Sean C. Morgan
Of The New Era
Dr. Bob McDonald’s top priorities as a senator would be health care, education and the economy.
McDonald, a Democrat, is running against Republican incumbent Fred Girod for state Senate District 9. Ballots will be mailed Oct. 17 for the Nov. 4 election.
“The issue about which I’m most passionate is health care,” said McDonald, who is a physician. “I believe our health care system is broken and causing suffering.”
It is the number-two cause of bankruptcy, he said, and those bankruptcies happen to people who thought they were covered.
Health insurance often doesn’t cover pre-existing conditions, he said. There’s gaps in coverage, co-pays and other reasons it costs patients who have coverage.
“People who thought they were safe were bankrupted,” he said.
He doesn’t have the whole solution, he said, but he has the expertise to help the Legislature craft a good policy.
A year ago, he was at a town hall meeting with then-District 9 Sen. Roger Beyer, he said. Beyer answered a question, “I buy insurance for my family. Everybody should.”
He didn’t see a problem with the health care system, and neither does his opponent, Fred Girod, McDonald said. It’s sort of like John McCain three weeks ago saying the economy is sound.
McDonald is the first Democrat to run for this seat in a decade, he said. “If I run and lose, at least I’ve given people a choice.”
That’s why he is running.
The Oregon Health Fund board was established in 2007 to study the health care situation and come up with recommendations for the 2009 Legislature, McDonald said. He has been attending those meetings and giving public testimony.
He said he has the best experience to evaluate the recommendations wisely, he said. He has been a doctor, patient and a small business owner providing family wage jobs.
“So I know it from the business angle,” he said. He is a founding member of the Silverton ethics review board, mediating between angry patients and defensive doctors. He now provides free health care to those in need at the Silverton Clinic.
His goal is “to be sure all Oregonians have health care coverage,” he said, and he means good health care.
He also wants to decrease the cost of health care, he said.
“It sounds impossible, including everybody while decreasing the cost.”
But Americans spend twice as much money per individual compared to other countries in the world, he said. Americans spend more, but they don’t spend as wisely.
American health care doesn’t focus on prevention, he said.
“Our model is wrong for how we deliver health care.”
Until someone is sick, they are assumed to be healthy, he said. Patients go to the hospital, and the doctors fix them and send them out the door.
Americans spend 80 percent of their health care dollars on chronic illness, he said. Instead of effectively treating high blood pressure, American health care waits for the heart attack or stroke.
“We should have prevented that heart attack,” he said. That means bringing the patient into the process and giving the patient responsibility for measuring blood pressure at home and working with health care providers at all levels.
By letting all levels work with patients, patients can save money, McDonald said. While monitoring blood pressure at home, a patient can report to a pharmacist, who should be authorized to dispense medication as needed.
Practitioners should be allowed to practice up to their competency levels, McDonald said, and “you have to take an active role in your own health care.”
People spend like crazy to treat diabetes, while schools have pop machines in the halls to raise money, McDonald said.
“There’s just so much we can do better at less cost,” he said.
The health care system will have to incorporate everyone or it won’t cost less, he said. “You have to pull everybody into the pool. That’s the way insurance works. Everybody pays for it.”
He also expects individuals receiving health care to pay, at least the cost of a pack of cigarettes, for their health care, he said. They should be invested in the system.
“It’s not something people should expect the government to give them. Everybody should make a contribution,” he said, even people on the Oregon Health Plan. When people get something for free, they don’t appreciate it.”
Oregon can improve health care, cover everyone and lower costs, McDonald said. There’s no one system Oregon can adopt, but it can look to other systems and adopt what will work for Oregon and incorporate responsibility and personal accountability.
McDonald is the son of public school teachers, he said. His whole education, including college and medical school, was in the public school system. He is endorsed by the Oregon Education Association.
“I think that education is the future of our state,” he said. “Without strong education, we won’t have democracy or our economy.”
Oregon now spends more money on incarceration than higher education, he said. Pulling more money out of higher education “will drive our economy into the ground.”
He is a firm believer in public safety, he said, but he thinks drug addicts should be treated instead of imprisoned. Every dollar spent on treating addiction saves $7 in other areas, he said.
“It’s the addiction driving the behavior,” he said, “and methamphetamine is a horrible addiction.”
It’s the number-one cause of child abuse, he said, and when meth addicts are incarcerated, “they receive a higher education in crime.”
Instead of incarceration, drug treatment has saved $250 million in Texas, he said.
Energy is the key to the economy, McDonald said, and Oregon can establish itself as a leader in energy technology.
In June, Oregon Institute of Technology graduated its first student with a renewable energy engineering degree, he said. “Oregon has really taken the lead in clean energy technology.”
Those are “well-paying jobs that can’t be outsourced,” he said. The jobs require education, so the state can’t keep cutting education to warehouse more prisoners.
The money saved by drug treatment instead of incarceration can help provide higher education, keep students in Oregon and create a better life for Oregonians.
“Without education, you don’t have a strong economy,” he said.
Restored timber payments have provided a lifeline to timber counties, he said. They’ll run out in four years, so in the meantime, Oregon needs to improve its rural economy.
For more information, visit drbobfororegon.com on the Web.
Gun Control
Gun control is where it should be, McDonald said. He would not support adding or removing any laws.
Abortion
“Abortion is not a state issue,” he said. “It’s a federal issue. I believe you can’t trounce on patient rights.”
Abortion should be considered as part of public health and safety, he said, asking if it’s “moral to say we’re pro-life,” while 120,000 children are without health care insurance.
What he can do in Oregon is work on making sure children have coverage, he said.
