"It's really mind-boggling to think that we continue to cling to this thing, in spite of the fact that it's not working for any of us."
-- Gov. John Kitzhaber, M.D., on the U.S. health-care system
Dr. John Kitzhaber, a former emergency-room doctor, was the governor of Oregon from 1995 to 2002.
During his time in the state Senate, he wrote and implemented the controversial Oregon Health Plan, which decided which treatments would be paid for based on which were considered the best value -- price vs. results.
In January 2006, Kitzhaber began the Archimedes Movement, which describes itself as a plan for health-care reform aiming to create a viable goal of an equitable and cost-effective system.
In an interview with ABC News, Kitzhaber talked about what he perceives as an outdated health-care system in America.
Here's what Kitzhaber said to ABC News:
On the Lack of Universal Access in the United States:
"Every other industrialized country in the world has some form of universal access. In other words, people can get access to primary and preventive care. They can get access for emergency care. Sometimes they have to wait for nonemergency care, but people can actually get in and get their problems dealt with on the front end."
"[In the] United States, the growing number of people who don't have the ability to have health insurance often get their care through the emergency room, so instead of paying pennies to manage someone's blood pressure in the community, we pay tens of thousands of dollars to take care of their stroke in the hospital. So, that's our de facto system of universal access, and it's a lot cheaper obviously to keep people healthy than to take care of them after they become sick."
On How the Uninsured Raise Prices for Everyone:
"What people don't appreciate is we do have a de facto policy of universal access. It's called the emergency room, so the people who can't get in to see a doctor in a timely manner will go to the emergency room and then federal law requires that they be seen and treated."
"Then those uncompensated costs are shifted back to people who have insurance coverage by increasing their bills or increasing their insurance premiums. So, if you have a private insurance policy, about 10 percent of your premium is picking up the cost of people who are getting care in these other venues."
On Whether Our Current System Makes Sense:
"If we were to start over today with the public dollars we currently have in the system, which is over $900 billion a year, and looked at those expenses through the lens of the 21st century. … Would we allocate them in the same way and create what we have right now?"
"Would we set out to create a system that puts employers at a competitive disadvantage? Would we set out to create a system where a middle income working family with no coverage subsidizes the health-care needs of wealthy people over the age of 65? Does that meet our sniff test for equity? … The answer is clearly no!"
"No one would create what we have today, and it is astounding to me that we continue to cling to it."
On Making Tough Decisions About Who Gets Treatment:
"We'll always have more stuff we can do to people than we can afford. So, the central question in the health-care debate no one wants to look at is: 'How much claim should any one individual have for his or her health care on common resources of the society?'"