She also notes:
The Oregon Health Services Commission Web site explains that the 2009 list emphasizes preventive care and chronic disease management because these services are less expensive and often more effective than treatment later in the course of a disease. However, there is no evidence that preventive care will reduce expenditures for the general population. Good evidence for the cost-effectiveness of disease management programs beyond those currently offered by physicians, individuals, insurers and patient groups also remains elusive.Given that many of the supporters of "universal health care" at the national level are also plugging preventative care as an alleged source of savings, we may be on the verge of seeing this dynamic play out at the national level.
What is driving the move away from procedures to save lives in immediate danger? Oregon's prioritized list is drifting toward increasing expenditures for politically popular care. This means preventive care for the healthy and treatment of diseases with active political constituencies. This drift in rationing appears to be unavoidable when political processes are given control over medical decision making.