Lottery for health care?

That's how they do it in Oregon:

With some 45 million Americans uninsured, how to pay for medical treatment is a big issue in this year's presidential election.

Now officials in Oregon say they have come up with a fair way of providing coverage for some of those who cannot afford it.

In her comfortable home in Portland, Oregon, Louanne Moldovan sifts through a pile of papers.

They are unpaid medical bills, stretching back a year, arising from treatment for Crohn's Disease, the chronic intestinal condition she suffers from. She thinks she owes nearly $15,000 (£7,500) in all.

Louanne says she is looking for full-time employment but, she adds, her earnings through freelance work will not buy enough health insurance for the treatment she needs. For her the state healthcare lottery offers an uneasy solution.

"It's a symbol of how degraded our system is in this country that we are resorting to a lottery," she tells me.

"It's pathetic and repugnant at the same time... [but it's] a necessity because I don't earn thousands each month."

Many do not share her feelings, but Louanne is not alone in trying her luck. More than 90,000 in Oregon are vying for a maximum of 10,000 places in the state's healthcare plan.

Yet it is a drop in the ocean. There are some 600,000 uninsured in Oregon.

At the Outside In community clinic in downtown Portland, doctors see 7,000 different patients a year, 90% of whom have no health insurance.Yet it is a drop in the ocean. There are some 600,000 uninsured in Oregon.

I don't have much to say other than, how did we get to this point? People's health shouldn't be up to a lottery. You can live without winning $25 million in the Powerball, but you have to have health care. Sadly, this is probably the best Oregon, a pretty progressive state, could come up with. That's why we need real leadership on this issue from the next president.