Insurance
is a major obstacle preventing many from receiving the
care they need.
Portlanders are concerned about high insurance rates
and the ever-growing number of people that lack health
insurance because they cannot afford it. Many Portlanders
see lack of insurance as the primary barrier preventing
people from receiving the medical care that they need.
Even those with insurance want their premiums, co-pays
and deductibles to be more affordable and provide a
greater range of benefits. When it comes to obtaining
insurance, many Portlanders look to their employers—they
want more employers to offer insurance and they want
company-sponsored insurance plans to provide better
coverage. Other Portlanders look to the Oregon Health
Plan, believing that this plan should cover many more
people than it currently does.
Still others favor alternate insurance arrangements,
including a local single payer system or group insurance
pools, which could lower the costs of premiums and offer
coverage to a much larger number of people. Many people
envision a future in which all Portlanders have the
insurance they need to access whatever medical services
they find necessary. However, disagreements emerge over
whether insurance should be free for all or only for
those who cannot afford to purchase it on the private
market. It is also unclear whether Portlanders want
to improve the current employer-based model or move
towards a universal or single-payer model that shifts
the burden away from businesses and onto the local or
state government.
- The
cost of health insurance is a barrier preventing many
from receiving the medical care they need.
- More
employers should offer health insurance to their employees.
- The Oregon Health Plan
no longer meets the needs of low-income families.
- Portland should find a
way to insure all people in the community.
- How should we expand insurance
to cover all those who need it?
- Should everyone be eligible
for free health insurance?
- The
cost of health insurance is a barrier preventing
many from receiving the medical care they
need.
- Too many Portlanders lack insurance, either
because their employer cannot afford to offer
it as a benefit or because they cannot afford
to purchase it for themselves.
- Many Portlanders believe that if health
insurance were more affordable, many more
people would purchase it, reducing the current
over-reliance on emergency room care and bringing
down costs across the system (see Health:
Cost of Healthcare).
- Portlanders who do not have insurance speak
of foregoing the medications, doctor’s visits
and preventative care they need to stay healthy.
- Those who are forced to seek medical care
without insurance speak of enduring crippling
debt to pay for their healthcare expenses.
- Some with insurance can no longer afford
it because it becomes more expensive as they
get older and as they develop certain medical
conditions.
| “They
need to make medical coverage affordable
for families, like medical and dental,
prescription and emergency care. This
really needs to happen for low-income
families. I want my kids to have insurance,
it’s important, but I can’t afford it.” |
“Better
medical care. I don’t have insurance,
so I do without the medication I need." |
| “[In
the future] insurance companies are banned
from charging outrageous deductibles and
co-pays - sometimes people who have health
insurance come to the MCHD immunization
clinic where I work because their co-pays
are incredible.” |
- Develop a city-wide small business health
plan, so that more individuals can afford
insurance and medical care.
- More
employers should offer health insurance to
their employees.
- Many, many Portlanders want their employers
to offer health insurance or offer better
quality health insurance to employees.
- Time and again, community members call for
businesses to contribute their part to the
community by providing their employees with
access to healthcare.
- When discussing job creation, Portlanders
consistently say they want more jobs created
that offer living wages and full benefits,
including health insurance (see Economy:
Employment).
- At the same time, respondents acknowledge
that many businesses, especially small businesses,
cannot afford healthcare for their employees.
- People would like to see the following in
terms of employer-based insurance:
- Insurance coverage for all full-time
workers;
- More affordable insurance for family
members, especially children;
- Insurance coverage for part-time workers;
and
- Assistance to small businesses so that
they can afford the costs of insurance.
| "They
need to make medical coverage affordable
for families, like medical, dental, prescription,
and emergency care. This really needs
to happen for low income families. I want
my kids to have insurance, it’s important,
but I can’t afford it.” |
| “Portland
is struggling to bring up wages and provide
social services to the most needy. The
Oregon health system has unraveled and
needs to be looked at again from between
a partnership between state and business
to provide cost contained health care
for all. Businesses and public services
are bleeding because of health care costs
in this state and all over the country.” |
| “[In
2030] every worker in the city would be
earning a living wage and be provided
with health insurance. We will have invested
in the lower income neighborhoods and
made them safer and cleaner. Schools will
have all the money they need because corporations
will be paying their share of taxes.” |
- Give businesses a tax break if
they provide benefits to employees.
