Yay health care!

The Problem

Background

• 14% of Oregonians Uninsured

• Health Care costs increasing

Hmm… If only there was a way to increase the number of people covered by Medicaid without increasing costs…

The Oregon Health Plan

• The Prioritized List• Managed Care

• Coverage for all Oregonians below the poverty level

• Mandatory Employer Insurance Coverage

Success – The mid 90s

• All Oregonians below the federal poverty line made eligible for Medicaid

• 2% drop in number of uninsured

• Expanded areas of health care coverage

• Movement to managed care

Failures – The present

• Budget Cuts

• Decreased Areas of Coverage:

– Mental Health

– HIV Carriers

Lessons

• The Political Process

• Bringing Health Care into the public debateWow,

health care is great!

I don’t want my health care rationed!

Health care sucks!

I like cheese.

Lessons

• Unreliability of Tax Increases

• The Problem of Explicit Rationing

• Implicit Rationing

• Public Knowledge

Lessons

The Future

• Can the OHP be saved?

• What lessons does Oregon offer for other reformers?