Why the Oregon health experiment “failed”
In 1989, Oregon reformed their Medicaid program in part by using comparative effectiveness research to generate a prioritized list of services that they used to define covered benefits. The goal was to restrict wasteful or needless therapies (like spine surgery for uncomplicated low back pain) rather than restrict the number of people covered by health insurance. The plan eventually hit regulatory roadblocks, and Oregon was forced to limit the number of people covered after all. Critics subsequently dismissed the plan as a failed attempt at rationing health care.
Somnath Saha, MD, MPH, Chairman of the Oregon Health Services Commission and author of a recent Perspective in the New England Journal of Medicine on the matter, spoke with The HCC about lessons learned and what a national healthcare reform effort would need to do in order to allow an approach like Oregon’s to succeed.
In Part 2, Dr. Saha gives a primer on comparative effectiveness research.
NEJM, Oregon H&S Univ, Policy | apples49 | 
September 23, 2011 1:01 am
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