Sen. Thatcher: Alarm over $54B health care bill (SB 704)

By Oregon State Senator Kim Thatcher,

SB 704 establishes a Universal Health Plan Governance Board and puts Oregon on the path towards implementing the country’s first single-payer universal health care system by 2027. The bill is currently in the Senate Committee on Health Care awaiting a work session.

Beyond its sheer costs, building such a system would be a massive, complex, and unprecedented endeavor, and we have every reason to doubt and little reason to trust the state will get it right. That, and like any other state agency, government-run healthcare has its own inherent set of problems – like long-wait times, decreased health care quality, and rationing of care – which are seen both right here in our country and abroad and warn us about the future implications of such a system.

The Costs of Bringing Universal Health Care to Oregon

The costs of creating a universal health care system in Oregon would be immense. A 2022 legislative task force report estimated the program would cost 54 billion in 2026 alone (for context, Oregon’s 2021-23 biennium budget is about 112 billion), and proposed new business payroll and personal income taxes to fund it. In a state that already has some of the highest taxes in the country, these two new taxes mean Oregonians could expect an almost 20-billion-dollar tax increase in the system’s first year of implementation.

An Implementation Problem

Moreover, implementing a government-run healthcare system is both a very large and complex task, and it’s something no other state has successfully done, meaning Oregon would be the first state to attempt this. But given the state’s poor track record in administering large-scale programs, we have every reason to doubt Oregon’s chances of success.

Take the failure of the Cover Oregon health exchange website, for instance. The project, which intended to create an online health insurance marketplace for Oregonians, failed in part due to the state’s own problems, such as feuding bureaucracies and technical incompetence, and culminated in a bitter 25-million-dollar legal fight. Beyond that, delays in the state’s delivery of unemployment checks during state-mandated lockdowns, as well as in promised Measure 110 addiction treatment funds while addiction rates continue to soar, show Oregon has a chronic problem in overpromising and underdelivering. Are we really going to trust the state that can’t even create a health exchange website to run a system as novel, massive, and complex as universal health care?

A Better Solution Than Universal Health Care

Our current healthcare system has its own issues, but universal health care is no panacea, or perfect solution, to our healthcare problems. Rather than radically upending our current healthcare system and switching to a government-run one, there are better and more targeted solutions to fixing healthcare in Oregon. As of 2019, Oregon’s uninsured rate was 7.2% — lower than the national uninsured rate of 9.2%. Instead of dismantling and rebuilding our current healthcare system and then forcing this change on everyone — which is the path SB 704 puts us on – our approach should focus on expanding access and health care coverage to the uninsured population through the preexisting Oregon Health Plan.