PT  - JOURNAL ARTICLE
AU  - Jonathan Oberlander
AU  - Theodore Marmor
AU  - Lawrence Jacobs
TI  - Rationing medical care: rhetoric and reality in the Oregon Health Plan
DP  - 2001 May 29
TA  - Canadian Medical Association Journal
PG  - 1583--1587
VI  - 164
IP  - 11
4099  - http://www.cmaj.ca/content/164/11/1583.short
4100  - http://www.cmaj.ca/content/164/11/1583.full
SO  - CMAJ2001 May 29; 164
AB  - The Oregon Health Plan (OHP) has been widely heralded as an important innovation in medical care policy and rationing. Oregon's pioneering method of prioritizing funding for health care through systematic and public ranking of medical services has drawn substantial international interest. This paper reviews the experience of the Oregon plan since it began operation in 1994. We argue that widespread misconceptions persist about the significance of the OHP. In particular, there is little evidence that the OHP has operated as a model of explicit rationing. In reality, Oregon has not rationed services, nor has its policy of cutting public coverage for services produced substantial savings. These findings have important implications regarding the desirability and feasibility of adopting a policy of removing items from the list of insured medicare services in Canada. Oregon's experience suggests that drawing the line on medicare coverage would be more difficult and less financially rewarding than advocates claim.