Published 16 October 2008, doi:10.1136/bmj.a2119
Cite this as: BMJ 2008;337:a2119

Editor's Choice

It’s the evidence, stupid

Fiona Godlee, editor, BMJ

fgodlee@bmj.com

The first 150 words of the full text of this article appear below.

Nearly 20 years ago, the US state of Oregon embarked on a brave experiment to explicitly ration health care. The aim was to create and then whittle away at a prioritised list of treatments covered by the state funded Medicaid programme, so that the available money would cover more people. With the global credit crunch likely to make scarce resources even scarcer, this week’s BMJ looks back at what can be learnt from Oregon and forward to how we should ration health care in the future.

As Vidhya Alakeson explains (doi:10.1136/bmj.a1563), the unique thing about Oregon’s 1989 health plan was its commitment to being both systematic and transparent. But it hit the rocks of an economic downturn, and almost no other health system has adopted the approach. Oregon’s latest attempt at health reform is more sophisticated, but, says Alakeson, it may prove just as unlucky in its timing. . . . [Full text of this article]


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This article has been cited by other articles:

  • Wardle, J. L (2008). Involve complementary medicine practitioners in research. BMJ 337: a2389-a2389 [Full text]  

Rapid Responses:

Read all Rapid Responses

Evidence in complementary medicine needs to be appropriate
Jon L Wardle
bmj.com, 17 Oct 2008 [Full text]
Researching CAM
George T Lewith, et al.
bmj.com, 20 Oct 2008 [Full text]
Re: Researching CAM
Leslie B Rose
bmj.com, 21 Oct 2008 [Full text]
Respecting the research question
Vinjar Fønnebø
bmj.com, 22 Oct 2008 [Full text]
Evidence, perspective and transparency: is 0.22 a reasonable estimate of 0.4?
Nigel Dudley
bmj.com, 24 Oct 2008 [Full text]
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