Health Care by Lottery??

91,000 residents of the state of Oregon are watching the lottery. It is not dollar signs that attract them, but rather the hope that a winning number will provide them with health insurance that they do not currently have. One of those residents is Melvin Trosies, a man whose heart attack of a month ago has resulted in escalating medical bills that currently have exceeded the $200,000 mark. William Yardley of The New York Times reports:

“They said they’re going to draw names, and if I’m on that list, then I’ll get health care,” said Mr. Tsosies, 58, a handyman here in booming Deschutes County. “So I’m just waiting right now.”

Despite the great hopes of people like Mr. Tsosies, only a few thousand of Oregon’s 600,000 uninsured residents are likely to benefit from the lottery anytime soon. The program has only enough money to pay for about 24,000 people, and at least 17,000 slots are already filled.

While the national average is 16% of the population uninsured, on the eastern side of Oregon's Cascade range in Deschutes County the number is roughly 19%. Many of those suffering a lack of coverage are seasonal or service workers, including many construction workers who are suffering from a slowdown within their industry.

Chris Coon, the outreach manager for the Community Clinic of Bend and the two other clinics, is quoted as saying that resorting to health care by lottery is a sign of "profound desperation," in response to the overwhelming need.

The lottery was born out of a consensus among state officials and advocacy groups that small steps can help. As part of the state’s Medicaid program, known as the Oregon Health Plan, the lottery is intended for low-income adults who lack private insurance and do not qualify for Medicaid or Medicare. Although the plan once served more than 100,000 people, budget cuts in 2004 reduced the number to about 17,000.

This situation is quite disturbing when you consider the fact that in the late '80s through early '90s, the state was a leader in health care reform. The Oregon Health Plan had reduced the number of uninsured to 11% of the population by 1996. Everything seemed to going smoothly until a major recession hit the state earlier this decade.

“Oregon was way ahead of everyone else,” said Charla DeHate, the interim executive director of Ochoco Health Systems. “And then we went broke.”

SOURCE: "Drawing Lots for Health Care" 03/13/08
photo courtesy of St A Sh, used under this Creative Commons license