OPINION
Health plan should be approved second time around
When I lived with my par
ents, the rule for doing
chores was, “If you see
something that needs to be
done, do it.“
Oregon hoalth cate planners,
to their credit, recognized that
something had to bo dono
about health care coverage In
Oregon. And, aftor almost 10
years of back-breaking effort,
they've come up with a solu
tion.
In 1983, Oregon health care
planners brought doctors, busi
nessmen and labor loaders to
gether to discuss the distribu
tion of Oregon’s financial re
sources. These hoalth CBre
planners came up with detailed
computer models that would
rank medical procedures by
c.ost-effnctiveness.
simply put, cuts bock on exten
sive medical coverage for
230.000 residents so that It can
afford to extend basic coverage
to an additional 450,000 Orego
nians These are residents who
do not otherwise qualify for the
state's Medicaid program or
who are employed, but current
ly havo no health insurance.
The proposal ranked 700
medical procedures according
to their cost-effectiveness Un
der the new plan, Medicaid
would cover as many of the
medical procedures as the state
could afford, which turns out to
be the first 587 on the list.
Among the services being cut
were medical therapy for the
common cold, chronic bronchi
tis and AIDS patients believed
to be in the last six months of
their lives.
Other services cut included
certain kinds of epilepsy, defor
mities of the foot, traumatic
bruin injury and breast recon
struction after mastectomy for
breast cancer.
Last August thn proposal was
rejected.
Almost ju
town meot
i n g s took
place to cjis
cuss the rules
by which
medical prior
ities would be
set.
Before the
plan was sub
mi11 e d for
Washington's
approval in
August of
1991, those
health care planners conducted
a telephone survey of 1,000
random Oregon households to
help shape the final proposal.
The plan would have guaran
teed basic health tare coveragu
to almost every Oregonian by
1993
The Oregon health care plan,
Oregon has matte a
bold step forward
to provide
adequate health
care coverage for
all Oregonians
instead of
generous coverage
fora few.
tv i i (I in u
words "taint
ed by discrim
ination,'' US.
Secretary of
Health and
Human Ser
vices Louis
W Sullivan
damned the
health care
proposal, say
ing it would
illegally dis
criminate
against the
disabled.
Sullivan said ho believed the
Oregon rankings were based on
the idea that "the value of tho
life of a person with a disability
is less than the life of a person
without a disability ” This as
sumption. Sullivan said, vio
lates the 19U0 Americans with
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In defending his position.
Sulllvun could only cite two
weak examples of bias. First,
the plan proposed covering liv
er transplants for non-alcohol
cirrhosis, but not those for alco
hol-related cirrhosis In actuali
ty. tiie proposal would only re
frain from treating current alco
holics on ihe assumption that a
liver transplant would lie futile.
Second. Sullivan said thut
premature iiabies weighing less
than about IB ounces at birth
would not lie eligible for the
extensive life support that ba
bies weighing more than this
would.
Because of the scant evidence
to tuck up Sullivan's discrimi
nation claim, the Bush admin
istrutlon's rejection of the
health care plan was rumored
to have more to do with the ap
proaching election than with
righteous indignation
Now that the election's over,
the President has no reason to
play political games The plan
has also been revised to accom
modate the flush administra
tion's concerns Final approval
is expected sometime after Dec.
4.
If the Oregon health care plan
is approved, it could set a new
standard of coverage that Is
based on the medical proce
dures covered instead of on the
people who need coverage.
But if the Oregon health care
plan is rejected again, it's not
too soon for Oregonians to de
rmind tin' support from l*resi
dunt-ulect Dill Clinton that ho
promised during his buttle for
tint presidency.
Oregon has maoo a bold stop
forward to provide adequate
health care coverage for till Ore
gonians instead of generous
coverage for a few It's u lough
decision to make, hut until
America provides affordable
coverage for every citizen in
the notion, Oregon health care
planners art! doing the best they
cun for our state.
Stephanlo Sisson writes 11
monthly column for the Emer
ald.
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