Background
• 14% of Oregonians Uninsured
• Health Care costs increasing
Hmm… If only there was a way to increase the number of people covered by Medicaid without increasing costs…
The Oregon Health Plan
• The Prioritized List• Managed Care
• Coverage for all Oregonians below the poverty level
• Mandatory Employer Insurance Coverage
Success – The mid 90s
• All Oregonians below the federal poverty line made eligible for Medicaid
• 2% drop in number of uninsured
• Expanded areas of health care coverage
• Movement to managed care
Lessons
• The Political Process
• Bringing Health Care into the public debateWow,
health care is great!
I don’t want my health care rationed!
Health care sucks!
I like cheese.
Lessons
• Unreliability of Tax Increases
• The Problem of Explicit Rationing
• Implicit Rationing
• Public Knowledge