OHSU's Dr. Peter Kohler Speaks to SVPP About Oregon Health Safety Net

(From the July 2006 Newsletter)

The keynote speaker for SVPP's annual meeting this year was Dr. Peter Kohler, President of Oregon Health and Sciences University. Dr. Kohler was selected as OHSU President in 1988 and has become a leader in state health policy, research and education issues at the national level. He is noted for his advocacy for increased access to health care and quality of life for underserved populations. He is a graduate of the University of Virginia and Duke Medical School.

The topic of Dr. Kohler's speech to SVPP was "The Safety Net for Children: What is it and How do we Protect it?" According to Dr. Kohler, in health care, the term "safety net." refers to the process by which we "catch" those who would otherwise fall through the cracks – primarily those without health insurance. In addition to the uninsured, however, we also have the underinsured – frequently, this means Medicaid or OHP patients. They may have coverage, but the challenge is practitioner access. Generally, the safety net refers to primary and preventative care. OHSU Hospital and other health systems provide significant amounts of uncompensated care for low-income individuals each year, but the biggest issue is access to primary care practitioners.

There is one universal truth about safety net care, however. It does not exist unless a community creates it and supports it. Unfortunately, here in Oregon, the safety net has become badly frayed for adults as well as children. Children are especially vulnerable. Today there are 117,000 uninsured children in this state, a figure that will undoubtedly rise unless a statewide solution to health care access can be found. In addition, children make up 41 percent of Oregon's Medicaid population. The majority of children on Medicaid now get their care from safety net clinics. There are a number of safety net clinics in the Portland metro area, but not all provide health care for children.

As the state's only academic health center, OHSU has long been one of the primary providers of hospital care for low-income individuals. This has been particularly true for needy children. OHSU also treats low-income children through a number of outpatient venues, including the Richmond Clinic in SE Portland and OHSU pediatric clinics. Dr. Kohler also remarked on the major safety net role played by Doernbecher Children's Hospital throughout its 80 year history and the Child Development and Rehabilitation Center which treats children with disabilities or other special health needs.

OHSU is traditionally the state's leading provider of uncompensated care. However, as the state cuts support for both the Oregon Health Plan and for OHSU's base budget it leaves OHSU with an unsustainable burden of care.

Dr. Kohler concluded his speech by saying. "OHSU will continue to be the health care provider of last resort for Oregonians. We will continue to treat the state's sickest and poorest children. But we do need help – from our colleagues in the health care community, from our leaders in the state legislature, and from generous citizens such as you, who play an increasingly important role in funding social services such as health care and education for Oregon's most vulnerable children".