Is there any problem in focusing UHC work on careful restriction of costs (affordability of care)?
The strategic limitations of approaching UHC from the scarce resource point of view has been very well demonstrated by the recent history in Oregon. Oregon, which once led the nation in innovative efforts to expand health coverage for its citizens, has now fallen to the bottom tier of states when it comes to health insurance for working families, according to a spring 2004 report issued today by the States Health Access Data Assistance Center. Oregon’s great innovation however was in taking the “overutilization myth” of UHC to an extreme and devising a list of which procedures and medications could be covered under each and every possible circumstance (not listed, not covered). Their rationed UHC experiment has been a disaster. Highlighting Oregon’s “Cover the Uninsured Week 2004,” found: • One in five working-age Oregonians (20.5%) are now without health insurance, placing Oregon 38th of the 50 states in health insurance coverage for adults. • More than half of Oregons uninsured (51.9
