Thank you for this great perspective, I support this legislative effort.
While I am of a free market, less government advocate I too often see greed, profit, power and control the motivators decision making. Maybe we encourage a cultural mindset of letting people just do what they do when it comes to health and public safety. Doctors doctor, law enforcement enforces the law, fire fighters prevent and fight fires, etc. I will support anything that gets out of the way of professionals doing their profession just as your legislative proposal suggests for health care. Thank you for taking a stand that is neither left or right but a common sense solution, or at least a start.
Appreciate your support! The goal here is exactly that—letting doctors practice medicine without corporate interference. A free market works best when professionals are free to do their jobs without middlemen distorting priorities. This bill isn’t about more regulation, it’s about restoring balance.
Cyrus is vice-chair of House Committee on health and I'm glad he is. He may have distorted the OHA thing in relation to Tillamook dialysis a bit, but what's happened since December 2024 is terrible. It's a shame the house/senate only make the laws. We should pelt the governor with calls and letters until the shameful situation here is resolved. The governor is in charge of enforcing the laws.
I have to think if all of us kibitzers would call/write Tina and keep calling/writing something might happen. I e-mailed her yesterday, but I think e-mail is too easy to ignore. Cyrus was wrong about it being 11 people being denied local dialysis, it's actully 16 says Molly, head nurse of kidney unit in Tillamook. The hang-up excuse that is given is Tillamook does not have isolation room, which didn't seem to matter when for profit US Renal was doing it. DCI the company that wants to start local dialysis is a non-profit.
So great to read this post. Would you share with us who helped draft this bill? Were any doctors or insurance or other@ “stakeholders”( sorry for that term, it’s all I can come up with for now) consulted when crafting this solution? I don’t have any problems with it, just curious about its genesis. Thanks.
Fair question. Rep. Bowman held multiple stakeholder meetings during the interim, with input from hundreds of people and groups—including doctors, MSOs, community members, and others directly affected.
Dr. Jarvadi I appreciate your personal expertise on this issue, and your historical perspective. 1947 was before my time, but I remember back in 1974 when the USA had the best health care in the world. People would fly into the states from all over the world to get that care here.
Doctor's could decide which patients to see all by themseves, too, and whether or not they would take a couple chickens or a piglet in trade for a home visit.
But the the US Congress in it's wisdom decided to make health insurance a tax that employers had to pay, and mandatory health insurance turned insurance company profits into part of the US government. As you must know, corporations have a primary obligation to maximize returns for their shareholders, and this is diametrically opposed to the primary obligation of doctors to first do no harm to their patients. We have seen 5 years of profiteering from bioweapons being mandated by schools, hospitals, and the federal government itself, and now we're finding out that tens of millions of people are dead and perhaps billions injured by GMO jabs laced with synthetic DNA that cause every medical harm I could name, from heart attacks in little children to VAIDS.
That is the fruit of turning over the practice of medicine to corporations, taking the decision making power from doctors caring for people to unborn, undying, unfeeling inhuman and inhumane corporations that first and foremost have a legal obligation to maximize the profit of their shareholders. That's turned into an actually hellish situation, and it's not your fault, nor is there anything you can do about federal corruption of American laws by Big Pharma lobbyists.
We are plummeting in every quality of care metric there is. America is 50th in infant survival. At the federal level Sec. Kennedy seems determined to make some changes, ensuring the mandated vaccination schedule inflicted on our kids that correlate almost perfectly with the rise in Autism from 1 in 10k when I was a kid my parents took to measles, mumps, and chicken pox parties so I'd catch those mild illnesses at the right age and gain lifelong immunity from them, to 1 in 6 kids today, is the result of double blind placebo studies by researchers without financial obligations to pharmaceutical corporations. What I haven't heard from Sec. Kennedy is a determination to sever that chain between medical care and corporate profiteers, and that's what needs to happen to restore America to it's position as the number one best health care system in the world.
I see that's what you're doing your best to do by 'preventing MSOs from meddling in doctor's decisions.' I also see the elimination of non-compete clauses as a step in the right direction. But I don't think these can overcome the legal mandate corporations have to maximize profit of their shareholders. Clinics and pharmacies we depend on are being centralized and small towns on the coast are losing access to doctors and medication providers that used to serve their communities. Today I have to drive an hour and a half to pick up my prescriptions or see my doctor. Corporations are going to keep cutting costs - they have to, by law - and that means they're going to keep merging clinicians offices, keep reducing the number of pharmacies to fewer and fewer larger and larger retailers, until we're going to have to drive to the valley and instead of an hour and a half it'll be six hours drive to see a provider or pick up prescriptions.