If a measure of society is how well it takes care of its most vulnerable, he said, he hopes those who would look at using abortion as a single issue would look at taking care of the vulnerable.
“I’m a compassionate person,” he said, and one of the most stringent issues in ethics is patient autonomy.
“People should have control over their own healthcare,” he said.
Banning abortions would lead back to the old days when the rich could go to another country and get an abortion, while the poor would often attempt to do their own, endangering their lives and the chance to have children.
He thinks parents need to educate their children, he said. “Every time I had a teenage pregnancy come into my office,” his two boys “would get the lecture.”
“You can’t divorce the issue of abortion from the issue of taking care of children,” he said.
Illegal Immigration
“We certainly need some kind of immigration reform,” he said. “What we’re doing right now doesn’t seem right for anybody.”
This is a nation of laws and a nation of immigrants, he said.
Sweet Home north through the valley is agricultural, and “farming is really dependent on migrant labor,” he said. It’s not as if the migrants are taking jobs away from citizens who would want the jobs. He supports a program where guest workers can find transportation here for work and then go home.
Allowing them to come legally through a work visa will keep them from having to use “coyotes” to get across the border at a cost of thousands of dollars, he said. “We’re partially, at least, responsible for the human suffering.”
Allowing legal ways into the United States to work “would be much more humane and cheap,” he said. “I don’t believe we should make the farmers the enforcement arm for the immigration service” or criminalize farmers for using the labor.
While illegal immigrants come across the border, they are invisible, hiding drug runners among their numbers, he said. If they came through the borders legally, the drug runners would be more visible.
There is less crime among working Hispanics than Americans in general, he said, and they actually do pay into the public service system while being held outside of the benefits.
For example, if they have a fake Social Security number, money is still deducted for Social Security, he said. They won’t be able to collect on it.
“It’s misrepresented they’re ripping off the system,” he said. “They’re paying into the system.”
Bailout
“I don’t think this was necessarily the right thing,” he said. “I think we rushed into it.”
He certainly opposes the government bailing out the banks, favoring the big financial institutions rather than individual taxpayers, he said. He also doesn’t like the huge debt encumbrance.
Drug Testing for Those Receiving Public Assistance
“It always frosts you when you feel like people are gaming the system,” he said. “I don’t know if there’s a system where you can help people without people working you.”
It happened to him in his practice, he said, but “I don’t want to exclude people who are down and out.”
He is concerned that the outcome might be punitive, while he favors providing addiction treatment.
He doesn’t know how to make the situation pure, but maybe there’s a way to provide safeguards to keep people from taking advantage of the situation, he said. “I don’t want to have my heart hardened, but I don’t want to be a sap.”
“Under God” in the Pledge
No problem, he said.
Drilling Offshore
McDonald doesn’t think it will change the price of gasoline, he said. Any effect, decades later, will be small.
The United States uses 25 percent of the world’s oil and has 3 percent of its reserves, he said. “We wouldn’t see an increase in oil production for 30 years.”
Still, he’s not opposed to offshore drilling, he said. He is opposed to liquefied natural gas terminals in Oregon.
The goal should be ending dependence on fossil fuels, particularly foreign fossil fuels, he said. “It’s not good for us or the planet.”
Clean energy would help strengthen the economy, he said.
Iraq
“I believe it’s a misguided war,” he said. It was started under false pretenses.
“We took our eye off Afghanistan and bin Laden to attack Iraq,” he said. This doesn’t mean the United States can leave Iraq precipitously because it must take responsibility and then refocus its efforts toward Afghanistan and bin Laden.
Education Standards and No Child Left Behind Act
“I don’t know any teacher that likes No Child Left Behind,” he said. “It means they’re simply teaching to tests.”
Critical thinking skills get left behind in favor of teaching to the tests,” he said. “One thing you can do is decrease class size.”
Smaller classes yield better results, he said. When a class is too large, one-on-one time with teachers is reduced.
Regarding standards, he “would listen to the recommendations of current educators and see what they think,” he said.
He added that teachers are underpaid.
Economic Difficulties and Tax Revenue
“You can’t raise taxes out of a down economy,” he said. “You can just put people down further.”
Fortunately, Oregon has a rainy day fund to help deal with tough times, he said. State police is one area where he would not want to cut. He would rather invest in more troopers.
He also would prefer to avoid cutting programs like Oregon Project Independence, which saves money by helping seniors live independently and avoid the high costs of nursing homes and other facilities.
Oregon can also leverage funds by treating addiction instead of incarcerating addicts, he said.
He supports increasing the tobacco tax.
It is reasonable, he said, and it can get health care coverage to more children while drawing matching funds from the federal government. Increasing the cigarette tax amplifies revenue, and as the price per pack increases, fewer teens get hooked.
Tobacco needs new teens addicted every year to replace the adults that it kills, he said. “It’s (cigarette tax) positive for kids in both ways.”
Universal Health Care
“We need to make sure everybody’s covered,” he said. “If you don’t cover everybody it doesn’t work.”
He doesn’t like the terms “universal health care” or “socialized health care” because they have negative connotations, he said. “Universal health care” smacks of “socialized health care,” a term used to discredit President Harry Truman by connecting it to communism when he attempted to provide coverage for all Americans.
Speed Limit
Before he supported a speed limit increase on highways and freeways, he would want to see data correlating the increase with fatal accidents from other states. He also is concerned that higher speed limits decrease gas mileage.
Ducks or Beavers
“Whoever’s winning,” he joked. He doesn’t really pick a side during the Civil War. “I like to see everybody play up to their ability.”
Country or Rock ‘n’ Roll
He prefers his music more folk and country rock.