Sipes-Metzler P R
Oregon Health Services Commission, Portland 97232.
J Med Philos. 1994 Aug;19(4):305-14. doi: 10.1093/jmp/19.4.305.
The Oregon Health Plan gained national attention by changing the focus of health care from who is covered to what is covered. This change was facilitated by insurance reforms in the areas of small market, employer mandates, high risk pooling and Medicaid. Most controversial of the reforms is the use by the legislature of a prioritized list of health services to determine benefit levels for the insurance programs. Significant debate has occurred over whether the use of such a list is rationing or reasoning. The Oregon Health Plan represents a thoughtful and deliberate blending of fact with public value for the purpose of responsible health policy. It is that unique blending of public values developed through community participation with fact that focused the attention of the world on Oregon.
俄勒冈健康计划通过将医疗保健的重点从覆盖人群转向覆盖内容而获得了全国关注。小市场、雇主强制参保、高风险保险池和医疗补助等领域的保险改革推动了这一转变。改革中最具争议的是立法机构使用一份按优先级排列的医疗服务清单来确定保险计划的福利水平。关于使用这样一份清单是配给还是合理决策,已经引发了激烈的争论。俄勒冈健康计划体现了为制定负责任的健康政策而对事实与公共价值进行的深思熟虑且审慎的融合。正是通过社区参与形成的公共价值与事实的这种独特融合,让俄勒冈吸引了全世界的目光。