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Access to Care, Controlling Costs, and the Oregon Health Plan

Although Caplan’s lecture was presented in 1990, the lecture’s topic is under intense consideration today, with a view to altering the future of medical care in the United States. Thus, it is important to dispel misperceptions that this lecture might encourage, since its unqualified acceptance could damage legitimate efforts to solve the growing problems of escalating health care costs and limited access in the United States. Some of Caplan’s facts are wrong, and his logic is flawed. By examining the errors of logic and fact, particularly with regard to the Oregon Health Plan, I hope to clarify, in a constructive way, the major issues that are integral to an equitable, realistic resolution of the health care crisis.