Oregon lawmakers are taking the first steps toward providing a single-payer health system for everyone living in Oregon in the form of Senate Bill 770.

As appealing as the idea may sound, there are no simple answers to improving health care. It takes time to get it right and the Legislature is about out of time to get a revised SB 770 right.

Sen. James Manning, D-Eugene, is chief sponsor of the bill. It would basically start the process for universal, state-supplied health care for every Oregon resident by creating a public option.

His initial bill was more limited, but some believed it didn’t go far enough. That’s where House Bill 2012, sponsored by Rep. Andrea Salinas, D-Lake Oswego, and others, came in. HB 2012 directs the Oregon Health Authority to have a Medicaid buy-in plan ready for the Legislature by May 1, 2020.

Apparently, sponsors of both bills have agreed to combine their efforts. Both measures have been languishing since April, and there’s clearly hope that a single, broad measure stands a better chance than either one does on its own. There’s not a publicly available copy of the proposed combined measure.

It’s easy to find problems with the current health care system. Nobody really likes how much care costs. There are people who don’t have coverage or have inadequate coverage. Will moving to a public option in Oregon, though, definitely be an improvement in quality, coverage and cost?

There should be no mistaking that creation of a public option would almost inevitably crowd out most private health care. Government subsidized health care wouldn’t just keep private insurance honest. It would be able to undercut them on prices. It would also, no doubt, lead to mandates on benefits, mandates on what patients accept for coverage and mandates on what doctors must accept for payments.

Of course, that may achieve the laudable goal of lowering the cost of care. But government subsidized systems such as Medicare and Medicaid work now in part because the costs are shifted to privately insured patients. When there are no or far fewer privately insured patients, there will be less room for cost shifting and more need to limit available coverage for medical care.

With just weeks left in the 2019 legislative session, getting a combined new SB 770 through both houses of the Legislature may be a stretch. That’s not a bad thing at all.

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