Caring for the uninsured. The Oregon experience.

A commission was appointed by the governor of Oregon to develop strategies to increase health care access for the estimated 400,000 Oregonians who were without health insurance. Because of real or perceived financial barriers to access, these uninsured usually had more expensive, acute, and episodic care that resulted in the shifting of cost to the insured and in higher health care costs. After studying the problem for 6 months, the commission made specific recommendations that if fully implemented, would ensure access to health care for virtually all uninsured Oregonians. The recommendations support existing medical and insurance systems, foster public and private partnerships, and provide for the leveraging of federal Medicaid dollars in a favorable ratio to the state. The implementation of these recommendations should ultimately reduce costs and at the same time provide more care.