Editorials from around Oregon

Selected editorials from Oregon newspapers:

The (Yamhill Valley) News Register, March 3, on the cost of drugs:

According to the Milliman Medical Index, the pre-insurance cost of health care for the typical American family has more than tripled since the turn of the 21st century, rising from $8,414 in 2001 to $25,826 last year.

Popular targets of blame for unaffordable health care include global pharmaceutical giants known collectively as Big Pharma, along with biotech startups eager to cash in and real life villains like Martin Shkreli. Given that lineup, it’s easy to see why reducing drug prices is a major target for politicians.

Drug outlays account for just 16 percent of overall health care costs. However, they are rising the most rapidly, and are among the easiest to identify.

A group of Oregon legislators is championing a price-control measure proposed as a potential national model - House Bill 2387. Introduced by Rep Rob Nosse, D-Portland, it would require pharmaceutical firms to reimburse insurers for any “excess costs” associated with a drug.

The bill defines excess costs as those exceeding the so-called “foreign price cap” - the highest price paid for the drug in any developed country other than the U.S. If a cancer drug wholesaled for $10,000 per treatment, while the highest developed world price outside the U.S. ran $6,000, the manufacturer would have to reimburse insurers $4,000.

It sounds logical, right?

Except, there is nothing in the bill to ensure the savings are passed on to the consumer. The bill does nothing to reduce the cost for families or employers, only for insurers.

It won’t shock you to learn, then, that the director of legislative affairs for Regence BlueCross BlueShield of Oregon was on hand for the bill’s introduction.

A sibling bill was introduced to provide relief to pharmacy benefit managers, who are hired to negotiate drug prices on the behalf of insurers.

PBMs are far from just an administrative client. They wring billions of dollars in rebates from manufacturers.

But the PBMs also play a role in rising drug costs, as most of their dealings go undisclosed. That makes it difficult to exactly gauge the extent to which rebates are actually being passed on to the customer.

Put the puzzle pieces together and check some campaign finance contributions. You’ll find these two bills don’t protect consumers from an “evil profiteer.” They simply take from the rich and give to the rich, creating loads of additional regulations in the process, all on the public’s dime.

That sounds like politics as usual to us.

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The East Oregonian, March 3, on immigration in eastern Oregon:

Plenty is bound to change in the first year of a new president, no matter who is elected. And Donald Trump is certainly more of a change agent than any president in recent memory.

On immigration, things are in a state of flux. But how on-the-ground policy has changed and will change under the Trump Administration is unclear. Anecdotal evidence has popped up of increased raids and deportations of domestic violence victims, farm workers and community linchpins across the nation, but there is also increased media scrutiny on the issue due to Trump’s extreme campaign rhetoric.

We know Trump has ordered stricter enforcement of immigration laws, more detention and deportation and has plans to hire 15,000 more ICE agents. He has also promised a new travel ban from war-torn countries to replace a previous iteration that was declared unconstitutional.

In Umatilla County, immigration will be the primary issue in 2017. Perhaps it has been for a few years already.

Fear from the president’s promises has resonated locally, especially in immigrant communities in Hermiston, Milton-Freewater and Umatilla. Social unrest has rippled through each town, and school districts are dealing with increased absences caused by families distrustful of government in any form - even public schools.

There have also been strains of celebration by those hoping the harder stance on people living here illegally will cure some of our social ills.

Much of the growth in Umatilla and Morrow counties is due to immigrants both documented and undocumented, some with full citizenship, others with work visas and still others with no legitimate paperwork. Those communities are an irreplaceable part of our economy. We have a lot to lose with a change in immigration policy, but a lot to gain, too.

This newspaper has reported on immigration issues multiple times since the election. It has been surprising to see the basic rights many readers want to rip from noncitizens - Miranda rights, the right not to incriminate yourself and the right to attend public schools, for instance.

The Fourteenth Amendment addresses citizenship questions and the rights of citizens of this country and those who live here. It reads in part: “No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.”

The equal protections clause may be the most powerful and defining words in all of the U.S. Constitution. It is among the most commonly used - and most commonly fought over - phrase in a court of law. The phrase has helped decide landmark cases like Brown v. Board of Education, Roe v. Wade and Bush v. Gore.

