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The face of American health care has changed since the creation of the two largest government funded health programs, Medicare and Medicaid. Whatever positive cultural benefits those programs have provided, they have carried with them one overwhelming defect: a language with obscure and untreatable words and phrases which has added to the mystery and impenetrability of the underlying substantive law. This article discusses Oregon’s proposal for prioritization, reviews legal arguments, a policy argument against the proposal, and finally concludes that any priority list that generalizes from condition-treatment pairs necessarily overgeneralizes, that the range of cost-utility ratios for any condition-treatment pair varies so widely that the application of a state formula is bound to fail. The solution is to evaluate conditions and treatments in terms of the more general goals of medicine, and, then, with much less categorization, to set priorities so that those goals can be best achieved.

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St. Louis University Law Journal



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