If Not Price, Then What?
When political forces take control of health care, as they have done in Oregon, what gets treated gets politicized. The best lobbying groups with the most effective lobbying efforts can get their pet treatment pushed to the top, along with other flavor of the month, politically popular treatments and diseases. Because Oregon Health Plan officials refuse to let price ration care, they must use another mechanism, and in this case it is a “priority list.” Below is their revised priority list for 2009, with 2002’s priorities for comparison:

It’s difficult to look at something like this and not be disgusted. Someone’s tobacco addiction is a more pressing need than Type 1 diabetes or AIDS? Lactose intolerance is more urgent than a ruptured spleen or even TB? Health Care Policy Center director Linda Gorman’s newest article (the PDF is found here) concerns Oregon’s new priority list.
To our knowledge, the Oregon Health Plan is the first government health care program anywhere in the world that has drawn up a formal procedure for rationing. After comment from interested parties, this state health program for low-income people ranks treatment for various diseases and conditions, currently from 1 to 680, in order of priority. The health care dollars available determine which priorities are met. As program costs have grown, the list of covered procedures has become shorter. In 2009, the state will pay only for the first 503 procedures.
Amy Oliver had to hear more about this dry run for nationalized, “single-payer” health care, so she phoned Linda for our latest iVoices.org podcast. Read Linda’s report and listen to the podcast, you will not believe what you discover.