If MSOs are limited in their ability to increase profits, those corporations will enter different businesses. Preventing them from cutting costs will cause them to invest in other businesses that provide better returns to their shareholders, and that's what the law requires them to do. What needs to happen is that corporations be prevented from providing medical care, because corporations by law have to maximize returns to their investors, and that cannot somehow also provide the best medical care to Oregonians.
Half measures won't do. If we want small towns on the Oregon coast to have medical clinics and pharmacies, we have to eliminate corporate ownership of medical service providers, and nothing else will prevent that primary purpose of corporations to profit their investors by US law from degrading medical care.
A couple decades ago there was a clinic in Cloverdale, and a pharmacy too. They're both gone.
Now Tillamook Pharmacy is gone, and Kroger owns both pharmacies in Tillamook, because Kroger owns both Fred Meyers and Safeway, and those are the only two pharmacies in Tillamook. Do you think it will take 5 years for the Kroger corporation to combine those operations and cut the costs of operating two competing pharmacies in Tillamook? I do not. What will Senate Bill 951 do to prevent that from happening?
When it comes right down to it, Kroger has pharmacies that provide better returns with lower operating costs in Portland and Salem. Will Senate Bill 951 prevent Kroger from closing the last pharmacy in Tillamook and leaving everyone in the county a six hour drive to Portland and back to pick up their scrips every month? Senate Bill 951 doesn't resolve this issue, and that corporate profiteering is what is continually eroding the quality of health care in America, and has to end unless we want to tolerate even worse care at even higher costs.
Price fixing causes shortages. Preventing corporations from maximizing profit in health care will cause them to go into other businesses where they aren't legally constrained from profiteering.
The only solution is to sever medicine from corporations. Medicine is about people, not profits.
Appreciate the thoughtful response. You're absolutely right that corporate consolidation is hollowing out local healthcare, and rural communities are feeling it the most. Senate Bill 951 won’t single-handedly stop Kroger from making business decisions, but it does put real guardrails on how MSOs interfere with patient care. Is it a full cure? No. But it’s a step toward tipping the scales back in favor of doctors and patients instead of corporate bottom lines. The bigger fight—keeping medical care out of the hands of profit-maximizing conglomerates—is one we need to keep pushing.
I find we're in a position where the future of our health care decisions is already in the hands of corporations, and I have little control over the health care I will receive. I have untreated conditions that will remain untreated as a result of exorbitant costs of treatments that I can't undertake, and no board in it's right mind would fund either. I am not alone.
You're absolutely right that we need those guardrails right now, but I cannot ignore that putting those guardrails on corporations will be tantamount to restraining that corporate quest for maximizing profit - and that is equivalent to price fixing, that will reduce the availability of services. I've had doctors go to bat for me by properly diagnosing and prescribing medication I needed and being fired because of it. Finally one of them pleaded with me to understand the position they were in, because every decision doctors make are overseen by committees that have other priorities than patient care, even political pressures that as a mere patient I had no clue were even involved, and because of that I still have that doctor and we work together to manage my medical needs as best we can with the tools the doctor is allowed to use.
A lot of people and their doctors are in similar circumstances, and worse. Not long ago Luigi Mangione shot Brian Thompson, the CEO of the health insurance corporation that more denied care than it's competitors, and enjoyed better returns for it's investors as a result. That shooting sent shockwaves across boards of directors. Several corporations pulled pictures of their corporate officers off their websites and otherwise rearranged their deck chairs, but suddenly a lot of treatments that were denied payment were provided funding, and suits for malpractice were quickly settled, instead of the usual tactic of dragging them out for as long as possible.
Now, I'm not recommending you shoot anyone, but am trying to point out that the capture of medicine by corporations is a fait accompli, and Americans are so unserved by having their medical needs funded by corporate boards that a majority of young Americans feel that Luigi was justified. We can see the future from here, and where corporations are facing restrictions on their financial rapine they will simply close clinics and pharmacies to invest their money in markets where there are no guardrails.
While the solution is to cut them out of our medical industrial complex, the reaction of insurance corporations to that level of anger at their profiteering was to relent and fund some damn medical care, and settle suits instead of dragging them out to win the cases that the their opponents defaulted by dying. President Trump threatens tariffs and gets action from countries that have ignored reasonable requests to act.
