From: Earl.Appleby@p4.f429.n275.z1.fidonet.org (Earl Appleby)
Newsgroups: misc.handicap
Subject: Oregon plan
Date: 12 Aug 92 18:58:10 GMT
Reply-To: Earl.Appleby@p4.f429.n275.z1.fidonet.org
Organization: FidoNet node 1:275/429.4 - HandiNet B B S, Virginia Beach VA
X-Fidonet: Able News Conference

Index Number: 23698

[This is from the AbleNews Conference]

 > Has anyone seen the exact text of Louis Sullivan's
 > decision not to approve the Oregon Health Plan on the
 > grounds that it was contrary to the ADA?

No, but we'll try to get further information from HHS and report it
here on ABLEnews for your information. Your interest is
appreciated.

Switching hats, to speak as director of CURE, a U.S. patient
advocate network, we've long opposed the Oregon rationing plan and
similar checkbook euthanasia schemes because they discriminate
against persons with disabilities and the vulnerable sick.

 > The brief reports I have seen don't make sense.
 > Apparently they claim that it might be discriminatory
 > because only poor people would have rationed care.

That's one point. Senator Al Gore, the Democratic Vice Presidential
candidate, who called on President Bush to reject the Orgeon plan,
observed, "This plan is seductive to the policy makers, but it is
dangerous to the people who really need help. (It) leaves poor
women and children at risk."  Senator Gore was, no doubt, referring
to the Draconian Medicaid cuts for which children and women of
child-bearing age were targeted by the Oregon cost-cutters.

 > I find their logic impenetrable since any plan that
 > does not cover everything for everyone is, in some
 > respect, rationing.  I see only the political logic -
 > they don't want to approve anything which might be
 > seen as Medicaid cutbacks nor anything that might be
 > seen as rationing since they argue against it.

Funding choices are made in any government program as you point
out, but in the States (as elsewhere) there has been a pattern of
"choices" (such as DRGs) that have been made by the powerful to the
detriment of the powerless, specifically, the infirm, the aged, the
poor, persons with disabilities, etc.  It is the nature of the
choices and, more profoundly, the basis of the choices that the
Oregon TABs propose that CURE and other disability rights advocates
object to.

 > I would be really interested in knowing how people are
 > responding, particularly to the use of the ADA as an
 > excuse?

I'm interested, too, but before you jump to the conclusion that
"the ADA" is just "an excuse," you might want to weigh the
evidence.

According to an Administration source, "Oregon's formula for
ranking procedures explicitly took account of quality of life.
Under the plan a person without disability is more likely to get
reimbursement for health care because it is assumed that he or she
will have a higher quality of life after being treated."

Robert Pear, a veteran reporter on medical issues for the New York
Times, describes the Oregon plan as assigning a higher priority to
medical services that improve quality of life than to those that
safeguard life.

[switching hats once again to resume my editor's chair]

I'll try to get additional information as indicated above ASAP,
Patricia. I'm sure some of our ABLEnews participants have
additional information and analysis of the Oregon plan that can
inform us all. That's why we're online.

Thanks again for your interest and comments.

Earl

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