Word: carefulness
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Dates: during 1980-1989
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...Oregon and California's Alameda County, which includes Oakland, are on the verge of taking that seemingly drastic step. In April, the Oregon senate passed a bill that would extend Medicaid coverage to 86,000 low-income people previously not covered. There would, however, be limits to the care they could expect. The measure, now before the lower house, would also establish a commission of experts and consumers to rank health services in order of importance; the legislature would then decide which to finance. Oregon has already set up committees of doctors, nurses and social workers to & establish priorities...
...medical experts in deciding what specific services will be made available to the county's uninsured poor. "It's scary," says Dr. Marye L. Thomas, Alameda's director of mental health and a member of the committee. "As a physician, I was trained to give the best possible care to anyone, period. Back when I was in medical school, I never thought I would be discussing this...
Health officials cite grim statistics as evidence that they are acting out of fiscal need, not cruel disregard for human suffering. In Alameda, roughly 75% of the county's $278 million health-care budget comes from state and federal sources. But that money is drying up. For example, state funds are currently only about one-half of what the county received in 1982. Health administrators argue that rationing is a pointed way of telling legislators they must bear the responsibility for their budgetary decisions...
...sense, rationing medical care is a form of triage -- the mellifluous French term, derived from wartime practice, for giving medical attention to the most likely survivors. This goes against the American grain. According to a 1987 Harris poll, more than 90% agreed with the statement that "everybody should have the right to get the best possible health care -- as good as the treatment a millionaire gets." But another survey, by the Public Agenda Foundation, found that only one person in ten would accept a $125 tax increase to support a national insurance program for catastrophic illness. As medical costs rise...
...experts who favor rationing as a solution note that the reality of it is not new. In 1987 Oregon decided that it would no longer pay for organ transplants for Medicaid patients, even as the legislature added $5 million to the state budget for prenatal care. Many doctors readily admit that applicants for new high-tech operations have to pass a "green screen" or "wallet biopsy" -- meaning those who can pay get first crack at the operations...