I have to think that Oregon has some tools with teeth that can get that kind of action from corporations that will walk back their profiteering, in the post-Luigi environment they are in, or we need tools with those kind of teeth. My preference in this regard is for maximum pressure on the boards that are consolidating clinics and pharmacies and reducing services to Oregonians. Hit them in their wallets when they do this, and hit them hard. We need to demand small town pharmacies and clinics from the corporations that are making me drive an hour and a half to see my doctor and pick up my prescriptions today so their stockholders get a couple more cents on their quarterly dividend.
If you can put forth legislation that does that I am confident that the people that think Luigi is a hero will realize you're the real hero, and that the solution to rising health care costs and worsening service isn't assassinating CEOs. There's a lot of people hurting, angry, and looking for heroes. If you build it, they will come. Things can't go on as they are, and pushing corporations to pull out of markets with reasonable requests isn't going to raise the pressure on them to do what we need them to do right now, which is fund treatment doctors prescribe, get committees off the backs of doctors prescribing for their patients, and to serve markets in smaller communities that are underserved today.
There's a lot of hot iron out here in people that are being held in the fire, and it's time to hit it hard. If you propose legislation with brutal teeth that will commit unreasonable devastation of corporate bottom lines, like 25% of the income of corporations operating in oregon that deny funding a certain percentage of services, or that fail to open pharmacies and clinics in small towns, every purple haired Commie with a bunion will come out and cheer, and so will all the Boomers that are suffering from untreated conditions, like me.
Fortune favors the bold, and these are times for bold men to make bold moves.
Thank you for this great perspective, I support this legislative effort.
While I am of a free market, less government advocate I too often see greed, profit, power and control the motivators decision making. Maybe we encourage a cultural mindset of letting people just do what they do when it comes to health and public safety. Doctors doctor, law enforcement enforces the law, fire fighters prevent and fight fires, etc. I will support anything that gets out of the way of professionals doing their profession just as your legislative proposal suggests for health care. Thank you for taking a stand that is neither left or right but a common sense solution, or at least a start.
Appreciate your support! The goal here is exactly that—letting doctors practice medicine without corporate interference. A free market works best when professionals are free to do their jobs without middlemen distorting priorities. This bill isn’t about more regulation, it’s about restoring balance.
And it is not just rural Oregon that is negatively impacted. Look what happened to patients in Portland when the giant Providence fired local physicians and outsourced anesthesiology services to a private equity firm. It’s still a mess over a year later. https://www.oregonlive.com/business/2024/02/providence-hospitals-surgeries-halved-following-anesthesiology-transition-delays-continue.html
Exactly. When bean counters run healthcare, patients get the short end—rural or urban.
Cyrus is vice-chair of House Committee on health and I'm glad he is. He may have distorted the OHA thing in relation to Tillamook dialysis a bit, but what's happened since December 2024 is terrible. It's a shame the house/senate only make the laws. We should pelt the governor with calls and letters until the shameful situation here is resolved. The governor is in charge of enforcing the laws.
Unfortunately we have Kate Brown 2.0 as governor.
Elections are coming, don't tell me, tell Tina
I have to think if all of us kibitzers would call/write Tina and keep calling/writing something might happen. I e-mailed her yesterday, but I think e-mail is too easy to ignore. Cyrus was wrong about it being 11 people being denied local dialysis, it's actully 16 says Molly, head nurse of kidney unit in Tillamook. The hang-up excuse that is given is Tillamook does not have isolation room, which didn't seem to matter when for profit US Renal was doing it. DCI the company that wants to start local dialysis is a non-profit.
So great to read this post. Would you share with us who helped draft this bill? Were any doctors or insurance or other@ “stakeholders”( sorry for that term, it’s all I can come up with for now) consulted when crafting this solution? I don’t have any problems with it, just curious about its genesis. Thanks.
Fair question. Rep. Bowman held multiple stakeholder meetings during the interim, with input from hundreds of people and groups—including doctors, MSOs, community members, and others directly affected.
Thank you!
Jan,
You can find more details on the bill here:
https://olis.oregonlegislature.gov/liz/2025R1/Measures/Overview/SB951
Thank you Cyrus for your efforts!
I think you've found a winner here. I urge all of us to write Gov. Kotek about the dialysis situation in Tillamook. Here's address
Governor Tina Kotek
Attn: Constituent Services
900 Court Street, Suite 254
Salem, Oregon 97301-4047
February 26, 2025
Her phone is 503-378-4582
Cyrus can't change this here-and-now, but maybe if we citizens applied pressure, the Governor can.
