When you hear that Oregon might move to a single-payer, state-run health plan, you may think: Yes!

Every Oregonian would get health care coverage and the same level of coverage. Equity and quality might go up. Overall costs may be held down. You would pay taxes instead of health care premiums.

That’s the kind of plan the state’s Joint Task Force on Universal Health Care is supposed to develop. It met again Jan. 27, taking another step toward its goal of submitting a Health Care for All Oregon Plan to the Legislature by September 2022.

Is Oregon going to make such a momentous shift in health care? Should skeptical Oregonians, health insurers, pharmaceutical companies and others be nervous?

We can’t answer that. We are just going to slice off one piece of this issue. That’s a form of care that the plan won’t cover: long-term services and supports.

Long-term services and supports is medical and nonmedical care provided to people who are not able to do things for themselves, such as cook, dress, bathe or make it to the bathroom. The harsh reality is that while people can need that at any stage of life, Medicare and most health insurance do not pay for it. People need to “spend down” their assets to where they have very little left and keep their assets low to be eligible for government assistance. Buying additional insurance can help.

That harsh reality would continue under an Oregon single-payer plan, at least as the task force discussed on Jan. 27. They even deleted language from their proposed recommendation to the Legislature that highlighted the issue. Struck from the recommendation was this sentence: “Oregonians who are not eligible for LTSS benefits will continue to ‘spend down’ assets before becoming eligible.” Task force members weren’t trying to hide what they were doing. It is just not something Oregon’s single-payer plan would do. It’s a state of affairs in health care that isn’t going to change.

No state that has been developing a single-payer plan has found a simple way to cover long-term services. They have all struggled with it, as Oregon’s task force is. If the government started paying for that type of long-term care, it would increase health care costs substantially for any new health system because substantial parts of it aren’t covered now.

It might be that an Oregon single-payer plan would cover long-term services and supports at some point in the future. For now it’s important to note that a type of care that many Oregonians may need at some point in their lives would not be covered by the Health Care for All Oregon Plan.

Unsigned editorials are the opinion of the Baker City Herald. Columns, letters and cartoons on this page express the opinions of the authors and not necessarily that of the Baker City Herald.