In 2003, the Oregon Health Assessment Project issued a report, entitled A Vision for Change, proposing fundamental changes to financing and delivery of health care in Oregon.
The 2003 report, A Vision for Change, included four basic recommendations:
All Oregon residents would be asked to have an individual "health management fund" as a central depository of moneys from public, private and personal sources.
The current health care delivery and financing system should be reorganized into three discrete segments:
- A government-run "civic segment" providing a "basic" standard of health care.
- A "coordinated care" segment similar to existing managed-care systems.
- A "self-directed" segment, featuring high deductible, catastrophic insurance plans with financial incentives to manage one's own health risks.
Health insurance would be reoriented so that premiums would be age and regionally adjusted and derived from community risk pools; coverage would be guaranteed.
Universal access to basic health care services should be ensured with the creation of a funding mechanism designed to generate the necessary moneys and distribute the burden widely and fairly among all community constituencies.