Here's link to December Headlight Herald article that made it seem like the problem was solved
https://www.tillamookheadlightherald.com/news/tillamook-kidney-center-prepares-for-opening/article_19badaa6-b0d6-11ef-9005-733ab83857cd.html
Cyrus...For the people.
I'm a Dem but pleased you are stepping up and finding common ground with Dems to get things done. Good job.
Your mantra can be "Conservatives Care." Thanks so much to you and Ben.
Betty Holladay
Dr. Jarvadi I appreciate your personal expertise on this issue, and your historical perspective. 1947 was before my time, but I remember back in 1974 when the USA had the best health care in the world. People would fly into the states from all over the world to get that care here.
Doctor's could decide which patients to see all by themseves, too, and whether or not they would take a couple chickens or a piglet in trade for a home visit.
But the the US Congress in it's wisdom decided to make health insurance a tax that employers had to pay, and mandatory health insurance turned insurance company profits into part of the US government. As you must know, corporations have a primary obligation to maximize returns for their shareholders, and this is diametrically opposed to the primary obligation of doctors to first do no harm to their patients. We have seen 5 years of profiteering from bioweapons being mandated by schools, hospitals, and the federal government itself, and now we're finding out that tens of millions of people are dead and perhaps billions injured by GMO jabs laced with synthetic DNA that cause every medical harm I could name, from heart attacks in little children to VAIDS.
That is the fruit of turning over the practice of medicine to corporations, taking the decision making power from doctors caring for people to unborn, undying, unfeeling inhuman and inhumane corporations that first and foremost have a legal obligation to maximize the profit of their shareholders. That's turned into an actually hellish situation, and it's not your fault, nor is there anything you can do about federal corruption of American laws by Big Pharma lobbyists.
We are plummeting in every quality of care metric there is. America is 50th in infant survival. At the federal level Sec. Kennedy seems determined to make some changes, ensuring the mandated vaccination schedule inflicted on our kids that correlate almost perfectly with the rise in Autism from 1 in 10k when I was a kid my parents took to measles, mumps, and chicken pox parties so I'd catch those mild illnesses at the right age and gain lifelong immunity from them, to 1 in 6 kids today, is the result of double blind placebo studies by researchers without financial obligations to pharmaceutical corporations. What I haven't heard from Sec. Kennedy is a determination to sever that chain between medical care and corporate profiteers, and that's what needs to happen to restore America to it's position as the number one best health care system in the world.
I see that's what you're doing your best to do by 'preventing MSOs from meddling in doctor's decisions.' I also see the elimination of non-compete clauses as a step in the right direction. But I don't think these can overcome the legal mandate corporations have to maximize profit of their shareholders. Clinics and pharmacies we depend on are being centralized and small towns on the coast are losing access to doctors and medication providers that used to serve their communities. Today I have to drive an hour and a half to pick up my prescriptions or see my doctor. Corporations are going to keep cutting costs - they have to, by law - and that means they're going to keep merging clinicians offices, keep reducing the number of pharmacies to fewer and fewer larger and larger retailers, until we're going to have to drive to the valley and instead of an hour and a half it'll be six hours drive to see a provider or pick up prescriptions.
If MSOs are limited in their ability to increase profits, those corporations will enter different businesses. Preventing them from cutting costs will cause them to invest in other businesses that provide better returns to their shareholders, and that's what the law requires them to do. What needs to happen is that corporations be prevented from providing medical care, because corporations by law have to maximize returns to their investors, and that cannot somehow also provide the best medical care to Oregonians.
Half measures won't do. If we want small towns on the Oregon coast to have medical clinics and pharmacies, we have to eliminate corporate ownership of medical service providers, and nothing else will prevent that primary purpose of corporations to profit their investors by US law from degrading medical care.
A couple decades ago there was a clinic in Cloverdale, and a pharmacy too. They're both gone.
Now Tillamook Pharmacy is gone, and Kroger owns both pharmacies in Tillamook, because Kroger owns both Fred Meyers and Safeway, and those are the only two pharmacies in Tillamook. Do you think it will take 5 years for the Kroger corporation to combine those operations and cut the costs of operating two competing pharmacies in Tillamook? I do not. What will Senate Bill 951 do to prevent that from happening?
When it comes right down to it, Kroger has pharmacies that provide better returns with lower operating costs in Portland and Salem. Will Senate Bill 951 prevent Kroger from closing the last pharmacy in Tillamook and leaving everyone in the county a six hour drive to Portland and back to pick up their scrips every month? Senate Bill 951 doesn't resolve this issue, and that corporate profiteering is what is continually eroding the quality of health care in America, and has to end unless we want to tolerate even worse care at even higher costs.
