TY - JOUR
T1 - Prioritising health services in an era of limits
T2 - The Oregon experience
AU - Kitzhaber, J. A.
N1 - Funding Information:
Results ofconsensus Although viewed as controversial outside the state, the plan was enacted with broad based support. It was not achieved through confrontation nor by trying to find villains and scapegoats. Rather, it represents a consensus building exercise that was supported by the Oregon Medical Association, the Association of Oregon Hospitals, consumer groups, organised labour, and the business community. It passed both houses of the Oregon legislature with huge majorities in both parties.
PY - 1993
Y1 - 1993
N2 - How do we decide who should receive the benefits that medical science has to offer? One approach to this decision process, that used by the state of Oregon, is described: who and what are covered, and how health care is financed and delivered, are considered. Oregon's priorities were set on the basis of broad consensus. The objective of health care reform, it was agreed, is to improve, maintain, or restore health - not universal coverage, access to health care, or cost containment. A Health Services Commission was created to consider clinical effectiveness and, through public involvement, to attempt to integrate social values into the priority list. Oregon's legislature can use the list to develop an overall health policy which recognises that health can be maintained only if investments in several related areas are balanced.
AB - How do we decide who should receive the benefits that medical science has to offer? One approach to this decision process, that used by the state of Oregon, is described: who and what are covered, and how health care is financed and delivered, are considered. Oregon's priorities were set on the basis of broad consensus. The objective of health care reform, it was agreed, is to improve, maintain, or restore health - not universal coverage, access to health care, or cost containment. A Health Services Commission was created to consider clinical effectiveness and, through public involvement, to attempt to integrate social values into the priority list. Oregon's legislature can use the list to develop an overall health policy which recognises that health can be maintained only if investments in several related areas are balanced.
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U2 - 10.1136/bmj.307.6900.373
DO - 10.1136/bmj.307.6900.373
M3 - Article
C2 - 8374424
AN - SCOPUS:0027312796
SN - 0267-0623
VL - 307
SP - 373
EP - 377
JO - BMJ (Online)
JF - BMJ (Online)
IS - 6900
ER -