Abstract

MAXON H. EDDY, MD: All right. I've read your articles about what's going on in Oregon.1-3I agree with you that their first attempt to use cost-effectiveness analysis to set priorities failed but that that failure did not necessarily doom the entire method. I also understand that even now Oregon's commission is not totally satisfied with the priority-setting process it eventually used and that it is seeking ways to improve the process. Based on what you've already written, I'll bet you're going to try to convince me that Oregon should use cost-effectiveness analysis to rank its services. I've got to warn you that you're going to have a hard time. In 40 years of practice I never withheld a test or treatment that I thought would help my patients, even when I had to absorb the cost myself. I believe that what we do in medicine should be determined

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