Setting health care priorities: Oregon's next steps

Area of Science:

• Health Services Research
• Health Policy Analysis
• Bioethics

Background:

• Oregon's Medicaid prioritization plan, the Oregon Basic Health Services Act (OBHSA), faced significant controversy since its 1987 proposal.
• The Oregon Health Services Commission was mandated in 1989 to study service prioritization.
• A draft list of ranked health services was released for public comment in March 1990.

Purpose of the Study:

• To conduct an in-depth, informal analysis of the OBHSA model for health care reform.
• To evaluate the potential benefits and drawbacks of Oregon's health care prioritization plan.
• To inform the ongoing debate surrounding the OBHSA.

Main Methods:

• A two-day meeting sponsored by the Hastings Center and the Wesley Foundation in January 1991.
• Informal analysis and discussion of the OBHSA model by participants.
• Consideration of public comments and expert opinions.

Main Results:

• A majority of participants felt the OBHSA is an experiment worth trying.
• Some believed the OBHSA should be tried for extending access and improving health outcomes for the poor, even if larger goals aren't met.
• The general view was that OBHSA is valuable if it leads to universal health insurance without burdening the poor.

Conclusions:

• The OBHSA is viewed as a potentially valuable experiment in health care reform.
• The success of OBHSA is contingent on its ability to expand access and improve health outcomes for vulnerable populations.
• The ultimate value of OBHSA is linked to its contribution towards a statewide system of universal health insurance in Oregon.