Oregon “Health Care Rationing” Plan: Bad Idea for Minnesota Patients

The HHS Conference Committee is discussing the Senate proposal to adopt, for state health care programs (Medicaid, MNCare, GAMC) the Oregon Heath Plan’s list of conditions (plus others) for which treatment would not be covered.

CCHC’s concerns include:

Insufficient Information for Informed Vote - There was no public hearing on the policy of this proposal, and the diagnosis and treatment codes slated for exclusion are not defined in the bill.

State Authority Displaces Medical Expertise and Patient Choice - Coverage is excluded for treatments of more than 1,400 diseases and diagnoses - despite a physician’s treatment decision. An ad hoc committee will determine which services are excluded. Patients and parents will have no say, even if it’s the only service they need all year.

Playing God - Authorizes denial of care for a patient with cancer if someone makes a determination that the patient has only five (5) percent chance of being alive in five years.

Guarantees No Access for Most Vulnerable - The recipients of state health care programs will find no access to care for some of the most common ailments. Only if their condition is ranked high enough on the list of priorities will treatment for their acute or chronic condition be covered.

Pain and Suffering Approved by Law - By statute, certain conditions will be officially deemed unworthy of care, including fully or partially detached fingertips, chronic fissures and fistulas, viral meningitis, chronic bronchitis, chronic ear infection, foreign object in the nose or ear, mononucleosis, etc. There will be work force, societal, and financial costs stemming from statutory denial of care for these conditions.

State-Imposed Value Judgments - Bureaucrats will make judgments about patients and health care services. If Patient A’s condition is on the list of excluded conditions (not valued), and Patient B’s condition is not on the excluded list, only Patient B receives treatment. Therefore Patient B’s condition and person are treated as more valuable than Patient A. For instance, on Oregon’s October 2001 list of 736 conditions (#1 is highest priority), treatment for croup/epiglottis is #16, male sterilization is #93, kidney transplant for end stage renal disease is #109, sexually transmitted diseases is #206. And treatment for breast cancer is #229.

Individual Ethics Supplanted by State Directives - Using taxpayer funds, bureaucrats impose personal ethical standards when determining which services are available (sterilization, contraception) versus which are not (fertility treatment, liver transplant).

Slippery Slope - Once government bureaucrats are authorized by law to make priority of treatment decisions--and effectiveness of treatment decisions--in public health care programs, there will be pressure to implement their decisions in the private sector.

Lower Costs Doubtful

- According to the former governor of Oregon in the Jan/Feb 2003 edition of Health Affairs policy magazine, the cost of the OHP has risen

60 percent

in the last two years. In addition, it has not stopped the legislature from mandating health benefits.