Welcome, everybody. Lets thank the First Unitarian Church for welcoming us here this evening. Church steps up and stands out and steps up for equal rights and social justice, and we want to thank them for that. I think we should thank comes blumenauer for holding this congressman blumenauer for holding this event. We think this is a major step toward to have this forum to talk about where we would like to go, and how you can get involved to move toward this goal. Let me outline the plan and i will get out of the way. We have some Major National and local experts on this issue about Health Reform who can help us understand these terms like singlepayer, medicare for all. And help us understand the National Landscape and then known and the local landscape in the state. They will be introduced in turn. Will endbefore 7 00, of that part of the program and have questions and answers. , whatwho have questions we will do is there will be people with microphones up top and down below, and when you ask a question we will feel them at willlists will ask answer them as best they can. I will moderate. Cspan is here, so willie will try to they on time, and hopefully they will turn the cameras around and show that the audience here the audience is here while the speakers are speaking. Congressman blumenauer . [applause] representative blumenauer thank you, paul. Thank you, t. J. I cannot think of a better place to have this conversation. Over the course of the last 10 months, they have been unlike we have ever seen. In fact, we have had several of these conversations right here in this church. But the last 10 years have been an intense period of political upsets, challenging basic assumptions, watching our problems get worse while fundamental assumptions about halt about how to solve them, the question. Because of the near meltdown of the company, the fierce tea turmoil, theal chaos of the last 10 months, i think we are in addition to date to put the pieces together with a different kind of Coalition Surrounding solutions that are supported by a much broader crosssection of the public. Likeld describe issues transportation or food and farm policy, but the area that i truly think offers the greatest opportunity is health care, and that is why we are here. Ironically, much of the thanks stars start toe align goes to trump, the tea party, and republican recklessness. Over the last 10 weeks, america is not just getting a National Civics lesson, that it is getting a graduate education in health care. Now, president obama governs basically slightly left of center and was quite moderate in most of his tactics, notwithstanding the flaming rhetoric that was directed towards him. For the first five years he was in power, you really tried to avoid stark partisan differences. He did work hard to engage republicans. I watched him. And he made compromises. Some of which i disagreed with at the time on taxes, infrastructure, and the economic recovery. This instinct to bring people together to take the middle ground was no more clearly on display than with his approach to health care, where he combined market accommodation with some of the powerful interests in congress and the pharmaceutical industry and other special interest and a request for republican cooperation that i do not think was ever really in the cards. We were certainly not helped by some in congress, some of my blue dog colleagues in the house and in the senate, senator max baucus, trying to lowering the sights to be over modest in our aspirations, and we lost a lot of time to thousand night. And ultimately did not gain anything for that trade up. Had ted kennedy not died in office, this would have looked much difference, a stronger Affordable Care act, it still a sub optimal compromise. While it is worth acknowledging the past and at some point over hall,t the goose call we can speculate on what happened and why, but our purpose is not to dwell on where we were, to move on to the opportunities that are afforded to us now. The irony is that were in a better position to begin implementation of a much that are solution. The Affordable Care act did achieve significant advances expansion of coverage, introduction of some concepts that ultimately set the stage for improvements to the American Health care, a lot of the pilot projects that are involved now but i think we will be moving past this foundation towards a singlepayer or a medicare for all or a medicaid [applause] [cheers] representative blumenauer or medicaid for more. Candidate care i am less concerned about what we call it then moving in that direction. The bottom line is america still pays far more than anyone in the averageouble the oecd for health care in rich countries. And while we all acknowledge that people get some of the finest health care in the world, that is not what the average american gets. Chambers thehouse last time the president of the United States claimed we had the finest health care in the world. That was 2002, and it was not accurate then. The reality is that most americans do not get the finest health care in the world. Americans on average get sick more often, we take longer to for the, we die sooner privilege of paying twice as much. In some areas, our record orders on third. World. L third Paternal Health has been given a lot of attention. Uprightse wally the and services, but medical services are singularly difficult for consumers to be able to navigate to comparison shop and understand the dynamics. Need the most critical, expensive, and Invasive Services when we are least likely to be able to process the information. When we or a loved one is sick