This act is for the establishment of a state-run health insurance company. This act does not increase tax funding for health insurance. This act does not cover all Oregonians with tax funded health insurance. This act strictly creates a state-run health insurance company that will sell health insurance to Oregonians. The primary benefits of this act are that all medical facilities and professionals will be in network covered by one insurance company, and that annual health care costs will be decreased by an estimated $800 million-$1 billion.
Section 2: This act requires that all hospitals, doctors, dentists, medical clinics and any other facilities or professionals that state congress requires be covered by the state-run health insurance established by this act. Oregonians who use the state-run health insurance will have complete choice of medical professionals and facilities they use. If there is over demand for certain medical professionals or services, out-of-pocket costs may potentially be increased for those professionals or services to decrease demand. Out-of-pocket costs, fees and other medical costs may be regulated, as approved by state congress.
Section 3: This act requires that companies providing health insurance to their Oregon employees use the state-run health insurance. This act requires that all individuals on Medicaid, Medicare, and government subsidized health care through the Affordable Care Act use the state-run health insurance. This act requires that any government within the state use the state-run health insurance when providing health insurance to government employees. Individuals who do not receive health insurance through a company or government can purchase private health insurance if they choose, or purchase the state-run health insurance. Employees who do not want to use the state-run health insurance provided by a company or government through their job, can purchase private health insurance if they choose. The state-run health insurance company will create different options for levels of coverage.
Section 4: The state-run health insurance will be run through a website. Patients will have an account where all their medical records and history will be available to them, as well as to doctors, dentists and other medical professionals in Oregon as needed. The website will also allow patients to schedule their own appointments. Schedules of doctors and other medical professionals will be made available online. Patients will be able to search for appointments by soonest available appointment, as well as nearest location. The website will insure patients don’t over schedule appointments. Some appointments may require referrals. All payments and applying for coverage will be done through this website. Estimated Savings: A state-run health insurance company is estimated to save the state between $800 million - $1 billion annually. Savings within the health insurance industry are from elimination of profits, marketing, and insurance agents, decreased management and property use, as well as eliminating extra costs associated with using facilities and services that are out of network. Within the healthcare industry further savings come from decreased secretarial work, and decreased appointments. Profits are eliminated in a state-run model since there are no owners. Marketing is eliminated in a state-run model since it is essentially a monopoly and there is no competition, which means no need to advertise. Insurance agents are eliminated in a state-run model since it is essentially a monopoly and there is no competition, which means no need for sale representatives. Management is decreased in a state-run model since there is only one company and the efficiencies of scale economies are fully utilized. Less property is used in a state-run model since there is only one company. In a state-run model since the insurance covers all medical facilities and professionals in Oregon there will never be extra costs due to using out of network facilities or services. Within the health care industry savings in a state-run model come from decreased secretarial work as appointments will now be set online. Less appointments will be needed in a state-run model as medical records are universally available and appointments to reassess symptoms won’t be as necessary when using a different facility or medical professional. Elimination of profits by itself will save the state around $800 million annually based on national data.1 Total personal income of employees in the health insurance industry in Oregon is estimated to be around $550 million based on national data. 2 How much savings there will be from decreased employees and other expenses are unknown but as listed above there are a fair amount of cuts, so possibly between $0- 200 million, maybe more. Savings will primarily be for companies that provide private health insurance to their employees, governments that provide private health insurance to their employees, selfemployed workers that use private health insurance, and residents that use private health insurance through the affordable care act. Inflation and population change may affect these savings overtime.