- Attract businesses to Portland that will
pay living wage jobs with better benefits.
- Regulate businesses so that they are required
to provide insurance to all workers.
- Assist small businesses so that they can
provide health coverage to their employees.
- “Create incentives so that smaller businesses
buy group insurance for their employees. I
just read that Burgerville now gives its employees
health insurance - what motivated them to
do that? Can we similarly motivate other companies
to do the same?”
- The
Oregon Health Plan no longer meets the needs
of low-income families.
- Significant concern is expressed over the
perceived deterioration of the Oregon Health
Plan (OHP) both in terms of the number of
people it covers and the quality of coverage
it provides.
- Many low-income families and children are
not covered by the OHP, yet they cannot afford
to purchase their own health insurance.
- Some would like to see OHP expanded to serve
many more people, while others feel that the
plan needs to be overhauled or eliminated
in favor of universal coverage for everyone.
| "The
politicians overspend our money, leaving
the poor to get poorer and the rich to
become richer. They cut OHP for a lot
of people, causing people to either suffer
with illness, or go into extreme debt
to get help.” |
| “More
accessible health services. Our program
has deteriorated. OHP is so limited. It
has fallen apart/expensive. I was in the
health field and it was so discouraging
to me that I wouldn’t practice anymore.
The treatment was being compromised.” |
- Portland
should find a way to insure all people in
the community.
- Many Portlanders are disillusioned with
the employer-based healthcare model and want
to see some form of universal health coverage
through which all people can be insured.
- Portlanders discuss different types of insurance
systems, including:
- Pooled insurance programs (small businesses,
nonprofits, etc…) to bring down premium
costs and ensure more employees;
- A single payer system run at the city,
county or state level;
- Free insurance for all children, presumably
supplied through the state (although this
isn’t specified);
- Drastically expanding the Oregon Health
Plan (OHP) to cover many more people than
it currently does;
- Tiered systems that would provide free
insurance to children and the needy and
more affordable insurance to everyone
else.
- Regardless of which system they prefer,
respondents want the City to take bold action
to guarantee that all Portlanders have access
to the healthcare they need.
| “I
would like to see health insurance for
all of us! National health care isn’t
happening. Lets do something locally.” |
|
"[I would like to see] single-payer health
care (get employers/healthcare providers/citizens
to the table and get creative) more prevention/health
initiatives. More rapid transit-MAX, more
bike lanes, consumer owned PGE, more solar
production, more hybrid cars.” |
|
“[In the future] I would not longer need
to own a car. I would have a decent paying
job with publicly funded health benefits
so I would not have to constantly worry
about medical expenses as I age. I would
not have a garbage bill—I would recycle
everything.” |
|
“20 years later: everybody has free medical
insurance or people pay for a medical
service only when it is necessary and
it is quite affordable.” |
- Raise taxes. Many Portlanders
say they are willing to pay higher taxes for
quality health insurance if they can be assured
that their money won’t be wasted.
- Create an unprecedented state health program
that eliminates the need for insurance and
provides excellent care for all residents.
|
-
How should we expand insurance to cover all those
who need it?
The vast majority of respondents agree that all Oregonians
should have access to health insurance; however disagreements
emerge over how to accomplish this goal. Many people
speak of the importance of expanding the current employer-based
system so that all those people who have steady jobs
receive adequate insurance through their workplace.
Throughout this report, Portlanders speak of their
desire to have “living wages with full benefits,”
including health insurance for themselves and their
family members.
On the other hand, an equally large number of people
think that the current employer-based model is incapable
of fully insuring all those who need it. These people
would prefer to move towards a system in which the
government (either local or state) offers insurance
that will cover all people, so that health insurance
is not tied to employment. Proponents of various
single-payer systems feel that these systems will
cover more people and will also reduce the burden
on businesses (especially small businesses), which
will be able to compete more effectively once they
are no longer saddled with soaring insurance premiums.
- Should
everyone be eligible for free health insurance?
Many Portlanders have a vision of the future in which
no community member lacks health insurance. These
Portlanders believe that health insurance should be
provided free of cost for everyone, funded by tax
dollars. Others would prefer a system in which only
those who cannot afford health insurance receive free
insurance through the government. Under this scenario,
those who can afford to would continue to purchase
their own private insurance or obtain insurance through
their workplace. Individuals who are children, elders,
homeless or have low-incomes would be eligible to
receive publicly-funded insurance.
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