Health care seems rigged. There is fantastic care, but then comes the question of paying for it. Surveys have shown some Oregonians forgo health care because of cost. Premiums keep rising, going up an average of 12% in 2025 in Oregon’s small group markets.

Oregon legislators have set in motion a plan to have the state take over much of health care. A state board is working on plans to switch Oregon to a single-payer health care system run by the state, upending how health care works and putting many people in health care insurance in Oregon out of a job. The goal is to get everybody good care, improve care and try to keep costs down.

Oregon’s Universal Health Plan Governance Board meets about once a month, plotting how to make it happen. It is assigned to come up with a way to finance and administer a universal health plan and deliver the concept to the Legislature by Sept. 15, 2026.

How would Oregonians pay for it?

What care would Oregonians get?

What savings, if any, would there be?

One idea the board has been weighing is to have health care in Oregon run by a public corporation. There are only a handful of public corporations in Oregon. One example is Oregon Health & Science University. Another example is SAIF, Oregon’s not-for-profit workers’ comp insurance company. No two public corporations in Oregon have the same structure.

Oregon’s health care public corporation wouldn’t be a state agency. The concept is it would be a public body bound by rules of transparency, such as the public meeting and records law. All the laws that apply to state agencies wouldn’t necessarily apply. All laws that apply to public bodies would apply. It would be a part of state government, but very different from it.

A board would need to be established to run it. Board members would be appointed by the governor and approved by the Senate, at least as explained in a meeting of the state’s health plan governance board.

We have to wonder what the level of accountability would be to Oregonians. This new public corporation would control billions of tax dollars and make health care decisions that will affect millions of lives and jobs. There would be no direct accountability to Oregonians. It would only have tangential accountability to the Legislature.

What if the public didn’t like the decisions this public corporation was making about health care? How exactly would the public be able to express its opinion and what influence would the public have? Of course, it’s not like the public has any real say now.

Decisions about this public corporation and Oregon’s single-payer health care are, at least, more than a year away. But remember a couple years ago when the state was talking about a statewide wildfire hazard map? Hardly anybody was paying attention. Look how that turned out. The health care changes under consideration may change the flow of billions of dollars and how and what health care you receive. You can find out more here: tinyurl.com/ORsingle.