Engaging the Public in Health Policy
Bruce Goldberg, MD
Director-designee, Oregon Health Authority
National Health Policy Conference
February 8, 2011
Oregon’s History with Health Reform
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Innovating in health reform since the 80s
1990s: Redesign of Medicaid into the Oregon Health Plan
was rooted in:
surveys of community values
public meetings throughout the state
citizen led, public commissions making difficult decisions in
a transparent and public manner
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Most recent efforts by the state started in 2007
Had an evolution of public engagement and input from 2007
through today
2007 - Laying the Groundwork for Public Engagement:
Senate Committee on Health Reform
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Oregon Senate held hearings in 2007 legislative session
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Stakeholders, partners, advocates, and the general public
invited to provide testimony and advocacy
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Senate leaders of the committee traveled around the state
holding meetings
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Committee began conversation to identify problems and set in
motion a plan for reform
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Resulted in citizen Oregon Health Fund Board to develop a plan
2008 - Expanding the Conversation
• 7 member citizen led Oregon Health Fund Board
• Task: develop a comprehensive plan for Oregon
• Stakeholder committees heard public testimony
• More than 100 public meetings
• 15 statewide community meetings
• Polling data used to identify important themes
• Coalitions of advocates were organized
• Final report to Legislature
2009 - Response by the Legislature
• Omnibus bill for health reform passed
• Laid out path for implementing reforms
– Establish Oregon Health Authority as single point of
responsibility for health and health care programs in the
state
– Established citizen led Oregon Health Policy Board
– Required planning for an insurance exchange
– Greater transparency in insurance rate review
– Called for Board to submit detailed plan to legislature by
12/21/2010 for comprehensive reforms that would lead to
better health and access to affordable health care
Lessons Learned
1. Public process - outside of the
legislative arena - is critical for
success
Transparent, decision making that is
led by and involves the general public
can be an effective way to change
public policy
2. Go where they are
Integrating Public Engagement into
Implementation
• Hired Community Engagement Coordinator
– Created two-way communication
– Outreach to new orgs/communities
– Go where people are meeting
– Met with 400 people individually as well as
numerous small groups
• Local chambers of commerce, rotary, hospital
staff, etc.
– Create a uniform strategy
3. Structure is critical
• Need an infrastructure to organize
stakeholders
• Create a consistent message
• Use partners to get your message out
and vice versa
• Repetition
4. Invite people in – stakeholder
developed proposals
• Committees of stakeholders developed
recommendations to boards
• Proposals vetted through committees
and again through board
– Recommendations made public
– Input obtained before board’s final action
5. Communicate regularly and involve
new media
• Monthly e-Bulletin to 10,000+ recipients
• Meetings are live web-streamed
• Facebook, Twitter, YouTube
2010 public input
• Board meetings - live streamed
– Real time email questions
• 850 people attended
community meetings
• 600 people commented through
web survey tool
• More than 200 e-mail
comments and testimony
6. Make it Personal and Local
• Making it about “Oregon’s Health Reform”
• Relating back to local values
• Use personal stories and examples about
Oregonians
• Its about “us”
• Get help from experts to hone your message
7. Focus on success
• Talk about what works
• Show success stories