of our judgment may be clouded, and it relates to items that are spectacularly complex. Seldom are the incentives aligned properly with the providers and patients. There are some exceptions and there are some exciting models, some great innovation, some of which is going on in this community. But in the main, the American Health care system is still volumetwovolume to overvalued. Now, americans may not fully understand [indiscernible] representative blumenauer i am getting all choked up. Support continue to medicare. Increasingly, as result of what has been going on in congress, they appreciate the value of medicaid, which provides health care for more americans than any other program. There are opportunities to supplement them with private insurance, but they were, they hold costs down. Administrative costs for medicare and medicaid are a fraction of traditional fee for service. They are Better Outcomes with lower cost and higher satisfaction. Brokennald Trumps Campaign promises, the naked attack on Medicaid Expansion through the Affordable Care act, and the attack on medicare solvency have brought this into sharp relief for a majority of americans. Republicans are in retreat, and donald trump is on the defensive, and not just about russia. We are going to spend time this evening exploring in greater detail singlepayer options, philosophy, and mechanics. We begin the keynote this evening from tr reid whose book made a profound impact on those of uswe begin the keynote this evening from tr in the middle oe Affordable Care legislation, the healing of america. It is a fabulous tale of how he schlepped his bum shoulder around the world to encounter different approaches to medicine and wildly different approaches to paying for it. The next four years, republicans will control the administration. Its not just hospital and obamacare, but Health Care Reform. They focused instead on lowering costs and denying care. That is their approach. Republicans will be in charge of congress, attempting to reconcile this meanspirited approach with an america that is pushing back. Fighting to save medicaid, medicare, and elements of the Affordable Care act that are working for many americans. Not yet a majority, but a strong segment of the population is becoming increasingly engaged and aware on health care. The landscape is changing. Im excited about how engaged the public is and the opportunities there are two not just protect the Affordable Care act but build on it and move forward. The American Government was famously not built to be efficient. Mission accomplished. [laughter] are innumerable opportunities, checks and balances, to interfere with Public Policy and prevent what the public may want. There needs to be an informed Public Opinion and engaged constituency, and we need to build on the consensus that is emerging from the people who work in the Health Care Space. I want to give a shout out to at men and women who work providing health care in this country. [applause] nurses, doctors, hospitals, the profession, the whole range of people, the emergency transport i have been involved with the political process for a long time, and ive never quite seen an entire sector of the economy where people have come together a well intended but not Perfect Piece of legislation work. People have rolled up their sleeves and moved forward. Encouraged byy the areas of consensus and progress. As of the areas being seen one area of potential is changing that value proposition, value instead of volume, cooperating. They see light at the end of the tunnel, and they will not be served by the continuing battles in washington, d. C. All of these people in the Health Care Space have different competing interests, values, economic, philosophical, but they have been united in rejecting the republicans assa ult on these protections. [applause] the signal is being sent that no one is going to be steamrolled when it comes to health care. Opportunities to broaden Public Awareness and develop initiatives that we can build on. Looking at the big picture is necessary to achieving these smaller steps. I think transformational change is possible for quicker than people recognize. There is something happening around the country. 20 years from now, there will be a singlepayer system of some variation. I think it could be 10 years. Sooner,ould happen , butding on what we all do first, we must know what the various singlepayer concepts entail,at they would how best to get there. ,re there intermediate steps dealing with the fact that republicans are in charge of congress for the next 20 months yet go i have high hopes for november of 2018. [applause] there is this administration for. Nother 44 months weve got an opportunity to be. Ble to move things forward the public is not going to stand for republicans pricing lower income seniors out of the health care market. They are not going to countenance this assault on , and i think theres an opportunity to be able to engage them in these steps, these strategies. What do we do Going Forward . Tr reid is the best person we could have this evening to get us going. I mentioned what he did with his bum shoulder. Mess,test book, a fine 15, about thepril i think theres another bestseller here for congress. Hes got a great knack. Leadership of an unsuccessful but important singlepayer campaign in colorado last year. [applause] he is insightful. Boil analytic, and he can it down in terms that are so simple, even a member of congress can understand it. Im going to shut up. Im going to sit down and welcome to the podium tom reed. [applause] thank you very much, congressman. I am