A large crowd gathers on the Capitol steps for the Health Care for All Oregon rally Monday Feb. 4, 2013Changes are underway to improve state and federal health care, but hundreds of Oregonians gathered at a rally Monday said they want lawmakers to move further toward establishing a universal single-payer system.

More than 200 people held up protest signs, chanted and even sang at the Capitol’s steps to show their support for legislation that would create a single health care plan to cover those who work or reside in Oregon.

Instead of paying private health insurance premiums, co-payments and other medical expenses, residents would fund the universal health care plan through a tax based on their ability to pay, according to Health Care for ALL Oregon, a coalition of labor, education and health care organizations that hosted the rally.

“We feel that every Oregonian deserves health care and there are minimal steps that are being taken,” said Mike Huntington, president of Health Care for ALL Oregon Education Fund, a sister organization.

Even with the expansion of health care coverage under the Obama administration, Huntington pointed to studies that showed an estimated 28 million people would still be uninsured.

Similar legislation has been proposed in previous years, but never moved beyond committee. Opponents, which include the Cascade Policy Institute, say a single-payer system would eliminate competition among insurance companies that help drive health care costs down.

“Anybody who takes a serious look at it realizes there’s a lot of unintended consequences,” said Steve Buckstein, a senior policy analyst and founder of the Cascade Policy Institute, a libertarian think tank. “It’s not a free lunch.”

Even with Democrats in majority control, Buckstein noted that a single-payer system could unravel some of the health care changes lawmakers have supported such as the development of a central marketplace called an exchange where individuals and businesses comparison shop for health insurance.

Many of the rally’s participants came dressed in red -- some as Supreme Court justices with umbrellas -- while waving signs that read “We want health care not wealth care” and “Everybody In. Nobody Out.”

Dr. Paul Hochfeld, an emergency room physician in Corvallis from Mad as Hell Doctors, said both the state and nation fall short of having a health care system in place.

“Everybody is trying to suck as much money from the non-system as they can. There’s nothing systematic about how we’re going to use our resources to create healthy communities,” he said. “The solution is to recognize on the outset that we’re all paying for everybody.”

Rep. Michael Dembrow, D-Portland, and Rep. Jennifer Williamson, D-Portland, who are co-sponsoring legislation that would establish an “Affordable Health Care for All Oregon Plan,” also spoke at the rally.

Dembrow said that a draft bill currently has 19 sponsors, including the chairman of the House Health Care Committee, and he’s working on getting more lawmakers to sign on.

There’s also a draft bill that would authorize a formal study of the health care financing system, he said.

Vermont passed a law in 2011 that would establish a single-payer health care system by 2017, using the federal health care overhaul as a springboard, The Associated Press reported.

Dembrow said Oregon wouldn’t be able to move toward a single-payer system under the Affordable Care Act until 2017 when states get more flexibility to design their own health care system.

But it’s not something lawmakers can do on their own, he said.

“This will happen with the people of Oregon demanding change, organizing for change and voting for change,” Dembrow said.

In 2002, voters rejected a ballot measure that would create a single-payer health care system in Oregon.