Oregon Plan 2
The purpose of this paper was to summarize the Oregon Health Plan, with regards
to cost containment. The goal is to provide the advantages and disadvantages of the plan.
I also discuss it philosophically, mentioning the problem our nation would have with the
widespread, mandatory implantation of this plan. In the conclusion I discuss an
alternative approach to the cost containment issue of health care.
Oregon Plan 3
Module 6: Oregon Plan
The Oregon Health Plan, was a revision of ...view middle of the document...
According to Oregon’s website, the Oregon Health Plan is administered by the Division of Medical Assistance Program and its goals are to increase access to health care for low-income Oregonians, improve the quality of health care and receipt of preventive
Oregon Plan 3
services by low-income Oregonians, thereby improving their health, and contain health care costs. In the early 90s this plan made it to national major media because it realized the limitations it had on funding resources head on, making it a cost- containing and realistic approach to health care. It was successful in enrolling more people into the plan and covering preventative procedures, but it did not cover experimental procedures like bone marrow transplants, at the time. Many expensive procedures were not covered. It is important to note that many commercial payers did not cover bone marrow transplant at the same time. Rationing was the component this plan implemented to control cost. The plan created a prioritizing list that gave priority to the most effective treatments that could be supported by the most recent published information.
This plan became famous with stories like that of Colby Howard, a 7 year old boy who died from Leukemia, while waiting for surgery for a bone marrow transplant. His mother who was on welfare, worked with the community to raise $70,000 after the Oregon Health Plan refused to cover the surgery. Her son was given a 50 percent chance of life. This case study was important because it raised issues that society cannot ignore. End of life care, and experimental procedures that can only add less than five years to a person’s life are extremely expensive. The charge for Colby Howard’s surgery was $100,000. If that was the self pay amount, the hospital would have easily accepted a fraction of that from an insurance company. The sad, ironic part was that his little body could not handle the chemo he was undergoing in preparation for the surgery and he died
Oregon Plan 4
before the scheduled date. According to author of the Weekly Standard article, Wesley J. Smith “Chemotherapy, for instance, is not provided if it is deemed to have a 5 percent or less chance of extending the patient’s life for five years, meaning that a patient whose life might be extended a year or two with chemo may not receive it. Worse, even though it is not a formally ranked procedure, assisted suicide is covered under state law.” That part of the plan has since changed, but people were still denied for second...