delighted to be here. I love coming to portland. I really like oregon. Ive never liked pumping my own today, boy, i was flying in this morning before the rain started. Mt. Hood was out there spectacularly next to the airplane. I was like, boy, these people must be lucky. As a person interested in Health Policy who has this nutty idea that a Decent Society should provide health care for everybody [applause] view hasho holds that to have respect for organ. Heres what youve got. You have a bunch of troublemakers and rabblerousers, applecart upsetters, doctors, nurses, members of congress, rabblerousers who refuse to our absurdly fragmented, ridiculously expensive, and in equitable Health Care System. Your rabblerousers for decades have been fighting to do Something Better about health care, and theres a long list of people in this state who have been National Leaders. Are you are out to allowed to Say Something good about John Kitzhaber in this room . [applause] it was remarkable to see what he did, and he still has the right idea. We ought to listen to him. The leaders of health care for all oregon have been National Leaders in this program. [applause] the oregon chapter of physicians for a National Health program, one of the best in old country. [applause] theres a group of oregon physicians who call themselves the mad as hell doctors. [applause] they went around the country delivering this message. The nurses have been leaders. Earl blumenauer is a leader in this field. Theres something about oregon where people have decided, why dont we find a way to provide highquality health care to everybody at a reasonable cost . A bunch of radicals. Im telling you. Im happy to come here. Im a little daunted coming to oregon, because im a coloradan. Im a proud coloradan, and we feel a sense of competition. Oregon, because im a coloradan. Last time i was here, i was bragging. I said, you guys have ducks and beavers. We have buffalo and rams. Somebody said, our docs igor buffalo for lunch, which is true. [laughter] ing have thunder rivers, rich forests, great cities, fruitful plains. That, but youof also have a notion. It seems unfair to me. The last time i was here, i did the 4t trail. Its fabulous. [applause] its a train, trail, tram, and trolley. Is that it . Me, wise portland ian told go west to east, and its free. If you go the other way, you have to pay. I did it. Its fabulous. Ek. Ac ust a great half day in the middle of a Great American city, you are in this thick forest. We dont have that in denver. I wish we did. Took met off, dr. Metz to flaming spanish coffee. We dont have that in denver either. [laughter] my assignment tonight is to take us out of portland, take us out oregon, the United States, take a rapid trip around the world to see other countries like us. There are about 35 of them in the world depending on how you define democracy. What do they do . One way of looking at it, most important, the answer is pretty simple. The other countries like us. All the other developed democracies on the planet have decided to provide health care for everybody. All of them do it. Health care for all. [applause] all their citizens, all their foreign residents, legal or illegal, foreign correspondents like me and my family. That is the fundamental rule. There is only one industrialized democracy that does not provide health care for everybody. That is the worlds richest country, the United States of america. Which up with obamacare, was in advance but not perfect. Got to 28. 5 Million People without Health Insurance. That was a milestone considered good. Now its clear they want to take us backward. We want to go back to 50 Million People without Health Insurance if they get their way. To me, this is a national disgrace. Its wrong. We should not do that. A decent democracy ought to provide health care for everybody. The United States is a rich, compassionate, decent country. We should provide health care for everybody. We should, and we could. I know we could, because all the other countries like us do it. If anybody needs to leave early, i can reduce my argument to a Bumper Sticker are you ready . If france can do it, the United States can do it. Thats the whole thing right there. [applause] as i said, that is the simple part. You make this fundamental commitment if you live in our country and need health care, we are going to provide it. It gets more complicated when we talk about how they do it. There are many different ways to do this. Agree onich countries the destination, a formal health care for everybody, but they disagree on the route to get the re. Earl didnt give me much time, so i dont have a lot of time to go through them. There is a book on the topic. Some countries do it with one singlepayer, and that system works great. I lived in great britain. My family got Great Health Care from the National Health service. We didnt have to wait that long. Britain covers everybody, 62 million brits, another 12 million foreigners or aliens in their country, foreign correspondents. They have Better Health statistics than we do and spent 44 as much per capita through the singlepayer system. Other countries have multiplanar systems. Japan covers everybody, Fabulous Health outcomes. 3200 different payers. Germany, 220 different payers. Those multipayer systems worked in a way the economists call it and all payer system. There are 3200 different insurance thes, but they all have same rule and same form and pay the same feed to the doctor. They work like singlepayer. That is the model that works. There are different approaches to how to do it. Some countries, britain for example, say, you s