This was a medical scheme which included 100,000 individuals who were not insured to the Medicaid program. In an effort to manage costs, a list of priorities was established. The state legislature determined which health services were eligible for coverage. The list focused its attention on those items which were considered to provide the highest quality and quantity of health care to the recipients. The list was comprised of 745 pre-requisites for treatment. The state of Oregon financed treatment for the items which appeared after line 574. Any condition lower than 574 was not insured by the state (Bodenheimer & Grumbach, 2012).
The Oregon health plan (OHS) is an equitably formulated program founded on the efficacy of health care provision. Therefore, it can be argued that it conforms to the ideology of ethical beneficence. It has been formulated to expand the coverage of health services to the vulnerable and poor populations. However, the program is not regarded as being equitable and fair due to its inapplicability in offering universal health care services to the entire population (Andersen, Rice & Kominski, 2011).
The Oregon policy should not be adopted in other states because its main initiatives of containing costs failed. After the Oregon health plan crumbled in 2004, the state administration entered a face of budgetary complications. Higher premiums and co-payments were established. Most of the health care beneficiaries covered in the program left the coverage scheme. The number of the uninsured population consequently increased from 11% to a high of 17%. However, the bold evaluation in the rational containment of costs should continue (Oberlander, 2006). This medical program was discriminatory against the poor and should not be encouraged.
The advantage of the Oregon health plan is that, it was not just a rationing program. Its prominent feature was to expand the coverage of medical care to more than 100,000 individuals in the state of Oregon. It also made an attempt to focus the attention of health care initiatives in terms of effectiveness. This assisted in the determination of an acceptable strategy of selecting the services to be eliminated (Mohindra, 2007).
It will be difficult for the Oregon health plan to be accepted nationwide. It denies insured individuals access to the Medicaid health care services. This is an attempt to expand coverage to those who are not insured. This suggests that the Oregon health plan does not resolve the ethical challenges it has experienced (Slee, Slee, & Schmidt, 2009).
During 1996, an estimated 12% of individuals covered by the program were denied access to health care because their ailments were below the coverage list. The case was further worsened when about 78% of the individuals who were denied access to health care claimed that the act had exacerbated their health conditions. Essentially, health care services were practically rationed for the poor in the state (Mitchell and Bentley, 2000).
The Oregon medical program focused on beneficial health care services within a state with a relative history of health care wastage. During 1988, most of the regions of Oregon recorded low figures in the utilization of health care facilities. The occupancy of health care facilities was lower than 50%. The closure of health facilities which were not used would have amounted to savings estimated to be $50 million annually. These funds would have been sufficient to finance some of the conditions eliminated from coverage. The state of Oregon did not critically assess its options on how it would contain the costs before it fully implemented the program (Bodenheimer & Grumbach, 2012).
The state of Oregon can consider learning from the Canadian system. The federal government financed the universal health care programs initiated by the regional administration by covering 33% of the cost. The remaining 67% is funded by the local administration (Andersen, Rice, & Kominski, 2011).
References
Andersen, R. M., Rice, T. H., & Kominski, G. F. (2011). Changing the US health care system: Key issues in health services policy and management. California: John Wiley & Sons.
Bodenheimer, T., & Grumbach, K. (2012). Understanding health policy: A clinical approach. New York: McGraw-Hill Medical.
Mitchell, J. B., & Bentley, F. (2000). Impact of Oregon’s priority list on Medicaid beneficiaries. Medical care research and review, 57(2), 216-234.
Mohindra, R. K. (2007). Medical futility: a conceptual model. Journal of medical ethics, 33(2), 71-75.
Oberlander, J. (2007). Health reform interrupted: the unraveling of the Oregon Health Plan. Health Affairs, 26(1), w96-w105.
Slee, D. A., Slee, V. N., & Schmidt, H. J. (2009). Slee’s health care terms. Ontario: Jones & Bartlett Publishers.