As Oregon continues to contend with the pandemic, health care workforce shortages, and the impending loss of Oregon Health Plan coverage for hundreds of thousands of people, the state’s next governor will have no shortage of health care crises to tackle.
The Lund Report reached out to top contenders in the 2022 gubernatorial race to see how they’d address the state’s most pressing problems related to health care. Here’s how Republican candidate Bud Pierce replied to our questions:
What specific policy would you pursue to improve health care for Oregonians?
The delivery of health care services to Oregonians begs for much greater innovation and variety. Hospital systems owning outpatient services is the antithesis of this goal. There need to be significant limitations on the ownership of outpatient services by hospitals. Hospitals which are monopolies in their communities will need to be fairly regulated to better control costs. A major push to better financially support primary care services is greatly needed. We spend one out of three health care dollars on the bureaucracy of delivering health care services and this number needs to be greatly reduced to lower the cost of health care services.
Oregon is simultaneously in the midst of addiction and behavioral health system crises. What is your plan for ensuring Oregonians have access to treatment when they need it?
We simply need to better fund addiction and behavioral health care services. I began medical school 45 years ago, and I continue in full-time medical practice. I’ve never seen adequate resources placed into the delivery of addiction and behavioral health services. This funding will in large part need to be delivered through Oregon’s Medicaid services and will require prioritization in the budgeting process.
What does Oregon need to do to rebuild its public health system — and strengthen it — to address disparities and improve equity?
We have a real crisis in public health which centers around drug and alcohol abuse and misuse, untreated mental illness, cigarette smoking, obesity and lack of exercise. We also face the continued public health crises regarding infectious diseases, best exemplified by the COVID-19 pandemic, as well as more traditional infections. Food and water safety remain a concern. The solution will be to have an active agency which works with existing public and private institutions, as well as government agencies, to better coordinate these efforts. All are to be treated equally in these efforts, and we need to focus on individuals in need of help as a primary means to improve disparities and inequities.
About 300,000 people must exit the Oregon Health Plan over the coming year because their incomes exceed the threshold, and Oregon is in the early stages of developing a bridge plan to cover a fraction of them — the working poor who make up to twice the poverty level. Do you agree with those who say Oregon needs a more ambitious “public option” plan covering people with incomes four times the poverty level?
As a practicing physician, I understand better than most that all individuals must have access to health care insurance to have adequate access to health care services. Before the Affordable Care Act, I led the effort in our community to help seriously ill patients with free medical care donated by local providers and our hospitals. This effort led to more than $50 million of delivered health care services, but the effort was exhausting and the results were certainly suboptimal to a good insurance system. As individuals transition from welfare and dependency to work, it is critical that they gain in our economic system, and not lose as a result of working. This includes pay and benefits. Whatever is necessary to ensure that individuals who transfer from dependency to work do not lose or face diminished health care benefits will be my goal. This includes an expanded public option.
Oregon’s public health response to the pandemic has been criticized from different perspectives. What is your take on what worked well and what didn’t?
Our political leaders did not consider Oregon’s citizens as equal partners in combating the pandemic. A very dictatorial tone was used in communicating with the citizenry. The decision to administer vaccinations to teachers over citizens at greatest risk was a bad one. The prolonged mask mandate was a bad decision. The threats and actual firings of citizens who did not wish to receive the vaccinations, rather than allowing for accommodations was a bad decision. There is good data to suggest that the number of excess deaths due to the stress of the pandemic, exacerbated by dictatorial government policies, was as great as the deaths due to the COVID-19 pandemic. My approach would have been one of encouragement, support, giving people in the trenches of life authority and accountability to keep themselves and other citizens safe. I think we would have achieved very similar results with much greater social harmony.
View responses from other leading gubernatorial candidates in Oregon’s 2022 election here.