We can and should argue about changing our immigration laws and how best to enforce them, but we should allow everyone the same human rights that American citizens have. That cannot be up for debate.

Yet the debate is here. And it’s worth noting that its existence is directly tied to government’s failure to solve a clear problem. For decades, both political parties admitted our immigration system was a wreck, and neither did anything about it.

That is one reason the president’s views, equal parts extremist and overly simplistic, have gained traction. Building a multi-billion dollar “beautiful wall” along our 2,000-mile border with Mexico is patently absurd, but neither political party has put any meaningful effort toward a better plan.

When our government cannot solve problems that exist for generations, it causes enmity and anger from citizens. Sometimes those citizens revolt at the ballot box, and those in control realizes they should have taken action long ago, before things got out of control.

Let’s hope it doesn’t get to that point. Eastern Oregon has a lot to lose.

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The (Albany) Democrat-Herald, March 4, on Oregon university tuition hikes:

As state support has waned over the years for Oregon’s public universities, students have filled the gap by paying more and more and more in tuition.

And it looks as if that’s going to happen yet again, as lawmakers grapple with a $1.6 billion shortfall that could leave the state’s public universities and colleges millions short of what education officials believe those institutions will need.

Just last week, the University of Oregon’s board of trustees authorized a plan to increase in-state undergraduate tuition by 10.6 percent. It’s the largest tuition increase at that university since 2010. Portland State University officials are considering a similar increase.

Oregon State University officials are mulling a 4 to 8 percent tuition increase, in addition to possible cutbacks in programs: President Ed Ray has said the university could be looking at a $20 million annual shortfall. OSU officials are mulling curtailing salary increases, going slow on new hires and leaving some open positions vacant. The University of Oregon is considering program cutbacks, with reports surfacing that it will cut $9 million from its budget.

It was just two years ago that sunnier budget times allowed Oregon lawmakers to approve a budget that included a 22 percent increase in spending on the state’s public universities.

That was enough of a boost to pull Oregon out of the cellar in terms of the amount of support it provides to higher education: The Oregonian newspaper reported last week that Oregon now ranks 37th in the nation in that category, which isn’t great, but is better than the bottom-five ranking the state usually earns.

However, It might be that we’re getting ready to resume that familiar slide to the bottom: The first-draft budget from Gov. Kate Brown called for flat-lining spending for the state’s seven universities at $667 million. University officials were hoping for an additional $100 million in funding. A later draft budget from legislative budget leaders added a bit to that number, but didn’t come close to filling the hole. The legislative budget also assumed that lawmakers would not be able to identify additional sources of revenue.

The problem with a flat budget is that it doesn’t take into account some of the very factors that are driving the state’s $1.6 billion shortfall: Increased obligations for public pensions and rising costs for medical insurance, not to mention inflation and salary increases.

Ray has said that 70 percent of OSU’s budget goes to personnel, so that limits the university’s options in trimming costs.

One budgetary option that universities do have, however, is raising tuition. The problem there, of course, is that if you raise tuition too much, the costs eventually drive students away (something like that might be happening at the University of Oregon). And as the economy continues to improve, potential students might well elect against assuming mountains of debt in order to earn a degree.

There are some ways to manage that, though: OSU, for example, is working on ways to keep students on track in school so that they can graduate in four or five years instead of six or seven, with obvious savings.

But those sorts of strategies, while useful, can only go so far.

It’s still early in the legislative session, so there’s plenty of time for changes to the state budget. Nevertheless, you would think that everyone understands the long-term risks of asking students, again and again and again, to cover the funding gaps in our state universities. Will it require a full-fledged meltdown at one or more of our schools to hammer the point home? Let’s hope not.

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The Bend Bulletin, March 4, on campaign finance and transparency:

The Oregon Secretary of State’s website allows anyone to see where campaign finance money comes from and where it goes.

But millions can slip in without much scrutiny. For instance, Secretary of State Dennis Richardson’s office says for the 2015-16 election cycle it had no way to ensure legal compliance for $7.5 million in miscellaneous contributions from 43 political committees.

