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Health plan helps, but many go uninsured By SUSAN JAY Every year, some 24,000 to 35,000 Jackson County residents can't see a doctor. Despite progress in Oregon toward providing health coverage to more poor people, that many local residents still can't afford health insurance, or they have health insurance that doesn't cover the treatment they need. Local and state health care providers and insurance representatives are meeting in Medford today to discuss possible solutions. On Thursday, they gathered at the Smullin Center at Rogue Valley Medical Center to learn more about the population of the uninsured and underinsured. They also learned what role HMOs play in this population's care, particularly the Oregon Health Plan. The conference is part of a continuing education program for doctors sponsored by the Southern Oregon Review of Medicine and the Center for Ethics at Oregon Health Sciences University. The Oregon Health Plan and community health clinics have significantly cut the number of people who weren't receiving adequate health care in the past several years. But now that may not be enough. "We have not been able to bridge that final gap, the 10 to 15 percent of people who have no access to basic medical care," said Dr. John Forsyth, a cardiologist at the Medford Clinic. He helped organize the conference. The Oregon Health Plan, a state Medicaid program, received a federal waiver in 1994 to administer health care to more people through HMOs, along with a state-approved list prioritizing covered treatments. In 1990, 18 percent of Oregonians were uninsured. The percentage dropped to 11 percent in 1996. The credit goes to the state health plan and employers, said Barney Speight, director of the Office of Oregon Health Plan Policy and Research. Since 1996, however, the figures haven't moved. "You can see we're kind of stuck at 11 percent," Speight said, pointing to a bar graph. While the state health plan has been a "qualified success," he said, the proportion of the state's poorest residents who are uninsured has actually increased, from 17 percent in 1996 to 23 percent in 1998. State administrators think the increase resulted from welfare reform and from the lack of awareness by these people that they qualify for the state health plan. Speight said he couldn't say much about the future of the health plan, especially in the middle of a legislative session. He said the goal should be to reduce the increase in health care costs to the health plan. Particularly vulnerable uninsured and under-served populations include the chronically mentally ill, the low-income elderly and the working poor. Take a young, single, working mother, who suffers from depression and is not insured, said Kathy Ingram, a consultant for health and human service agencies. She has nowhere in Jackson County to turn for help. While the Oregon Health Plan offers mental health services, there are no community mental health programs for the uninsured working poor. If it's serious enough, these folks may apply for disability, and drop out of the work force altogether, she said. These examples illustrate the complexity of providing adequate health care services to the uninsured and the poor. And even with local and state solutions, at some point an answer on the national level will be necessary, Forsyth said. Mail Tribune Copyright � The Mail Tribune 1999, Medford, Oregon USA