Talk Health Reform

The Oregon Medical Marijuana Program: Support of alternative medicine or contradiction of federal law?

The Oregon Medical Marijuana Act was adopted by voters in the November 3, 1998 general election (Ballot Measure 67). The Act was amended by House bill 3052, passed during the 1999 legislative session. The Act was again amended by Senate bill 1085, passed during the 2005 legislative session.

The Act intends:

(1) To allow Oregonians with debilitating medical conditions who may benefit from the medical use of marijuana to receive the benefit of their doctor's professional advice regarding the possible risks and benefits of medical marijuana;

(2) To allow Oregonians suffering from debilitating medical conditions to use small amounts of marijuana without fear of civil or criminal penalties when their doctors advise that such use may provide a medical benefit to them; and

(3) To make only those changes to existing Oregon laws that are necessary to protect patients and their doctors from criminal and civil penalties, and are not intended to change current civil and criminal laws governing the use of marijuana for non-medical purposes.

Supporters say marijuana is an important option for pain relief when other drugs do not work.  As of April 1, 2008, 16,635 Oregonians have been issued medical marijuana cards that protect them from criminal prosecution under state laws. This protection does not extend to federal laws; under which marijuana is classified as a schedule I controlled substance.

Some advocates of the medical marijuana program would like Oregon to enact dispensary laws similar to those adopted in California, but some Oregonians express concern that this will also lead to the abuses seen in California. Recently the CBS program "60 Minutes" documented the ease with which many without a medical need could pay doctors to write prescriptions. Also weighing in are those who would like to substitute a THC pharmaceutical product for the program (as reported in the Willamette Week).

What would work in Oregon, and to what extent should the state enact laws that conflict with federal law?

How Low Can You Go?

The state of Florida recently passed a health reform bill that would reduce the number of uninsured in the state by offering a "no frills" state health insurance product for as low as $150 a month.  Insurers participating in the program would be required to provide coverage for annual physician visits, inpatient hospital stays, mammograms, prostate screenings, immunizations, emergency department visits, and prescription drugs. Specialist care and long-term hospitalizations would not have to be covered. The product would also be exempt from the mandatory benefits of other health insurance products sold in Florida. 

Oregon has experimented with the idea of limiting benefits in its Medicaid program, yet faced opposition from the federal government. The state currently has a Prioritized List of Health Services developed by a public commission for the Oregon Health Plan. Florida's plan is not administered through Medicaid; it does not get federal funding and does not require federal approval. 

The Oregon Health Fund Board Benefits Committee is currently considering recommendations to the Board to create an "Essential Benefits Package" that instead of covering all health services would prioritize evidence-based medicine that keeps people heathy.  Health services identified as higher priority would be provided at little or no cost to the patient, while lower priority services would have higher co-payments or not be covered.

Is limiting services the answer for expanding health coverage?  How can the maximum number of people be covered without breaking the state's bank?