Since I am not a screaming liberal or "hard line health care universlaist" ( though my father-in-law may disagree) but having a deep concern for our present mechanisms for financing health care I offer the following as a brief counter point to the editorial you posted regarding the failure of the single payer proposal in Oregon. From today’s Oregonian Business News: "

In Oregon, voters overwhelmingly rejected a measure to create a single statewide health plan for all residents. The measure, which would have required at least $10 billion a year in taxes, failed by nearly a 4-1 ratio.

And faced with a worsening budget shortfall, state lawmakers last week eliminated coverage of mental health and several other services for about 100,000 low-income residents covered by the Oregon Health Plan. Lawmakers also delayed, potentially indefinitely, the start of the biggest expansion of the state and federally funded coverage since 1994.

"The kind of expansion we had hoped for likely will not occur," says Jean Thorne, director of the state Office of Medical Assistance Programs, who will keep her post when Governor-elect Ted Kulongoski takes office.

Soaring premiums, meanwhile, are making coverage increasingly unaffordable for employers and individuals. For Portland-area businesses and their workers, average health costs will jump by more than 15 percent to $5,510 per employee next year, predicts benefit consultant Hewitt Associates. That follows a 14 percent average increase this year and a 13 percent increase the year before. Among the area's small employers, traditional health insurance for workers and families now averages more than $10,000 a year.

People who've lost insurance are adding to the burden of businesses and individuals who buy coverage. Oregon's uninsured, estimated at 444,000 children and adults, are crowding free clinics and hospital emergency rooms. Hospitals and other caregivers recover the costs of uncompensated care by charging higher fees to private insurers. " [ed. note - I wasn’t able to link to the original article, it was no longer on the web page.]

Single payer, multiple payer, some time payer, what have you--I was disappointed in your brief dismissal of the Oregon results by posting an editorial with limited perspective and no alternative solutions: There are serious financing problems and little substantial discussion of pragmatic solutions:

1) The cost of administering health care insurance plans is only 2-3% less that we spend on pharmaceuticals (about 8% of total health dollars)--if one wants to be outraged about health care costs give pharmaceutical companies a break--at least they help patients--these costs do not even include the billions of dollars spent by providers supporting medical records and IT systems to manage billing responsibilities

2) Some one is paying for the a significant portion of the health care for medically indigent--it is employers and tax payers--is this really the way you want to go in assuring limited access--hiding the costs in private premiums and State/Federal Plans-

3) An employer driven system that depends on private insurance is intrinsically plagued by issues completely unrelated to the persons need for health care--swings in the economy, business closures and relocations, union strength, commercial economic incentives, a patch work of regulatory rules, the personal values of the employer,etc--

The list could go on and on--The point is--basic reform of some type is inevitable--do I personally support the Oregon plan--I have no idea--but States will be, and probably need to be, the source of imaginative health care reform--