Price fixing causes shortages. Preventing corporations from maximizing profit in health care will cause them to go into other businesses where they aren't legally constrained from profiteering.
The only solution is to sever medicine from corporations. Medicine is about people, not profits.
Thanks!
Appreciate the thoughtful response. You're absolutely right that corporate consolidation is hollowing out local healthcare, and rural communities are feeling it the most. Senate Bill 951 won’t single-handedly stop Kroger from making business decisions, but it does put real guardrails on how MSOs interfere with patient care. Is it a full cure? No. But it’s a step toward tipping the scales back in favor of doctors and patients instead of corporate bottom lines. The bigger fight—keeping medical care out of the hands of profit-maximizing conglomerates—is one we need to keep pushing.
I find we're in a position where the future of our health care decisions is already in the hands of corporations, and I have little control over the health care I will receive. I have untreated conditions that will remain untreated as a result of exorbitant costs of treatments that I can't undertake, and no board in it's right mind would fund either. I am not alone.
You're absolutely right that we need those guardrails right now, but I cannot ignore that putting those guardrails on corporations will be tantamount to restraining that corporate quest for maximizing profit - and that is equivalent to price fixing, that will reduce the availability of services. I've had doctors go to bat for me by properly diagnosing and prescribing medication I needed and being fired because of it. Finally one of them pleaded with me to understand the position they were in, because every decision doctors make are overseen by committees that have other priorities than patient care, even political pressures that as a mere patient I had no clue were even involved, and because of that I still have that doctor and we work together to manage my medical needs as best we can with the tools the doctor is allowed to use.
A lot of people and their doctors are in similar circumstances, and worse. Not long ago Luigi Mangione shot Brian Thompson, the CEO of the health insurance corporation that more denied care than it's competitors, and enjoyed better returns for it's investors as a result. That shooting sent shockwaves across boards of directors. Several corporations pulled pictures of their corporate officers off their websites and otherwise rearranged their deck chairs, but suddenly a lot of treatments that were denied payment were provided funding, and suits for malpractice were quickly settled, instead of the usual tactic of dragging them out for as long as possible.
Now, I'm not recommending you shoot anyone, but am trying to point out that the capture of medicine by corporations is a fait accompli, and Americans are so unserved by having their medical needs funded by corporate boards that a majority of young Americans feel that Luigi was justified. We can see the future from here, and where corporations are facing restrictions on their financial rapine they will simply close clinics and pharmacies to invest their money in markets where there are no guardrails.
While the solution is to cut them out of our medical industrial complex, the reaction of insurance corporations to that level of anger at their profiteering was to relent and fund some damn medical care, and settle suits instead of dragging them out to win the cases that the their opponents defaulted by dying. President Trump threatens tariffs and gets action from countries that have ignored reasonable requests to act.
I have to think that Oregon has some tools with teeth that can get that kind of action from corporations that will walk back their profiteering, in the post-Luigi environment they are in, or we need tools with those kind of teeth. My preference in this regard is for maximum pressure on the boards that are consolidating clinics and pharmacies and reducing services to Oregonians. Hit them in their wallets when they do this, and hit them hard. We need to demand small town pharmacies and clinics from the corporations that are making me drive an hour and a half to see my doctor and pick up my prescriptions today so their stockholders get a couple more cents on their quarterly dividend.
If you can put forth legislation that does that I am confident that the people that think Luigi is a hero will realize you're the real hero, and that the solution to rising health care costs and worsening service isn't assassinating CEOs. There's a lot of people hurting, angry, and looking for heroes. If you build it, they will come. Things can't go on as they are, and pushing corporations to pull out of markets with reasonable requests isn't going to raise the pressure on them to do what we need them to do right now, which is fund treatment doctors prescribe, get committees off the backs of doctors prescribing for their patients, and to serve markets in smaller communities that are underserved today.
There's a lot of hot iron out here in people that are being held in the fire, and it's time to hit it hard. If you propose legislation with brutal teeth that will commit unreasonable devastation of corporate bottom lines, like 25% of the income of corporations operating in oregon that deny funding a certain percentage of services, or that fail to open pharmacies and clinics in small towns, every purple haired Commie with a bunion will come out and cheer, and so will all the Boomers that are suffering from untreated conditions, like me.
Fortune favors the bold, and these are times for bold men to make bold moves.