The cost of health care is a major setback to the availability of disposable income and wealth among many households across the country. As a result, many federal and state institutions have come forth to set up systems to alleviate the burden of health care. Such packages are always characterized by efforts to shift the burden from the less fortunate to the able citizens through reallocation of costs.


The US is characterized by the need for social amenities just like any other nation. As a result, health care occupies a central place in debate, specifically regarding provision of such services by the government. Health care has received immense political and social interest over the years. The efforts of federal and state institutions to apportion the scarce resources to accord healthcare to all Americans are yet to bear fruit.

Philosophical underpinnings of the Oregon Plan

The Oregon Health Plan was one of the means developed by the Oregonian authorities owing to the fact that a significant portion of the population is unable to afford the existing health plans. The plan was geared towards focusing on health in lieu of the characteristics of the health services as posited by Diprete & Coffman (2007). By increasing the number of individuals who qualify for the health care services, the policy was aimed at meeting budget constraints by reducing the catalogue of services available to the citizens at the health centers. The authorities bore more emphasis on providing services to those conditions that affecting the lives of the Oregonians most (Oberlander et al, 2001).

Rationale for adoption

Adoption of the Oregonian health plan was based on the premise that individuals did not have the ability to choose the kinds of sickness to suffer from. Similarly, it worked on the proposition that people should only fall sick of diseases, whose treatment they could afford (Jacobs et al, 1999). As a result, it was common that the poor people would not access treatment for some conditions thus compromising the sanctity of life. Thus, the authorities were of the view that for health care for some conditions was imperative in spite of their socio-economic capabilities.

However, the overheads emanating from the administration of the health plans were self-defeating since the cost-benefit analysis portrayed how unviable the proposal was. On the other hand, Diprete & Coffman (2007) postulated that the scientific models created to measure the appropriateness of the plan portrayed sharp conflict with the view of physicians. This is because the cost-benefit analysis of alleviating effects of a condition cannot depict the importance of treating the condition from the onset.

Advantages and disadvantages

Bodenheimer (1997) posits that the plan was beneficial nonetheless. The categorization of the conditions was based on the perceived fatality of the conditions. As a result, the most life-threatening conditions were ranked first and as a result, Oregonians were able to access treatment for these conditions regardless of socio-economic capacity (Diprete & Coffman, 2007). Similarly, emphasis was laid on preventive measures, thus contributing to a healthier and richer state. However, the availability of these services to the casualties was depended on the assessment of individuals who are bound to be biased. Thus, without a foolproof method of calibrating seriousness of a condition, availability of emergency assistance is left in the hands of the doctors and administrators (Oregon Health Plan, 2009).

In order to achieve a nationwide health plan resembling that of Oregon State, the cost would be immense. The views of individuals are varied and in most cases, conflicting. As a result, the consensus building process on categorization of conditions would be a costly affair as outlined by Oberlander et al (2001). Changeover from the existing health plan would also present challenges. The difference in principle and objectives is major challenge during the changeover process. Thirdly, Jacobs et al. (1999) asserts that, as observed from the Oregon Plan, periodic reviews of the plans are necessary in order to accommodate the dynamic nature of the contemporary world. Such reviews are also cost centers whose significance cannot be overlooked.

Ethical implications

Numerous objections to the Oregon State Plan were voiced raising concerns about the ethical implications. Availability of healthcare could have long-term implication on the life of an individual (Bodenheimer, 1997). The segregation of services based on socioeconomic ability of citizens is bound to draw sharp divisions between the ‘haves’ and the ‘have-nots’. The plan, in one way or the other, offers a life-chance to the rich while to the poor, the decision rests with an administrative employee.


The health care plan instituted by the State of Oregon is characterized by good intent and positive eventualities. However, the implementation of the plan is prone to abuse by intentional manipulation of facts and situations. As a result, the plan is subject to deemed necessary and beneficial only if the articulated controls are well in place.

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