Setting health care priorities: Oregon's next steps.

Since the proposal was first broached in 1987, a storm of controversy has engulfed Oregon's plan to prioritize the health care services offered to its Medicaid recipients. After two years of debate, community consultation, and public opinion polls, the Oregon Health Services Commission was mandated in 1989 to study prioritization as part of a package of bills enacted as the Oregon Basic Health Services Act. In March 1990 the commission released a draft list of ranked health care services for public comment... As part of the ongoing debate, the Hastings Center and the Wesley Foundation sponsored a two-day meeting in January 1991 in Wichita, Kansas, to provide opportunity for thoughtful, in-depth, informal analysis of the OBHSA model for health care reform...a majority felt that OBHSA, in the framework of progress toward larger reform goals, is an experiment worth trying. Some felt that even if OBHSA doesn't attain its larger goals it should be tried since it will extend access and may lead to better health outcomes among the poor. But the general view was that OBHSA is a valuable experiment only to the extent that it leads to a statewide system of universal health insurance in Oregon without creating special burdens for the state's poor....