Oregon's Bitter Medicine

The scuttling of the state's model Medicaid plan raises doubts about the chances of achieving any kind of health-care reform in the U.S.

If anybody could find a way to solve the crisis of America's health-care system -- in which the insured get the world's most costly care and the uninsured get next to nothing -- it would be the good people of Oregon. Blessed with a long history of social-policy experimentation, they attacked the problem with almost heartbreaking earnestness. Beginning in 1983, they assembled doctors, businessmen and labor leaders for marathon discussions about how to distribute the state's limited resources. They built elaborate computer models to help rank medical procedures by cost effectiveness. They held 47 town meetings to thrash out the rules...

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