Oregon's health care system is unsustainable and will remain so until private and public sectors join "to find a solution for all of us," Dr. Bruce Goldberg, director of Oregon's Department of Human Services, told a health care crisis conference Wednesday.

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He told the Oregon Economic Forum that health care costs are increasing by 8 percent to 10 percent a year, with incomes going up at most 3 percent to 4 percent.

If the state responds by cutting people from health plans, increases copays or reduces benefits, he said, more people end up going to emergency rooms for free treatment, which is reflected in higher private insurance premiums, which means Oregonians "pay, pay, pay."

Oregon pays for long-term health care for 19,000 people and that will increase by 23 percent in 10 years, he said. "And those are just the numbers, not the costs," he said, which likely will be 25-30 percent higher than they are today.

About 600,000 Oregonians, 16 percent of the population, lack access to affordable health insurance.

He said in a graying nation, 40 percent of people aged 85-95 eventually will need long-term health care.

"How do we deal with this?" he asked.

When it becomes more difficult to afford health instance, he said, "it drives more people toward us."

Business talent for efficiency, he said, must be meshed with the public sector "for a common system to provide that care."

Thomas Nelson, chief operating officer of AARP, said Washington is in a partisan gridlock over health care reform, "and success must come from the state levels."

He said it is up to states to pass measures to "create tensions" that might bring federal action.

Patchwork fixes, he said, make no sense.

"We need reform from the ground up," he said. "The health care system is dysfunctional. It is essentially out of control."

He said an AARP poll found that 80 percent of voters aged 42 or older said they would look for a candidate on the ballot who supported national health care coverage.

He said better use of available funds, not more money, is the issue.

Jack Friedman, CEO of Providence health Plans, said the United States spends $7,000 per capita a year on health care, "40 percent more than our next industrial neighbor," and that 30 percent of clinical treatments are of no value.

Former Gov. John Kitzhaber, a physician who now works with his Archemedes Project aimed at channeling concern over health care into action, said health care must be available on an equal basis just as public education is, and said health coverage is "mired in the last century" in programs that made sense then but no longer do.

He said insurance coverage by businesses is dropping by more than 4 percent a year, and that companies paying to provide it are at a disadvantage with competitors in countries with universal care.

He said many uninsured Oregonians are one illness away from bankruptcy and that inability to pay medical bills is the second-leading cause of going bankrupt.

But Eileen Drake, whose duties with PCC Structurals includes the job of human resources director for 7,000 employees in 11 states and China, said medicine can do more than some companies can afford to pay for.

She recalled an employee at a plant that was self-insured who came down with an illness that required lifesaving drugs costing $26,000 a month. The employees came to the company for help.

The question was, she said, "Are we going to pay for the drugs or let him die. At what point do we say no?"

She did not say how the issue was resolved.

Kitzhaber said emergency room costs for people without health insurance add about 10 percent to health insurance premiums.

The status quo, he said, does not save money. "We all pay one way or another," he said, adding that costs are higher than they would be with universal access to affordable health care.

But, he said, change will not come by clinging to 40-year-old practices.