The aim was to create and then whittle away at a prioritised list of treatments covered by the state funded Medicaid programme, so that the available money would cover more people. With the global credit crunch likely to make scarce resources even scarcer, this week’s BMJ looks back at what can be learnt from Oregon and forward to how we should ration health care in the future. But it hit the rocks of an economic downturn, and almost no other health system has adopted the approach. Oregon’s latest attempt at health reform is more sophisticated, but, says Alakeson, it may prove just as unlucky in its timing. He is scathing about President Bush’s subversion of scientific evidence for political ends. A new president should swiftly recommit to science, transparency, and public scrutiny, he says.
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