Rationale for rationing no longer compelling

The Oregon Health Plan is regarded as having pioneered explicit, systematic and open rationing of health care by denying access to some services. However, Dr. John Oberlander and colleagues report that the reality is somewhat different.

In their review article, Dr. Oberlander and colleagues state that Oregon has neither achieved the universal coverage the plan was intended to allow, nor has widespread rationing been instigated.

Instead, the number of services that have been excluded is small, physicians still provide uncovered services, savings have not been significant and the original mathematical scoring system has been subverted by political concessions.

The authors conclude that Oregon�s experience, from which Canada and others might learn, is that the explicit removal of items from the list of insured services is unlikely to save much in the way of costs.

Rationing medical care: rhetoric and reality in the Oregon Health Plan � J. Oberlander et al.