Richardson’s office is not claiming that the 43 committees are hiding violations, but it doesn’t have a way to ensure the law is followed.

State Rep. Julie Parrish, R-West Linn, aims to change that with House Bill 2444. The Legislature should pass it.

In Oregon, campaign committees are required to report contributions from an individual only after they contribute $100 or more. The state’s system has three options for reporting campaign contributions. In two of the options, a campaign committee uploads a contributor’s information into the state website called ORESTAR. ORESTAR automatically labels any person’s contribution of less than $100 as “miscellaneous” and the person’s name does not appear.

In the third option, a campaign committee can opt out of ORESTAR and self-report the contributions below $100 without names. There’s nothing illegal about that. But it means that there is no way to ensure compliance with the law.

Parrish’s bill eliminates the transaction limit of $100, which means the names of people reporting less would have to be reported to the state. If the bill passed, the contributions would still show up in ORESTAR as “miscellaneous” without a name attached, but the state could track contributions from an individual.

Oregonians should have confidence in the transparency of the campaign finance system. Pass the bill and change the law.

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The Oregonian, March 5, on inmates with mental illness:

When it comes to the contentious and complicated issues of criminal justice and the mentally ill, all sides agree that Oregon’s prisons and jails are the worst possible place for people in need of medical help.

Still, due to a lack of therapeutic and housing options in Portland, the mentally ill make up at least 40 percent of the population of Multnomah County inmates, who most often are held in the Detention Center in downtown Portland. This growing inmate population presents a regular and complicated set of problems not only for county jails, but also for state prisons across Oregon and the nation.

And yet Multnomah County can no longer shrug off its experience as simply part of a national epidemic. As city and county leaders acknowledge systemic service gaps and nod in sympathy, a chilling real-life cuckoo’s nest exists high above Southwest Second Avenue within view of two Starbucks and a popular vegan restaurant.

An alarming report covered by The Oregonian/OregonLive’s Jeff Manning has shone a much-needed, public spotlight on how mentally ill inmates are treated at the facility.

The report, released this week by Disability Rights Oregon, was the third to highlight a disturbing pattern of violence and solitary confinement used to control sick inmates.

One schizophrenic inmate was so badly beaten by a deputy that jail staff wrapped his fractured face in a blanket so as not to traumatize the public when he arrived at the hospital. Another deputy tackled a mentally ill inmate, dislocating his hip and shattering the socket, yet he wasn’t provided medical care for more than six hours.

Another inmate who’d attempted suicide days before being charged with trespassing spent 14 months at the center, mostly in solitary confinement. Alone for hours on end, his conditioned worsened to the point he wouldn’t eat and pulled out his own tooth.

And on and on.

Dr. Wil Berry, a psychiatric fellow who worked a six-month rotation at the Detention Center assessed the situation with frightening clarity. “The product of the system as a whole is that we’re torturing very sick people. I hate myself for being part of it, and then I feel I don’t want to be there, and I feel guilty for leaving those patients behind. The cognitive dissonance required to work there is exhausting; it’s crazy making. There are various coping strategies: you can burn out, you can detach, you can become sadistic …”

What’s happened in the uppermost stories of this building in the heart of Portlandia is disgraceful and cannot continue.

Sheriff Mike Reese told The Oregonian/OregonLive Editorial Board that he doesn’t dispute the findings of the most recent report. And while it provides numerous recommendations on which Reese can act, the first should be to move as many mentally ill inmates as possible out of the Detention Center and into the more appropriate Inverness Jail in Northeast Portland.

As soon as possible.

Not only does Inverness provide inmates better access to open-air recreational areas, the facility has more cells that can allow ill patients more human contact. Numerous researchers have reported that solitary confinement can not only worsen a mentally ill inmate’s condition, but that prolonged time in segregation can also cause mental illness.

Inverness also is designed to offer inmates classes and rehabilitation programs, which can help inmates gain skills and find hope. Just as important, the programming allows more people from the outside to keep an eye on conditions inside the jail.

Sheriff’s office and county health officials are well aware of what’s going and know what they need to do. The time to protect these vulnerable inmates is now.