Universal healthcare is the Holy Grail of progressivism, as the Left longs for the utopia of free healthcare for all. But the Left doesn't realize that utopia is unachievable and attempts to create it result in a tyrannical disaster. Nowhere is this more evident than in Oregon's failed attempts to achieve universal healthcare.
Mark Hemingway had an excellent piece in The Weekly Standard from 2014 chronicling the ups and downs of Oregon's healthcare reform efforts. He explained that it all began in 1990s, when John Ritzhaber presided over Oregon's state senate at the time of crafting the Oregon Health Plan (OHP) and eventually became governor of the state. The OHP aimed to expand Medicaid through rationing; more people would be covered in exchange for less services provided.
To achieve rationing, OHP created a list of medical services that were ranked in order to determine who got which service, but "the list was based on subjective judgment and political compromise rather than any rigorous cost-containment formula." OHP also enlisted health maintenance organizations (HMOs) to provide coverage to Medicaid patients at a flat rate.
OHP initially worked well due to a strong economy, but as government programs typically do, it eventually apart. The rationing didn't actually take place since doctors found ways around the laws and the federal government prevented the state from implementing rationing. Naturally, costs soared, resulting in lower Medicaid payments, hospitals bleeding money and insurers fleeing the program.
Kitzhaber attempted to ameliorate the problem by splitting up OHP into two factions:
OHP Plus would enroll the traditional Medicaid population and cover the prioritized list of services. OHP Standard would enroll the new population—those making as much as 185 percent of the federal poverty level but not otherwise eligible for Medicaid. In order to save money, OHP Standard offered significantly reduced benefits. It also introduced co-payments, including $250 for a hospital visit. Failure to make co-payments would result in a suspension of enrollment in the Oregon Health Plan for six months.
The unintended consequence of this modification was that enrollment sharply declined by 53 percent in a year's time, eventually resulting in years before people could enroll into OHP Standard again. Even then, people had to enter a lottery system and could only enroll if their names were selected.
And rationing did occur. For example, Hemingway notes that "the state generated a flurry of headlines in 2008 after it sent a letter denying a 53-year-old man with prostate cancer chemotherapy but offering to cover the cost of physician-assisted suicide." Mark Levin cites the example in his book Liberty and Tyranny: A Conservative Manifesto of Barbara Wagner, who lived in Oregon and needed a drug to extend her life after she learned that her lung cancer had returned. But the state of Oregon denied her the drug and instead offered to cover assisted suicide. Wagner was saved by a pharmaceutical company that provided her with the drug she needed for free.
The Oregon experiment did provide researchers with the opportunity to study Medicaid's health outcomes, concluding that there were "no significant improvements in measured physical health outcomes in the first two years."
Other Oregon healthcare efforts have similarly failed. Their Obamacare state exchange was such a disaster that they had to replace it with a federal exchange; their Obamacare co-op went bankrupt as well. The state is now having to resort to cutting 335,000 people from their Medicaid rolls to address budget shortfalls.
Oregon serves as a microcosm for what would happen to the entire country if it did attempt universal healthcare through rationing: the costs of trying to cover everyone would eventually bankrupt the system and people would eventually have to be denied care.
The entire premise of having to cover everyone for less services is a false choice, as the wonders of the free market can best allocate resources so people can afford and have access to quality healthcare that best fits their needs, rather than a one-size-fits-all government scheme that plays with people's lives in order to satisfy the government's totalitarian tendencies.