Dealing With Limited Resources: The Oregon Decision to Curtail Funding for Organ Transplantation
Welch, H. Gilbert
Larson, Eric B.
New England Journal of Medicine. 1988 Jul 21; 319(3): 171-173.
The events leading to the decision by the Oregon legislature to eliminate Medicaid funding of organ transplantation in order to extend funding for basic health care to include about 1500 persons not previously covered are chronicled. Public reaction to the decision through the media and in the law courts is described. The state promised to reinstate the program if sufficient private funds could be raised to supplement matching federal funds and arrange preferred-provider agreements. Four lessons are suggested by the Oregon experience: medical resources are limited; the need for acute care is more visible to the public than the need for preventive care; new medical therapies are more likely targets for cost containment than those already established; and new therapies must replace older, less effective ones, in order to be widely funded. (KIE abstract)
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