"[I would like] To see this: many disparate voices converge around core ideas about the importance of access to healthcare for all and to position Portland as a model of the healthy city presents and exciting opportunity in thinking about our vision for the future.”

“[I would like to see] accessible, affordable health care.”

“I’d like to see Portland make more effort to house its homeless, have neighborhood schools for its children with art and music restored and see that all its citizens have access to good health care including alternative healthcare systems, including acupuncture, naturopathy, homeopathy, etc…"

“[In the future] everybody has the same opportunities for health care, housing and employment.”

Sample Strategies:

  1. Provide sufficient in-home services for elders.
  2. Provide free health clinics in every school so children can access the care they need.
  3. There should be more free clinics for those without insurance to prevent them from developing severe and costly illnesses.
  4. Build parks and walking/cycling trails in park-deficient neighborhoods to improve the air and create opportunities for outdoor activities.
  5. Focus on expanding access to healthy food in low-income neighborhoods.
  6. Develop universal health care, either at the local, state or national level.
  7. Build more affordable housing so that lower-income families can live in dense, walkable neighborhoods that are well-served by amenities.
  8. Develop a sales tax or increase cigarette and alcohol taxes to provide health services for all.
  9. Demand that schools improve the quality of cafeteria food and serve only healthy food to children.
  1. High costs and lack of insurance represent the largest barriers to access.
  • While Portlanders note that lack of proximity to health services is one factor reducing access for certain groups, they overwhelmingly believe that the primary barriers relate to cost and lack of insurance.
  • Specifically, people believe that the following limit Portlanders' access to the quality care they need:
    • The high and rising costs of medical care and prescription medicine;
    • The employer-based insurance system, which leaves many people without coverage;
    • Restrictive insurance policies, which do not cover certain procedures or many forms of preventative care that people need.
    • High co-pays and deductibles, which force some people not to seek care, even though they have insurance (for more on people’s thoughts regarding costs and insurance, see Health: Cost of Healthcare and Health: Insurance).
    “[In the future] health care is less costly and more readily available to all. That we live in a healthy, clean environment where civic pride prevails.”